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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
Wed Feb 22 2023
Journal Name
Iraqi Journal Of Science
Day to Day variation of Ionosphere Electron and Ion Temperature during Great and Severe Geomagnetic Storms
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The ionospheric characteristics exhibit significant variations with the solar cycle, geomagnetic conditions, seasons, latitudes and even local time. Representation of this research focused on global distribution of electron (Te) and ion temperatures (Ti) during great and severe geomagnetic storms (GMS), their daily and seasonally variation for years (2001-2013), variations of electron and ion temperature during GMS with plasma velocity and geographic latitudes. Finally comparison between observed and predicted Te and Ti get from IRI model during the two kinds of storm selected. Data from satellite Defense Meteorological Satellite Program (DMSP) 850 km altitude are taken for Te, Ti and plasma velocity for different latitudes during great

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Craniofacial Surgery
Barbed Broach in the Maxillary Sinus: A Report of Unusual Complication in Craniofacial Area
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Publication Date
Wed Jun 14 2023
Journal Name
Al-academy
The Effect of a Training Program in Introducing Saudi Traditional Fashion in Local Museums
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Museum education is of great importance to an appropriate representation of museums’ collections and exhibits, including traditional fashion. Therefore, museum educators/curators need to be equipped with the most essential skills in their profession in order to adequately present the museum’s history and holdings. This could be achieved through specialized training programs. However, Arab countries are still behind in terms of museum education. Therefore, this article aims to shed light on this issue by assessing the knowledge and skills possessed by museum educators/curators and how training programs could affect them

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Concept of the Constitution and the most Important of Human Rights
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The Concept of the Constitution and the most Important of Human Rights

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Publication Date
Sun Jan 02 2022
Journal Name
Journal Of The College Of Languages (jcl)
The Effect of Genderism on the Process and the Product of Translation
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    Many studies have been made and still concerning the field of translation. Since the mid-90's a considerable amount of researches has tackled the problem of gender and its effect on the process and the product of translation. Simon (1996, p 508) points out that when comparing women and men as translators and writers through history, women seem to be the weaker side. This paves the way to feminist movements which produce prominent studies concerning gender as a concept and translator's gender as practice on the quality and the accuracy of the translation.           

     Flotow (in Meschia, 2012, p 1-4) outlines several issues that can be

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Publication Date
Mon Jun 30 2025
Journal Name
مجلة القادسية للقانون والعلوم السياسية
Insurance of Unlawful Risks: Towards a Reinterpretation of Public Policy in Light of the Protection of Innocent Victims and Freedom of Contract
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The issue of insurance against unlawful risks raises a jurisprudential and judicial debate between two opposing trends: the first considers coverage of these risks invalid due to their impact on public order or morals, while the second—which this research analyses—calls for the possibility of covering these risks in specific circumstances, based on contractual considerations in accordance with the principle that the contract is the law of the contracting parties, and based on the obligation to compensate the harmed third party—the victim—who has no connection to the unlawful act. In this context, our research highlights that contractual considerations can justify coverage of some unlawful risks, provided that the goal is to achieve

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The Fraud under the fair value Exploratory Study
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The research aim is to identify the concept of fair value and its measurement approaches, shed light on the concept of fraud and its forms, motives, as well as how to identify fraud under the fair value method.

I have been using the program package SSPS statistical in the calculation of the research variables, and the research sample was a group of university professors and auditors working in the federal board of Supreme Audit. 

 The researcher has reached some conclusions, the most important; the lack of conclusive evidence about management's intent in adopting the use of fair value raises several doubts about the credibility of the statements prepared in under the fa

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Publication Date
Tue Dec 21 2021
Journal Name
Journal Of Engineering Mathematics
Fluid inflow from a source on the base of a channel
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Publication Date
Thu Jan 01 2015
Journal Name
Aip Conference Proceedings
Performance measurements of single server fuzzy queues with unreliable server using left and right method
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The fuzzy assignment models (FAMs) have been explored by various literature to access classical values, which are more precise in our real-life accomplishment. The novelty of this paper contributed positively to a unique application of pentagonal fuzzy numbers for the evaluation of FAMs. The new method namely Pascal's triangle graded mean (PT-GM) has presented a new algorithm in accessing the critical path to solve the assignment problems (AP) based on the fuzzy objective function of minimising total cost. The results obtained have been compared to the existing methods such as, the centroid formula (CF) and centroid formula integration (CFI). It has been demonstrated that operational efficiency of this conducted method is exquisitely develo

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Publication Date
Fri Apr 30 2021
Journal Name
Onkologia I Radioterapia
The prevalence of lymph proliferative disorders in a group of Iraqi patients and its relation to blood indices parameters
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Abstract: Lymphoproliferative Disorders (LPDs) are a group of neoplasms affecting various cells within lymphoid system. Each type has different treatment a..70619

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