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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 Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Unque Necklace ; ( Al – Iqd Al – Farid) ; A Reading in the Light of Speech Acts Theory
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Summed up the idea of this research in an attempt to find the establishment of the knowledge convergence to show the features of verbal acts that occurred a prime location in the lesson deliberative theory book unique contract ( IbnAbdRabbaAndalusian ) to prove that Arabic was the old literary studies included many of the features of this theory in both theoretical and practical

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Publication Date
Wed Apr 30 2025
Journal Name
International Journal Of Environmental Impacts
Analysis of the Effect of Heavy Elements in Polluted Industrial Water and its Environmental Treatment: An Applied Study on the Gas Power Plant/ 1 (Central Region) in Southern Baghdad and its Discharge into the Tigris River
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Water produced from power plants is one of the most important sources of water pollution, especially for areas like Baghdad, Contaminated industrial wastewater is a major environmental challenge due to the rapid growth of industries, leading to increased accumulation of harmful pollutants in water resources, the work is intended to study the impact of water generated from a power plant in the south on the level of heavy metals before and after the treatment process and after its discharge to the Tigris River. Objective is to determine the extent of heavy metals such as iron, copper, chromium, and zinc concentration in water extracted from various points and subsequently study the monthly variations of these elements with a view to assessmen

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Publication Date
Thu Sep 15 2022
Journal Name
Alustath Journal For Human And Social Sciences
The Impact of Mind and Informational Strategy on the ‎Achievement of the Second Intermediate Students in the Grammar ‎of Arabic Language
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The aim of the current research is to recognizing the impact of mind and informational strategy on the achievement with the second intermediate students in the grammar of arabic language, the researcher used a partial-set experimental design and intentionally selected a sample out of the second intermediate class from (AL- Markazya Intermediate school) in the district of Hilla, affiliated which belongs to General Directorate of Babylon Education in the year (2020-2021) for applying the experiment. The sample was composed of (50) students, (25) ones for each group, the experimental group and normal one. The researcher balanced between the two groups in various changes including: (the chronological age counted by months, the academic achie

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Publication Date
Mon Jan 01 2024
Journal Name
International Journal Of Literacy And Education
The availability of concepts and applications of artificial intelligence in the content of the chemistry textbook for the fourth scientific grade
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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
What is the contract of cultivating the land of the waqf in Islamic jurisprudence and the Algerian Awqaf law
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What is the contract of cultivating the land of the waqf in Islamic jurisprudence and the Algerian Awqaf law

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Publication Date
Thu Aug 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The use of the Biz method and classical methods in estimating the parameters of the binary logistic regression model
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Abstract

          Binary logistic regression model used in data classification and it is the strongest most flexible tool in study cases variable response binary when compared to linear regression. In this research, some classic methods were used to estimate parameters binary logistic regression model, included the maximum likelihood method, minimum chi-square method, weighted least squares, with bayes estimation , to choose the best method of estimation by default values to estimate parameters according two different models of general linear regression models ,and different s

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
The Jews of the East in the journey of Benjamin and the Andalusian Alttali (d. 586 AH): (دراسة تحليلية)
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Because of the diverse circumstances in Andalusia, the Jews lost much of the atmosphere of freedom and coexistence, which they enjoyed under Islamic rule there, to leave more Jews in the sixth century AH, under Spanish rule abolishing the existence of the other. And to impose his negativity with unjust domination. What motivated the people of Judaism; to turn their faces on the Islamic East; according to the coexistence climates that glorified various religions. It has emerged in this regard Benjamin Title (d. 685 e), who made a long journey to the east, recorded in the texts of the traveler, what will be shown research, God willing.

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
The aesthetics of employing the Cap Cut program in the montage and effects of digital content on the Internet
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Traditional programs and the tedious and financially costly processes they require are no longer the best choice for content makers. The continuous development and development have led to the emergence of competitive software that offers capabilities that are more suitable for aesthetic needs, as it breaks down stereotypical frameworks from the familiar to the unfamiliar to be more suitable for graphic subjects in terms of dealing with the requirements of the digital content industry. Video for communication platforms, as it has more advantages than traditional software and the flexibility and high quality it offers at the level of the final product, All of this contributed to supplementing the image with aesthetic employments with data

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Development and innovation in the theory of singing   In the Umayyad era
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The Umayyad era is characterized by the diversity of the subjects and their multiplicity in the literary phenomena. These phenomena are singing phenomena, although they were known in previous eras, they took a distinctive form in the era.
  In this light, the researcher tried to prove that singing theory in the Umayyad period was characterized by development and renewal. The research was entitled (evolution and renewal in the theory of singing in the Umayyad era).

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Population Therapeutics And Clinical Pharmacology
Evaluation of the Expression of RCC and KIM-1 Biomarkers in Nephrotoxicity of Rabbits Treated with Ochratoxins A
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