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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
Tue Feb 21 2017
Journal Name
Journal Of Entomology And Zoology Studies
Comparison study between a crude bacterial suspension and purified pseudomonal alkaline protease enzyme effect on the rabbit interleukin-2 bacterial keratitis
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Publication Date
Sun Jul 01 2012
Journal Name
Journal Of Engineering
Preparation of Design Charts for Estimation of the Length of an Upstream Impervious Blanket in a Homogenous Earth Dam
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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Preparation of Design Charts for Estimation of the Length of an Upstream Impervious Blanket in a Homogenous Earth Dam
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Earth dams are constructed mainly from soil. A homogenous earth dam is composed of only one material. The seepage through such dams is quite high. Upstream impervious blanket is one of the methods used to control seepage through the dam foundations. Bennet's method is one of the commonly used methods to design an impervious upstream blanket. Design charts are developed relating the length of blanket, total reservoir head, total base width of the dam (excluding downstream drainage), the coefficient of permeability of the blanket material, blanket thickness, foundation thickness, and coefficient of permeability of the foundation soil, based on the equations governing the Bennet's method for a homogenous earth dam with a blanket of uniform

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Publication Date
Wed Apr 01 2020
Journal Name
Biochemical And Cellular Archives
POSSIBLE ROLE OF HCMV INFECTION ON THE DEVELOPMENT OF HPV POSITIVE CERVICAL CARCINOMA IN A GROUP OF IRAQI WOMEN
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The cervical cancer considered as the fourth female prevalent disease worldwide, it was once the most extensively recognized female cancer two in many low-income countries. Human Cytomegalovirus (HCMV) exhibits broader tropism and can cause infection in most of the human body organs. Although, human cytomegalovirus HCMV is not yet considered an oncogenic virus, there is increased evidences of HCMV infection implication in malignant diseases of different cancer types. The present study aims to evaluate the effect of CMV infection on the development of HPV16 positive cervical cancinoma. The current retrospective study enrolled a number of paraffinized cervical cancer tissues .included 30 cervical carcinomatous tissues and 10 biopsies from an

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Publication Date
Tue Jul 02 2024
Journal Name
Scientific Reports
Impact of MTHFR gene polymorphism on the outcome of methotrexate treatment in a sample of Iraqi rheumatoid arthritis patients
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Abstract<p>Analyze the relationship between genetic variations in the MTHFR gene at SNPs (rs1801131 and rs1801133) and the therapy outcomes for Iraqi patients with rheumatoid arthritis (RA). The study was conducted on a cohort of 95 RA Iraqi patients. Based on their treatment response, the cohort was divided into two groups: the responder (47 patients) and the nonresponder (48 patients), identified after at least three months of methotrexate (MTX) treatment. A polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) technique was employed to analyze the MTHFR variations, specifically at rs1801133 and rs1801131. Overall, rs1801131 followed both codominant and dominate models, in which in </p> ... Show More
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Publication Date
Thu Dec 30 2021
Journal Name
College Of Islamic Sciences
Al-Hajjaj in pre-Islamic poetry hangs Imru 'al-Qays and the Twrfa of Ibn al-Abd as a model
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The topic of (pilgrims) of the old and modern subjects at the same time, as it extends his foot and is associated with the beginning of speech and argument, a modern because it is based on studies and research (and the theory of pilgrims) from (Austin and Cyril) through (Charles Breman) to (Aristotle) ), It is worth mentioning here to mention the role of (Hazem al - Qartagni) in mentioning the value of the pilgrimage of hair and saying the use of persuasion in the hair, is palatable and acceptable. Hence our research applied these views, and we chose the pendants as a model for that matter.

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Publication Date
Tue Jan 29 2019
Journal Name
Journal Of The College Of Education For Women
Impact Media to take off and when the special gifts in Baghdad for a period of 555-656h / 1160-1258
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The dislocation and gifts at special is the aspect of social life they reflect us how rich and influential class of society, a special category of the ruling category of the caliph and his family and his ministers and his generals and senior statesmen, a powerful and wealth and power and study here dealing with the effect the media for the distribution of dislocations and gifts to the special category both internally and for employers the state and its men or externally represented foreign relations with princes in the state and the regions and include the definition of the concepts above with surrounding contents and events distributed as the some of which were distributed in certain occasions fixed times while others did not have a spe

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Publication Date
Wed May 31 2023
Journal Name
International Journal Of Sustainable Development And Planning
Prediction of Formal Transformations in City Structure (Kufa as a Model) Based on the Cellular Automation Model and Markov Chains
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The research utilizes data produced by the Local Urban Management Directorate in Najaf and the imagery data from the Landsat 9 satellite, after being processed by the GIS tool. The research follows a descriptive and analytical approach; we integrated the Markov chain analysis and the cellular automation approach to predict transformations in city structure as a result of changes in land utilization. The research also aims to identify approaches to detect post-classification transformations in order to determine changes in land utilization. To predict the future land utilization in the city of Kufa, and to evaluate data accuracy, we used the Kappa Indicator to determine the potential applicability of the probability matrix that resulted from

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Publication Date
Sat Apr 30 2022
Journal Name
Biomedical Research And Therapy
Association between anti-collagen type II autoantibodies and the acute rheumatoid arthritis phenotype in a cohort of rheumatoid arthritis patients
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Publication Date
Tue Oct 04 2022
Journal Name
International Journal Of Dentistry
Comparison between Rolled and Nonrolled U-Shaped Flap in the Second Stage of Dental Implant Surgery: A Randomized Clinical Trial
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Background. The presence of black triangles around the dental implant-supported prosthesis and the failure to construct adequate papillae around them bothers dental implantologists. Peri-implant surgical soft tissue management will improve esthetics, function, and implant survival. Aim. To compare the effects of rolled and nonrolled U-shaped flaps combined with a temporary crown in enhancing the soft tissue around dental implants. Materials and Methods. Forty patients were included in this study; all patients were operated on by the same maxillofacial surgeon at Al-Iraq specialized dental clinics from January 2019 to January 2020. Patients were divided randomly into two groups: group A: at the second stage of implant surgery, a U-sh

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