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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 Jul 28 2023
Journal Name
Journal Of Advanced Pharmaceutical Technology &amp; Research
Development of a spectrophotometric analytical approach for the measurement of cefdinir in various pharmaceuticals
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Publication Date
Tue Aug 26 2025
Journal Name
Journal Of Contemporary Medical Sciences
Psychosexual Consequences that Iraqi Women Suffer after Emergency Hysterectomy
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Publication Date
Tue Aug 26 2025
Journal Name
Journal Of Contemporary Medical Sciences
Psychosexual Consequences that Iraqi Women Suffer after Emergency Hysterectomy
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Publication Date
Thu Mar 01 2007
Journal Name
Journal Of Economics And Administrative Sciences
International business particularly that centered on foreign direct investment
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While practicing of International business particularly that centered on foreign direct investment, let on one side, to achieving objectives of transnational corporations specially that represented in continuous pursue to improving its cash flows and maximization of stockholders wealth which is considered the most important objective to the transnational corporations, but in the same time its lead, on other side, to increasing the foreign exchange risk exposuring these corporations. So, the transnational corporations (TNCs) struggling to make strategies which are dealing in smart way, with this risk and its management in way that enable to avoiding risk comple

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Publication Date
Sun Dec 05 2010
Journal Name
Baghdad Science Journal
Study the structure of Hg1-x Cdx Te alloy
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A study carried out to prepare Hg1-xCdxTe compound and to see the effect on increasing the percentage of x on the compound structure by using x-ray diffraction and atomic absorption for 0

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Publication Date
Tue Nov 01 2022
Journal Name
Journal Of Engineering
Comparative Study on the Hardness of Mechroha Water Springs
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The vacancy of natural resources is undoubtedly limited by time. The sustainable development principle recommends modern technology for its protection and renewal. This project conducted analyses on two underground water sources in the north of Algeria (Mechroha Province). Besides, the use of the hardness factor and the adoption of the titration method, which is  the determining the concentration of an unknown solution using a known solution concentration, have permitted the characterization of the examples taken and to verify their conformity to the standard required, the results found showed HT=6.66 French degrees (oF) ) for Ain Guilloume water spring in comparison to Ain Messai water spring H

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Publication Date
Fri Jun 08 2012
Journal Name
Journal Of The College Of Basic Education
Study the adsorption of diphenhydramine – HCl on Iraqi bauxite
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Drug overdose and poisoning are common clinical problems and could occur with Diphenhydramine hydrochloride (DFH) (one of anti histaminic drug ). It therefore important to study the adsorption of the DFH on pharmaceutical adsorbents which could serve as possible antidotes for the emergency treatment of DFH overdose or poisoning when they occur. The rate and extent of adsorption of DFH on some pharmaceutical adsorbents, bauxite were investigated spectra photometrically also the effect temperature, pH, presence of sucrose as additive have been studied as well, adsorbent's weight and partical size.The equilibrium adsorption contact times were determined for clay surface. Adsorption isotherms have been analyzed by the freundlich model. The appa

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
The Sacrament of Baptism among Christian Denominations Descriptive Study
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Christianity has rituals and rituals to be carried out, and can not be abandoned, and they see that the sacred statutes ordered by Christ () his followers, including: (the mystery of baptism between Christian denominations, descriptive study) A Christian is to be baptized as the seal of faith, as evidenced by the Bible in the words of Jesus to His disciples.
Baptism takes place in the name of the Father, the Son, and the Holy Spirit. This makes them Christian through the practice of this obligatory man enters the Church, represented by the death, burial, and resurrection of Christ according to their belief. And every person who has received the sacrament of baptism remains a Christian until death, in the light of what they see.

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Physics: Conference Series
Study the Electrical Properties of Carbon Nanotubes/Polyaniline Nanocomposites
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Several schottky diodes were fabricated from polyaniline/ Carbon nanotube (single and multiwalled) composites. These composites were synthesized with different concentration and two carbon nanotubes types, Single and Multi-Walled Carbon Nanotubes (SWCNT & MWCNT). Aluminum and silver paste were chosen as schottky and ohmic contact respectively. physical and electrical were used to studied these composite by using Atomic Force Microscopy (AFM) and electrical measurements. The Root Mean Square RMS surface roughness of the composite samples was found to be around 4nm. The currentvoltage characteristic were measurements for all samples in the bias range ±15V at room temperature. The results shows the increasing in carbon nanotubes concentration

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Publication Date
Wed Jun 01 2005
Journal Name
Alustath Journal For Human And Social Sciences
An evaluation study of Islamic websites on the Internet
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The study aims to introduce the Islamic sites available on the Internet and determine the criteria that contribute to evaluating these sites to indicate their value, topics, and services, while evaluating a simple random sample of the general Islamic sites, which number (35) sites. The results were presented in (8) tables. The study concluded To a set of conclusions, including: (465) “Islamic” websites were seized during the research period, and they are constantly increasing. They were classified according to the name of the website (domain name) com, org, net, edu, and also according to topics such as general Islamic websites and websites of holy places. Mosques, sites of sheikhs, etc. Among the best general Islamic websites are: Isla

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