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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 Jan 08 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Recurrence Rate of Pleomorphic Adenoma in Minor Salivary Glands After Surgical Excision: A Retrospective Clinical Study
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Background: Pleomorphic adenoma of the minor salivary gland is a rare benign tumor. It commonly occurs in the hard and soft palates. Treatment by surgical excision achieved success in improving the patient’s health. Objective: To evaluate the recurrence rate after surgical treatment of pleomorphic adenoma in minor salivary glands. Methods: This retrospective study included patients who attended the Maxillofacial Surgery Unit in Ghazi Al-Hariri Hospital, Baghdad, from 2019 to 2021, complaining of soft tissue lumps involving the soft and hard palate, buccal mucosa, and upper lip. After the provisional diagnosis of these lesions, a total surgical excision of the tumor with a safe margin of 1 mm was performed, and the biopsy was sent

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Publication Date
Mon Jan 08 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Recurrence Rate of Pleomorphic Adenoma in Minor Salivary Glands After Surgical Excision: A Retrospective Clinical Study
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Background: Pleomorphic adenoma of the minor salivary gland is a rare benign tumor. It commonly occurs in the hard and soft palates. Treatment by surgical excision achieved success in improving the patient’s health. Objective: To evaluate the recurrence rate after surgical treatment of pleomorphic adenoma in minor salivary glands. Methods: This retrospective study included patients who attended the Maxillofacial Surgery Unit in Ghazi Al-Hariri Hospital, Baghdad, from 2019 to 2021, complaining of soft tissue lumps involving the soft and hard palate, buccal mucosa, and upper lip. After the provisional diagnosis of these lesions, a total surgical excision of the tumor with a safe margin of 1 mm was performed, and the biopsy was sent for hist

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Effect of early laparoscopic Cholecystectomy in Acute Cholecystitis
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Background: Laparoscopic cholecystectomy (LC) has become the treatment of choice for elective cholecystectomy.Objectives: To evaluate the safety and feasibility of early LC for AC and to compare the results with delayed LC.Methods: A prospective study done from April 2011 to October 2013, 88 patients with diagnosis of AC were divided randomly into two groups according to the mode of treatment; (early group n=40) treated by early LC within first 72 hours or (delayed group, n=48) initial conservative treatment for 4-6 weeks, followed by delayed LC.Results: There was no difference between the two groups (early & delayed LC), operating time (early 80min, delayed70min), conversion rate (early 7.5%, delayed 6.25%),postoperative complicatio

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The factors that affecting in the recruitment of a teaching staff for the Massive Open Online Courses (MOOCs) in university teaching at the University of Khartoum.
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This research aimed at identifying the factors that affecting in the recruitment of a teaching staff for the Massive Open Online Courses (MOOCs) in university teaching at the University of Khartoum. The descriptive method was followed. The questionnaire was used as a tool for data collection,, which was distributed directly to a sample of (181) respondent of the teaching staff members of the senate at University of Khartoum from those who were attend at the senate meeting No. (409) which was held on 22 August 2016 Of (272). The researcher followed for the distribution the chance method, where each questionnaire was distributed to each of a teaching staff from different faculties at the University of Khartoum, according to his willingness

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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of Stomatology
The effect of Winter’s red line, angle of impaction, and radio-morphometric indices on surgical difficulty of impacted mandibular third molar: a prospective observational study
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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Water Flow Visualization And Velocity Measurement Using Hydrogen Bubble Generation Technique In Low Speed Open Channel
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Visualization of water flow around different bluff bodies at different Reynolds number ranging (1505 - 2492) was realized by designing and building a test rig which contains an open channel capable to ensure water velocity range (4-8cm/s) in this channel. Hydrogen bubbles generated from the ionized water using DC power supply are visualized by a light source and photographed by a digital camera. Flow pattern around a circular disk of (3.6cm) diameter and (3mm) thickness, a sphere of (3.8cm) diameter and a cylinder of
(3.2cm) diameter and (10cm) length are studied qualitatively. Parameters of the vortex ring generated in the wake region of the disk and the separation angle of water stream lines from the surface of the sphere are plott

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Publication Date
Mon Jan 01 2018
Journal Name
International Journal Of Surgery Open
Does preoperative magnetic resonant cholangiopancreatography (MRCP), improve the safety of laparoscopic cholecystectomy?
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<bold>ABSTRACT</bold> <sec> <title>Background:

Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive imaging test with excellent overall sensitivity and specificity for demonstrating the level and the presence of a biliary obstruction. MRCP has emerged as an accurate, diagnostic modality for investigating the biliary and pancreatic duct. In some cases, it has been recommended that preoperative MRCP is a good choice for the detection of CBD stones.

Aim:

The aim of the s

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Publication Date
Mon Jan 01 2018
Journal Name
International Journal Of Surgery Open
Does preoperative magnetic resonant cholangiopancreatography (MRCP), improve the safety of laparoscopic cholecystectomy?
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Publication Date
Thu Jan 30 2020
Journal Name
Al-kindy College Medical Journal
The Impact of Prophylactic Dexamethasone, Metoclopramide or both on Nausea and Vomiting After Laparoscopic Cholecystectomy
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Background: Postoperative nausea and vomiting (PONV) are one of the most common complaints following laparoscopic cholecystectomy.

Objective: This study was designed to compare the effects of dexamethasone, metoclopramide, and their combination on preventing PONV in patients undergoing laparoscopic cholecystectomy.

Methods: A total of 135 patients enrolled in the study. American Society of Anesthesiologists (ASA) physical status I and II patients were included in this randomized, double blind, placebo-controlled study. Patients were randomly assigned to group A administered 8mg iv dexamethasone, group B received metoclopramide 10 mg, group C received combination of 8mg de

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Publication Date
Sat Nov 24 2018
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Outcomes of Operative Management of 96 Cases with Traumatic Retroperitoneal Hematoma: A Single-Institution Experience
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AIM: To analyse our experiences in the management of traumatic retroperitoneal hematoma (RPH), highlighting the various challenges faced and to report on the outcome of these patients. METHODS: From May 2014 to May 2017, all patients with traumatic RPH who underwent surgical treatment were retrospectively analysed. The kind of injury, intraoperative findings, sites of hematoma, postoperative morbidity and the overall outcomes were recorded. RESULTS: Ninety-six patients; 53 with blunt trauma and 43 with penetrating injury, were included in this study. The centre-medial hematoma was observed in 24 (25%) patients, lateral hematoma in 46 (47.9%) patients, pelvic hematoma in 19 (19.8%) patients, and multiple zone hematomas in

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