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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
Wed Mar 29 2023
Journal Name
Journal Of The College Of Education For Women
Blindness and the Critique of Society: Dystopia in “Blindness” by José Saramago""
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This paper addresses the new coloring in the concept of dystopian society as represented by the positive role of one of the characters vs. the passive role of the government and its mutual effect on the people of the society. In addition, it describes how all men in the dystopian society victimize and degrade the other through unlawful acts, like: stealing, rape, and fear, which are the lowest points in a moral decay. However, it offers hope by illustrating a positive sense, as exemplified by the doctor's wife out of Saramago's optimistic view that men may be descended from good women. Accordingly, the paper aims to examine the effect of the government’s role in the lives of the people who have later turned into blind in a dystopi

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Publication Date
Wed Jun 01 2022
Journal Name
Res Militaris
Relationship marketing and its role in the success of industrial project management
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The research aims to identify the role determined by the dimensions of marketing in the relationship represented by (trust in the relationship, commitment to the relationship, communication during the relationship) in how to contribute to the success of the industrial project management in Iraq as a case study in the General Directorate of Industrial Development. Their number is (50) workers, where the research problem centered on knowing the impact and importance of relationship marketing on the success of industrial project management. The descriptive analytical approach. Using SPSS and Amos, the researcher tested and analysed hypotheses about the relationship and the influence between the research variables through a questionnaire . Test

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Publication Date
Tue Feb 28 2023
Journal Name
Iraqi Journal Of Science
Gentamicin Upregulates the Gene Expression of hla and nuc in Staphylococcus aureus
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The current study aimed to detect the effect of gentamicin stress on the expression of hla (encodes hemolysin) and nuc (encodes nuclease) genes of Staphylococcus aureus. Fifty-eight isolates identified as S. aureus were isolated locally from different clinical specimens. Disk diffusion method was used to detect the resistance to S. aureus. The minimum inhibitory concentration (MIC) of gentamicin was estimated by broth microdilution method. hla and nuc genes were determined by polymerase chain reaction technique. The biofilm was evaluated using the microtiter plate method in the presence and absence of gentamicin at sub-MIC. The results showed that 18 (31%) and 40 (69%) S. aureus isolates were sensitive and resistant to gentamicin, respectiv

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Publication Date
Thu Aug 06 2020
Journal Name
Cuestiones Políticas
Political structure and the administration of political system in Iraq (post-ISIS)
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The objective of the investigation was to analyze the structure and administration of the political system in Iraq (post-ISIS). After 2003, the Iraqi political system suffered the fundamental problem of its failure to achieve the political and social inclusion that characterizes democratic systems, to guarantee the establishment of a "state for all", while respecting differences. Political representation has moved from the system of sectarian ethnic components, under the title of consensual democracy, to the representation of leaders and the realization of their interests and the interests of their parties at the expense of the groups that claim to represent them, which complicates the problem. In this sense, the new political syste

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Tue Nov 01 2016
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
The frequency of skin tumors and infections in patients with autoimmune diseases
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Publication Date
Sun Jan 01 2023
Journal Name
3rd International Conference On Smart Cities And Sustainable Planning
Theoretical structure of apparent and latent in the urban townscape: Subject review
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Publication Date
Tue Mar 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The reality of bee breeding in Iraq and ways to develop it
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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional Anesthesia
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Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intrav

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Publication Date
Thu Jan 11 2024
Journal Name
Научный Форум
Structural and semantic features of military metaphors in the modern Russian press
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Publication Date
Wed Mar 29 2023
Journal Name
Journal Of The College Of Education For Women
Blindness and the Critique of Society: Dystopia in “Blindness” by José Saramago""
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This paper addresses the new coloring in the concept of dystopian society as represented by the positive role of one of the characters vs. the passive role of the government and its mutual effect on the people of the society. In addition, it describes how all men in the dystopian society victimize and degrade the other through unlawful acts, like: stealing, rape, and fear, which are the lowest points in a moral decay. However, it offers hope by illustrating a positive sense, as exemplified by the doctor's wife out of Saramago's optimistic view that men may be descended from good women. Accordingly, the paper aims to examine the effect of the government’s role in the lives of the people who have later turned into blind in a dystopian so

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