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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
Thu Feb 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluating the Observing Internal System in the General State of Taxes and its Role in Increasing the Taxes Revenue
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The internal observing system is considered a cornerstone for the high management in all the systems. It aims at defending the things for waste and increasing efficient and application the rules and regulations and constrictions. To easier for the high management activity in the internal observing system which in presented and practiced and to what extent can depend on it. Thus it goes to evaluate the internal observing system periodically to check the weak points in that system so as the find out the mistake, in the construction of the system or mistake, by indication of the workers. The importance of this study is represented in the need of increasing the coactivity in the internal observing system so as to be in touch with the new tre

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Publication Date
Thu Sep 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Importance of Liquidity and Profitability in Enhancing the Banking Value in Private Banks for the Period 2016 - 2019
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The article aims to study the liquidity that is required to be provided optimally and the profitability that is required to be achieved by the bank, and the impact of both of them on the value of the bank, and their effect of both liquidity and profitability on the value of the bank. Hence, the research problem emerged, which indicates the extent of the effect of liquidity and profitability on the value of the bank. The importance of the research stems from the main role that commercial banks play in the economy of a country. This requires the need to identify liquidity in a broad way and its most important components, and how to

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Publication Date
Wed Oct 31 2018
Journal Name
International Journal Of Research In Pharmaceutical Sciences
The impact of systemic hypertension-related heart remodeling on right ventricle mechanics: A two-dimensional echocardiographic speckle tracking study
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Publication Date
Sat Apr 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Risk Analysis of Projects Accordance with the Professional Project Management System: A case- Study Mansur Construction Contracting Company here
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The research aims to identify the risks faced by projects and work on the administration, such as those risks by using professional Project Management System (Project Management Professional) by identifying those risks and their impact on the objectives of the project, if they occur and to provide appropriate responses to Ha.autam search application on the draft Law Faculty port by the General Mansour Construction Contracting company has been using a method personal interview with the heads of departments and project managers in the Al-Mansour and tools descriptive and quantitative analysis as was used (likelihood and impact of risk analysis, Ai_kaoa scheme Sbb- effect, analysis of probability and impact, risk matrix (probability

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Publication Date
Sun Oct 02 2022
Journal Name
Engineering, Technology &amp; Applied Science Research
Reliability Analysis of an Uncertain Single Degree of Freedom System Under Random Excitation
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In practical engineering problems, uncertainty exists not only in external excitations but also in structural parameters. This study investigates the influence of structural geometry, elastic modulus, mass density, and section dimension uncertainty on the stochastic earthquake response of portal frames subjected to random ground motions. The North-South component of the El Centro earthquake in 1940 in California is selected as the ground excitation. Using the power spectral density function, the two-dimensional finite element model of the portal frame’s base motion is modified to account for random ground motions. A probabilistic study of the portal frame structure using stochastic finite elements utilizing Monte Carlo simulation

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Publication Date
Sun Jan 01 2012
Journal Name
Journal Of Educational And Psychological Researches
The Psychological status of and the feeling of loneliness of the trainees (newly released Detainees) participating the training and rehabilitation courses
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The research aims to understand the psychological status of and the feeling of loneliness of the trainees (recently released detainees) participating in the training and rehabilitation courses held in the Technical College - Baghdad. The study was conducted on a specimen of (23) trainees. An open questionnaire was adopted which included one question that was ( What was your feeling psychologically and socially before taking part in the training course?) , also the feeling of  loneliness Scale , designed by ( Russel,Peplau, Cutrona /University of California Los Angeles ) was implemented after the courses .

 

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Publication Date
Mon Jan 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The Mathematical construct and its relationship with effective mathematical operations in both sides of the brain among students of the Department of Mathematics at the Colleges of Education and Basic Education
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The current research aims to identify: 1. The level of mathematical construct among the Department of Mathematics students in the colleges of education and basic education. 2. The level of effective mathematical operations in both sides of the brain at the Department of Mathematics students in the colleges of education and basic education. 3. The strength and direction of the correlation between the mathematical construct and effective mathematical operations on both sides of the brain at the Department of Mathematics students in the colleges of Education and Basic Education. To investigate the research objectives, the researcher formulated zero-main hypothesis for each aim and from the same hypothesis, three sub-zero hypotheses are deri

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Publication Date
Sun Jan 11 2026
Journal Name
Iklīl For Humanities Studies
The directions of the Federal Supreme Court in determining the parliamentary bloc with the largest number in the Iraqi constitution of 2005
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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Building marketing culture and reflection on the mental image Search for a pilot sample of managers in the General Company for Vegetable Oil Industry
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          The subject of marketing culture and mental image is one of the important topics in the field of management. There is no study that combines these two variables. The research is important because of the increasing importance of the subject. The future direction of the company in question will support the company's economic and marketing responsibilities. And reflect the company's mental image, as a culture that contributes to changing the reality of the organization investigated by polling the views of a sample of managers in the General Company for Vegetable Oil Industry, which (30) out of the (65) individual, and There are two hypotheses of research: There is a significant

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Publication Date
Tue Jun 01 2021
Journal Name
Baghdad Science Journal
The Existence of a Polynomial Inverse Integrating Factors and Studies About the Limit Cycles for Cubic, Quartic and Quintic Polynomial Systems
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