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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 Jan 01 2018
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
The Safety of Oral Ketoconazole in the Treatment of Skin Diseases (Single Blinded, Therapeutic, Comparative Study)
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Publication Date
Thu Mar 09 2017
Journal Name
Sensors
A Multimodality Hybrid Gamma-Optical Camera for Intraoperative Imaging
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The development of low profile gamma-ray detectors has encouraged the production of small field of view (SFOV) hand-held imaging devices for use at the patient bedside and in operating theatres. Early development of these SFOV cameras was focussed on a single modality—gamma ray imaging. Recently, a hybrid system—gamma plus optical imaging—has been developed. This combination of optical and gamma cameras enables high spatial resolution multi-modal imaging, giving a superimposed scintigraphic and optical image. Hybrid imaging offers new possibilities for assisting clinicians and surgeons in localising the site of uptake in procedures such as sentinel node detection. The hybrid camera concept can be extended to a multimodal detec

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Publication Date
Wed Jun 11 2003
Journal Name
Iraqi Journal Of Laser
Microdrop Size Measurement in a Mixing Unit Using Laser Technique
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One of the troublesome duties in chemical industrial units is determining the instantaneous drop size distribution, which is created between two immiscible liquids within such units. In this work a complete system for measuring instantaneous droplet size is constructed. It consists of laser detection system (1mW He-Ne laser), drop generation system (turbine mixer unit), and microphotography system. Two immiscible liquids, water and kerosene were mixed together with different low volume fractions (0.0025, 0.02) of kerosene (as a dispersed phase) in water (as a continuous phase). The experiments were carried out at different rotational speed (1180- 2090 r.p.m) of the turbine mixer. The Sauter mean diameter of the drops was determined by la

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Publication Date
Tue Aug 07 2018
Journal Name
Oral And Maxillofacial Surgery
Mandibular war injuries caused by bullets and shell fragments: a comparative study
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Publication Date
Tue Aug 07 2018
Journal Name
Oral And Maxillofacial Surgery
Mandibular war injuries caused by bullets and shell fragments: a comparative study
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Publication Date
Fri Dec 30 2022
Journal Name
Iraqi Journal Of Science
Structural, Optical, and Morphological Study of the Zinc Oxide Nano-Thin Films with Different Thickness Prepared by Pulsed Laser Deposition Technique
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The goal of this investigation is to prepare zinc oxide (ZnO) nano-thin films by pulsed laser deposition (PLD) technique through Q-switching double frequency Nd:YAG laser (532 nm) wavelength, pulse frequency 6 Hz, and 300 mJ energy under vacuum conditions (10-3 torr) at room temperature. (ZnO) nano-thin films were deposited on glass substrates with different thickness of 300, 600 and 900 nm. ZnO films, were then annealed in air at a temperature of 500 °C for one hour. The results were compared with the researchers' previous theoretical study. The XRD analysis of ZnO nano-thin films indicated a hexagonal multi-crystalline wurtzite structure with preferential growth lines (100), (002), (101) for ZnO nano-thin films with different thi

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Managing risk and its impact in the face of accidents and work injuries in industrial organizations
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The industrial sector of the important drivers of economic activity sectors due to having the capabilities and the potential to qualify biggest contribution to the economic development of the country, which requires the availability of a higher degree of safety in industrial organizations, and the preservation of the lives of employees and workers in emergency situations, and that all the work is not without its dangers, which produces in a year of uncertainty in the possible events get in the future, therefore, reduce the dangers that could be exposed to industrial organizations and management are at the heart of the strategic direction which works to stimulate thinking about the future and respond to the changes that occur in theextern

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Publication Date
Mon Jan 02 2017
Journal Name
Intraventricular Pressure Ventr
The Use of Rate of Increase of Intraventricular Pressure During Isovolumetric Contraction (dP/dt) in Assessment of Left Ventricular Function in Acute Coronary Syndrome
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BACKGROUND: Acute coronary syndrome (ACS) is the clinical manifestation of acutely diminished coronary arterial blood supply. The rate of increase of intraventricular pressure during isovolumetric contraction (left ventricular dP/dt) represents the rate of change of pressure during ejection. OBJECTIVE: The aim of this study is to evaluate the usefulness of the rate of increase of intraventricular pressure during isovolumetric contraction (dP/dt) in assessment of left ventricular function in patients with acute coronary syndrome and its relation to certain clinical and echocardiographic features. PATIENTS AND METHODS: The study is a cross sectional study including 50 patients with an established diagnosis of acute coronary syndrome. The

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Publication Date
Sun Sep 04 2011
Journal Name
Baghdad Science Journal
Oscillations of First Order Linear Delay Differential Equations with positive and negative coefficients
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Oscillation criteria are obtained for all solutions of the first-order linear delay differential equations with positive and negative coefficients where we established some sufficient conditions so that every solution of (1.1) oscillate. This paper generalized the results in [11]. Some examples are considered to illustrate our main results.

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Educational And Psychological Researches
Shyness and its relation to feeling of psychological isolation among first intermediate students
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The study attempts to measure the level of shyness; the level of psychological isolation; to identify the relationship between shyness and psychological isolation; and to identify the differences between shyness and psychological isolation among first-intermediate students. To this end, a random sample comprised (187) male and female students was chosen for the academic year (2016-2017) from Baghdad \ Al-Rasafa. To measure the shyness and psychological isolation, the researcher designed two scales: one to measure the shyness composed of (37) items divided into four domains; and the other to measure the psychological isolation made of (56) items divided into three domains. The study concluded that the sample has a medium level of shyness;

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