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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 Sep 01 2025
Journal Name
Microbial Biosystems
In vivo study of the expression of some immune markers in BALB/c mice exposed to Aspergillus fumigatus mycotoxin
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Gliotoxin (GT) is sulfur-containing mycotoxin within the 2,5-diketopiperazines class. First discovery from Gliocladium. Later discovered from different strains belonging to Aspergillus fumigatus mainly those have glicluster. This study outlines a study on the histological effects of gliotoxin (GT) on mouse brain and spleen tissues using light and electron microscopy, with a focus on its interaction with matrix metalloproteinases (MMPs). Histopathological changes through MMPs expressing variability estimated by using Immunohistochemistry (IHC). Mature mice were injected intraperitoneally with acute doses determined by data response analysis (EC50/IC50) as (125, 250, and 500 μg/ml) of GT and compared with a control group that received (metha

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Scopus
Publication Date
Thu Jan 22 2026
Journal Name
Al–bahith Al–a'alami
SOCIAL RESPONSIBILITY FOR THE EMPLOYMENT OF WOMAN IN SUSTAINABLE DEVELOPMENT DECLARATIONS: (An Analytical Study of Road Advertising in Baghdad)
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Woman is the first target of social advertising, because most of these advertisements are primarily belong to them. This paper which is entitled "Social Responsibility for the Employment of Woman in Sustainable Development Declarations, An Analytical Study of Road Advertising in Baghdad" focuses on the use of woman in advertising. This aspect shows that some people see that advertisement is a mirror to what’s found in society such as woman’s behaviors in her everyday life and so on, while other people see that as long as the public wants those advertisings, they are free to choose what they prefer. They think that the shameful advertisements are natural and unavoidable. These vie

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Publication Date
Tue Oct 20 2020
Journal Name
Journal Of Research In Medical And Dental Science
The Effect of Chicken Eggshell Extract on Microhardness of Artificially Induced Dental Erosion in Permanent Teeth (In Vitro Study)
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The Effect of Chicken Eggshell Extract on Microhardness of Artificially Induced Dental Erosion in Permanent Teeth (In Vitro Study), Shatha A Abbas*, Alhan A Qasim

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Publication Date
Tue Sep 27 2022
Journal Name
Journal Of Positive School Psychology .
The Explosive Capacity Of The Muscles Of The Two Men And Their Relationship To The Scoring Of Football Halls
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The research dealt with its forefront a definition of the aspects of the study and its variables, the explosive capacity and its relationship to the scoring of football for the halls and highlights the importance of these variables, and the problem of the research consisted that some players fail to score Amie because of the weak power of shots or the slow scoring, so the researchers saw studying this problem and knowing the extent of the influence of the explosive strength During the performance of the skill of scoring with five football, the study aimed to identify the relationship between the explosive strength and the skill of scoring with five football. Researchers assume that there is a statistically significant relationship between t

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Publication Date
Wed Jun 29 2022
Journal Name
Journal Of The College Of Education For Women
The Reality of Teachers’ Use of Modern Technologies in Teaching Arabic as a Second Language in Terms of Objectives and Selection Foundations at the Institute of Arabic Language in Umm Al-qura University Mamoun Eltigani Hassan Eldali
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This study aims to know the degree of importance and the availability of the enhancing specifications of the educational process, and the way its objectives are achieved. Such a step involves using educational techniques, laying the selection foundations, knowing the methods of their employment and tracking the obstacles that limit this employment in teaching Arabic to non-native speakers. To achieve these objectives, the study followed a descriptive approach, and collected the necessary data through an integrated questionnaire prepared for the purpose of describing the phenomenon or topic. This approach was adopted, as it is characterized by being comprehensive, focuses on collecting data related and necessary to the topic under study.

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Use of One-Way Multivariate Analysis of Variance in the Impact of the Database on the Fields of Banking Service in Some Iraqi Banks
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 The purpose of this paper is to recognize the impact of database levels on fields of banking service (provision of remittance services and transfer of funds, save financial deposits, provision of personal loans services) in some of Iraqi banks using one-way multivariate analysis of variance. The paper population consisted of (120) employees, then a random stratified sample of (104) employees was taken. A questionnaire paper consists of (24) items were designed in order to analyze by one-Way multivariate analysis of variance (MANOVA) using SPSS.One of the main findings of the current paper is that there is an impact of database on fields of banking service in Iraqi banks (Al Rafidain and Al Rasheed).

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Publication Date
Sun Jun 05 2011
Journal Name
Baghdad Science Journal
The study of antibacterial activity of some plant extracts against causes of pneumonia
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Eighty five samples were taken from patients suffering from pneumonia. Seventy-eight isolates were diagnosed as following: Staphylococcus aureus (23), klebsiella pneumoniae (29), Streptococcus pneumoniae (15), Serratia sp. (4), Haemophilus influenzae (4) and Pseudomonas aeruginosa (3). The clinical isolates were tested for antibiotics sensitivity. They appeared highly resistance to penicillin G and Ampicillin at percentage 89.7 and 84.6% respectly while the results showed highly sensitivity to streptomycin at percentege of (12.8%). To study the antibacterial activity of Alium sativum, Eucalyptus microtheca leaves and Cydonia oblonga seeds extracts, five multi resistant strains were used by using agar well diffusion and disk methods at c

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Publication Date
Tue Jan 01 2013
Journal Name
Journal Of Genetic And Environmental Resources Conservation
The study of food preference of Callosobruchus maculatus to five types of fabaceae
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Publication Date
Thu Jun 01 2023
Journal Name
Journal Of Engineering
A Control Program for Hydropower Operation Based on Minimizing the Principal Stress Values on the Dam Body: Mosul Dam Case Study
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This study examines the vibrations produced by hydropower operations to improve embankment dam safety. This study consists of two parts: In the first part, ANSYS-CFX was used to generate a three-dimensional (3-D) finite volume (FV) model to simulate a vertical Francis turbine unit in the Mosul hydropower plant. The pressure pattern result of the turbine model was transformed into the dam body to show how the turbine unit's operation affects the dam's stability. The upstream reservoir conditions, various flow rates, and fully open inlet gates were considered. In the second part of this study, a 3-D FE Mosul dam model was simulated using an ANSYS program. The operational turbine model's water pressure pattern is conveyed t

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Publication Date
Thu May 01 2025
Journal Name
Microbes And Infectious Diseases
Molecular detection and the frequency of a pore-forming toxin in Enterococcus faecalis isolated from urinary tract infections
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