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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
Sat Aug 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
A conceptual Framework For the Relationship between Human and Social Capital
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Purpose: The research seeks to develop the implications of intellectual human capital, and social capital in business organizations, and will be accomplished on three levels, the first level (the level of description) to identify, diagnose and display content philosophical Strategic Human Resource Management at the thought of modern administrative represented by human capital and Ras social capital. The second level (level of analysis) and the analysis of the extent of the impact of alignment between human capital, and social capital in the organizational strength of the organizations. The third level (Level predict) the formulation of a plan to strengthen the organizational strength in business organizations and to develop speci

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Theoretical And Applied Information Technology
A Survey on the Vein Biometric Recognition Systems: Trends and Challenges
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Vascular patterns were seen to be a probable identification characteristic of the biometric system. Since then, many studies have investigated and proposed different techniques which exploited this feature and used it for the identification and verification purposes. The conventional biometric features like the iris, fingerprints and face recognition have been thoroughly investigated, however, during the past few years, finger vein patterns have been recognized as a reliable biometric feature. This study discusses the application of the vein biometric system. Though the vein pattern can be a very appealing topic of research, there are many challenges in this field and some improvements need to be carried out. Here, the researchers reviewed

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Publication Date
Sat Jul 15 2023
Journal Name
2023 6th International Conference On Engineering Technology And Its Applications (iiceta)
Methodology for the Design and Programming Methods for a Smart Home
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Publication Date
Sat Sep 04 2021
Journal Name
Neuroquantology
Nanotechnology and the Most Important Characterization Techniques for Nanomaterial's: A Review
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Due to the importance of nanotechnology because of its features and applications in various fields, it has become the focus of attention of the world and researchers. In this study, the concept of nanotechnology and nanomaterials was identified, the most important methods of preparing them, as well as the preparation techniques and the most important devices used in their characterization.

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Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
Measuring and analyzing the relationship between the fiscal policy indicators and the bank stability index in Iraq for the period 2010-2016 using the ARDL model.
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The importance of this research is to clarify the nature and the relationship between the indicators of financial policy and banking stability in Iraq, as well as to find a composite index reflects the state of banking stability in Iraq in order to provide an appropriate means to help policymakers in making appropriate decisions before the occurrence of financial crises.

     Hence, the problem of research is that the fiscal policy has implications for the macro economy and does not rule out its impact on banking stability. Moreover, the central bank does not possess a single indicator that reflects the stability of the banking system, rather than the scattered indicators that depend o

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Publication Date
Wed Oct 02 2024
Journal Name
Journal Of Craniofacial Surgery
Maxillofacial Trauma in Females: A Retrospective Study
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Maxillofacial trauma in females is not widely reported. This study aimed to analyze the clinical characteristics and the patterns of maxillofacial injuries in females and to determine the differences in these patterns among different causes. This retrospective study analyzed several variables, including demographic, social, injury-related, and treatment-related variables, and compared these variables in relation to the main etiologies of maxillofacial trauma. The main etiologies of maxillofacial injuries involving females were assault, followed by road traffic accidents, and falls. There were significant differences in relation to the 3 etiologies in age groups (P= 0.002) and marital status (<

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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of The College Of Basic Education
A study effect Histological changes in Kidney
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Publication Date
Sun Mar 15 2020
Journal Name
Al-academy
Abstraction between the Symbol and the Code in the Artistic Painting: سحر عبد الكاظم غانم
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Abstraction showed a case of distinction between art schools, in which reality was reduced using overlapping artistic elements and techniques to reach the artist's self-realization when abstracting the reality, and searching for implicit implications for the content of the artistic painting.

Building a system of relations and formulations between abstracting the reality of the physical forms and employing the symbols and codes to convey a message to the recipient who interacts with what he watches through the processes of explanation, interpretation, and linking the particles and reveal the pure aesthetics for the artwork.

Thus the current research deals with the following chapters and sections: the methodological framewo

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Publication Date
Sun Sep 01 2013
Journal Name
Baghdad Science Journal
Preparation, characterization and study of biological activity and laser effect on the new Cu(II) complexes containing mixed benziloxime and furfuraldehydeazine ligands
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Abstract: New copper(II) complexes with mixed ligand benziloxime (BOxH) and furfural-dehydeazine (FA) using classical (with and without solvent) and microwave heating methods have been prepared. The resulting complexes have been characterized using physico-chemical techniques. The study suggested that the ligands formed neutral complexes had general formulas [Cu(FA)(BOXH)(Ac)2] and [Cu(FA)(BOX)(OH)] in neutral (or acidic) and basic medium, respectively. Accordingly, hexa-coordinated mono-nuclear complexes have been investigated by this study and having distorted octahedral geometry. The effect of laser have been studied on solid ligands and solid complexes, no effect have been observed on most compounds through the results of melting poin

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Publication Date
Tue Dec 10 2024
Journal Name
مجلة الثقافة الرياضية
The Effect of Resistance Training Using Elastic Bands on the Developmentof Specific Endurance and Performance of the Oji-mata Skill
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t: - Sports training in itself is a means, not an end. It is the core process that involves using exercises to provide an opportunity for athletes to perform their duties with the highest level of efficiency by developing and enhancing their capabilities and potential, using them to gain the greatest benefit for themselves and, consequently, for their team. This requires the selection of various methods and different means of training, focusing on specific physical and skill-related aspects. Therefore, training plans should take into account individual differences between players. Many researchers and experts in the field of sports in general, and combat sports in particular, emphasize the importance of having a holistic approach in the tra

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