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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
Fri Dec 26 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of dental implant stability during healing period and determination of the factors that affect implant stability by means of resonance frequency analysis(Clinical study)
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Background: Implant stability is considered one of the most important factors affecting healing and successful osseointegration of dental implants. The aims of the study were to measure the implant stability quotient (ISQ) values during the healing period and to determine the factors that affect implant stability. Materials and methods: Thirty patients enrolled in the study (17 female, 13 male). They received 44 Implantium® Dental Implants located as the following: 22 implants in maxillary jaw, 22 implants in mandibular jaw from them 17 implants in anterior segment and 27 in posterior segment. The bone density determined using interactive CT scan and classified according to the Misch bone density classification (29 implants in (D3), 15 i

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Publication Date
Sun Jul 21 2024
Journal Name
Journal Of Clinical Medicine
Microbiological and Salivary Biomarkers Successfully Predict Site-Specific and Whole-Mouth Outcomes of Nonsurgical Periodontal Treatment
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Background/Objectives: Nonsurgical periodontal treatment (NSPT) is the gold-standard technique for treating periodontitis. However, an individual’s susceptibility or the inadequate removal of subgingival biofilms could lead to unfavorable responses to NSPT. This study aimed to assess the potential of salivary and microbiological biomarkers in predicting the site-specific and whole-mouth outcomes of NSPT. Methods: A total of 68 periodontitis patients exhibiting 1111 periodontal pockets 4 to 6 mm in depth completed the active phase of periodontal treatment. Clinical periodontal parameters, saliva, and subgingival biofilm samples were collected from each patient at baseline and three months after NSPT. A quantitative PCR assay was us

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Degree of Focus of The Science Curriculum for the First Intermediate Grade on National, Health, Environmental And Economic Values in Light of the Education Policy in The Kingdom of Saudi Arabia and a Suggested Scenario for a Mechanism to Be Strengthe
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The study aimed to reveal the extent of the first intermediate grade science curriculum focus on the national values, health, environmental, economic values, in the light of the education policy in the Kingdom of Saudi Arabia, in addition to present a proposed vision to strengthen it in the science curriculum for the first intermediate grade. The study was applied to the two books student and the two books of activity on the first-second semesters for the academic year 1441 AH. To analyze the curriculum content, the study used a verified card prepared by the researchers and a criterion for interpreting percentages. The study reached the following results: environmental values ranked first with a concentration of (43%), i.e. with an avera

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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Assisting Students of Al-Quds Open University to Design Computerized Lessons According to ADDIE
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This Action research aimed at Assisting Students of Faculty of Educational Sciences  at Al-Quds Open University to design computerized  lessons using the Power Point software and according to ADDIE model. The study sample consisted of 40 students  who were taking a course titled Technology of Education during the second semester of the 2014-2015 academic year and three academic instructors . To collect the required date  , the researchers used  focus group technique and structured interviews to get information from the 40 students and the three academic instructors involved in the course Technology of Education in QOU /Nablus Branch. In addition to these methods, a workshop with a guiding checklist was employed t

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Publication Date
Sat Sep 21 2019
Journal Name
Journal Of The College Of Education For Women
Problems Facing the Teachers of Kindergartens
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The research aims at:

  1. Identifying the problems facing kindergarten teachers.
  2. Identifying the nature of the problems facing kindergarten teachers.

To achieve the aim of the research, the researcher prepared a questionnaire to identify the problems that face the teachers of kindergartens. The questionnaire was subjected to the consultation of a group of specialized expertise in the educational and psychological sciences to certify the propriety of the items of the questionnaire and it gained a rate of (80%), and the stability of the scale gained (0.91) and it stands for a correlation parameter with a statistical significance and it was calculated by using Person’s R Corre

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Publication Date
Fri Dec 26 2025
Journal Name
Nasaq
The effectiveness of educational-learning design according to the model of brain compatibility in collection among middle first- grade students in Mathematics
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The research aimed to identify "the effectiveness of educational-learning design according to the model of brain compatibility in achievement among firstmiddle grade students in mathematics", in schools affiliated with the Second Karkh Directorate of Education. To achieve the goal of research, the following zero hypothesis has been formulated: " There is no statistically significant difference at the semantic level (05.0) between the average scores of experimental group students who will study with design accreditation (educational - learning) according to the brain compatibility model and the grades of control group students who will study in the usual way in the achievement thinking test". The research community, which is represented by

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Publication Date
Thu Aug 08 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Novel Technique for Alveolar Ridge Expansion: A Comparative Clinical Study
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Background: Piezosurgery improved the split approach by making it safer, easier, and less prone to complications when treating extremely atrophic crests. Densah drills, with their unique design, expand the ridge by densifying bone in a reverse, non-cutting mode. Objective: To assess the effectiveness of sagittal piezosurgery, which involves cutting bone to the full implant depth and then expanding it using osseodensification drills. We use this technique to expand narrow alveolar bones and simultaneously place dental implants in the maxillary and mandibular arches. Methods: Fourteen patients received 31 dental implants. The maxillary arch received 19, and the mandible received 12 dental implants. This study will include patients who

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Publication Date
Wed Dec 01 2021
Journal Name
مجلة العلوم و التكنولوجية للنشاطات البدنية و الرياضية
The Effectiveness of Electronic Puppet Educational Theater by Camtasia Studio in Learning Some of The Artistic Gymnastics Skills For First-Grade
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The study aims to design an electronic puppet educational theater by Camtasia studio and identify the effectiveness in learning some of the artistic gymnastics skills for first grade, the research curriculum is experimental by designing two equal groups, and the research sample first grade students are distributed among 4 grade, and by the pumpkin determines two divisions (15 from each) representing the experimental group and control group, the main experiment conducted for 8 weeks by two educational units per week after which the post-tests were conducted, SPSS was used to process the results, and it was found that the electronic puppet educational theater contributed by making the learning process enjoyable and interesting and meeting the

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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of Crestal Bone Resorption around Dental Implants in Flapped and Flapless Surgical Techniques Depending on Cone Beam CT Scan (Comparative Study)
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Background: The long term survival of dental implants is evaluated by the amount of crestal bone loss around the implants. Some initial loss of bone around dental implants is generally expected. There is reason to believe that reflecting a mucoperiosteal flap promotes crestal bone loss in the initial phase after an implant has been inserted. The surgical placement of a dental implant fixture is constantly changing and in recent years, there has been some interest in developing techniques that minimize the invasive nature of the procedure, with flapless implant surgery being advocated. The purpose of this study was to compare the radiographic level of the peri- implant bone after implant placement between traditional flapped surgery and f

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Publication Date
Mon Jul 01 2013
Journal Name
Political Sciences Journal
Towards Promoting Political Participation of Female - University Students - Field Study on Al-Quds Open University Female - Students - Rafah
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نحو تعزيز المشاركة السياسية للطالبات الجامعيات الفلسطينيات

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