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The Surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: A single-center prospective study: The surgical outcomes of open fundus-first cholecystectomy technique.
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Background: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.

Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underwent elective open fundus-first cholecystectomy for intraoperative difficulties.

Results: the majority of cases had long-standing cholelithiasis with intraoperative difficulties revealed by pre-operative TUS and MRCP which required open fundus-first cholecystectomy in 173 (68.4%) of patients, (P-value <0.05). The operative surgical time was 120 minutes in 103 patients (40.7%), (P-value <0.05). During open cholecystectomy, variable intraoperative difficulties were found in all patients, (P-value <0.05) and were divided into: (A) Contracted intra-hepatic gallbladder seen in 157 (62.1%) of cases; (B) Distorted anatomy within Calot's triangle seen in 135 (53.4%) of patients; and (C) Intraoperative bleeding from the liver bed was observed as bloody oozing form in 150 (59.3%) of cases. Our patients had minimal postoperative complications like mild wound infection in 8 (3.2%) of cases and mortality rate was zero. 

Conclusions: There is a need for appropriate therapeutic and preventive strategies in healthcare systems for safe dealing with difficult cholecystectomy. Unclear anatomy due to severe inflammatory dense adhesions at Calot’s triangle and CBD stones needing difficult surgeries are the most important limiting factors for fundus-first laparoscopic cholecystectomy. Hence, we humbly recommend an open approach of fundus-first cholecystectomy as safe surgical option to reduce the incidence of bile duct injuries and intra-operative bleeding.

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Publication Date
Mon Sep 30 2024
Journal Name
The Scientific World Journal
Relationship Between the Level of Vitamin D3 Deficiency and Successful Osseointegration: A Prospective Clinical Study
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Purpose: This study aimed to evaluate the influence of vitamin D3 levels on bone density, primary dental implant stability, and successful osseointegration.

Materials and Methods: Clinical and radiological examination with a standardized cone‐beam computed tomography (CBCT) machine and laboratory investigation for serum levels of vitamin D3 were performed for all patients. Only patients in need of single or multiple straightforward dental implant surgery in either jaw with no history of systemic disease or condition that may interfere with bone healing were included in this study to receive the dental implant by the same oral and maxillofacial surgeon, which re‐opened

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Publication Date
Mon Sep 30 2024
Journal Name
The Scientific World Journal
Relationship Between the Level of Vitamin D3 Deficiency and Successful Osseointegration: A Prospective Clinical Study
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Purpose: This study aimed to evaluate the influence of vitamin D3 levels on bone density, primary dental implant stability, and successful osseointegration.

Materials and Methods: Clinical and radiological examination with a standardized cone‐beam computed tomography (CBCT) machine and laboratory investigation for serum levels of vitamin D3 were performed for all patients. Only patients in need of single or multiple straightforward dental implant surgery in either jaw with no history of systemic disease or condition that may interfere with bone healing were included in this study to receive the dental implant by the same oral and maxillofacial surgeon, which re‐opened

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
Ministry of Hamdy Al-Bachachy (the first) 3rd of Jun – 28 Aug. 1944 in Iraq The Ministry forum and the political and economical issues
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This study Studied Ministry of Hamdy Al-Buchachy(the first)and explain the features of
this Ministry in a critical time in the history of Iraq. The second world war had began and its
end had reached .The political situation in Iraq is so complicated. The Ministry had made
many things. The Ministry had situated in internal and external complicated time. The
situation in Iraq was so difficult, therefore the recommendor (Abdul-Ilah)asked Hamdy Al-
Bachachy to make be the head of the new governments Al-Bachachy had made irrelevant
government, thus it didn’t last more than three months and the British governorate and of
direct in terference in Iraq who worked to reduce the Iraqi army and the Minister of Defence
refus

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Publication Date
Sat Dec 15 2018
Journal Name
Journal Of The College Of Education For Women
The Reasons for the Behavior of Bullying school Students in the first grade average from the point of view of teachers and teachers and methods of modification
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 هدف البحث التعرف الى اسباب سلوك التنمر لدى طلاب الصف الاول المتوسط من وجهة نظر المدرسين والمدرسات واساليب تعديله، واستعمل الباحثان المنهج الوصفي واختيار عينة عشوائية من المدرسين والمدرسات في متوسطة أرض الرافدين ومتوسطة الرحمن للبنين وكان عددهم (46) مدرساً ومدرسة بواقع (32) مدرساً و(14) مدرسة، واعتمد الباحثان الاستبانة أداة للتعرف الى اسباب سلوك التنمر واساليب تعديله، واشارت نتائج البحث الى تنوع اسباب التن

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Publication Date
Mon Oct 01 2018
Journal Name
Iraqi Journal Of Science
Theoretical Study of The Electromagnetic Structure of Boron Isotopes Using Local Scale Transformation Technique
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Publication Date
Mon Dec 09 2019
Journal Name
Periodicals Of Engineering And Natural Sciences
The philosophy of the workplace spirituality in the third millennium organizations: A field study at the ministry of health center
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Purpose: The research aims to build an integrated knowledge framework for the basic research topic. The spirituality of the workplace is through access to the most important scientific proposals on these topics. In management thought framing, the knowledge within them in a serious attempt is to provide the appropriate answers about the intellectual dilemma of research by diagnosing the nature of the relationship with the influential elements and its historical development . Methodology: The study is relied on the analytical survey method. The research sample targeted (88) managers in the center of the Iraqi Ministry of Health exclusively from the researched senior leaders (general manager, assistant general manager, and head of department),

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Publication Date
Sun Feb 23 2020
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
The philosophy of the workplace spirituality in the third millennium organizations: A field study at the Ministry of Health Center
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Publication Date
Mon Jan 02 2017
Journal Name
Al-nahrain Journal For Engineering Sciences (njes)
Experimental Investigation of Forced Convection Heat Transfer and Pressure Drop in Open Cell Aluminum Fins
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Publication Date
Thu Jun 01 2017
Journal Name
International Journal Of Engineering Research And Advanced Technology
The Use of First Order Polynomial with Double Scalar Quantization for Image Compression
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Publication Date
Tue May 01 2012
Journal Name
2012 Second International Conference On Digital Information And Communication Technology And It's Applications (dictap)
The compact Genetic Algorithm for likelihood estimator of first order moving average model
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Recently Genetic Algorithms (GAs) have frequently been used for optimizing the solution of estimation problems. One of the main advantages of using these techniques is that they require no knowledge or gradient information about the response surface. The poor behavior of genetic algorithms in some problems, sometimes attributed to design operators, has led to the development of other types of algorithms. One such class of these algorithms is compact Genetic Algorithm (cGA), it dramatically reduces the number of bits reqyuired to store the poulation and has a faster convergence speed. In this paper compact Genetic Algorithm is used to optimize the maximum likelihood estimator of the first order moving avergae model MA(1). Simulation results

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