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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
Fri Aug 01 2025
Journal Name
Cabi Reviews
Precision agriculture strategies to reduce the impacts of soil degradation: A comprehensive review
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This review discusses precision agriculture techniques that help reduce the effects of soil degradation and improve soil health, based on an analysis of studies published in scientific databases such as Web of Science, Scopus, IEEE Xplore, Google Scholar, and ScienceDirect, with an emphasis on recent field research. The methodology included a qualitative analysis of case studies and application experiments in different areas to evaluate the impact of technologies such as controlled traffic farming (CTF), mechanized guidance (MG), precision fertilization (PF), precision irrigation (PI), conservation tillage (CT), and precision tillage (PT). Research results showed, CT to maintain soil structure and reduce organic matter loss increases soil f

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Publication Date
Sat Oct 20 2018
Journal Name
Journal Of Economics And Administrative Sciences
THE IMPACT OF MANAGEMENT CONTROL SYSTEMS (MCS) ON ORGANIZATIONS PERFORMANCE A LITERATURE REVIEW
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The impact of management control systems (MCS) on organizations performance empirical research has been the subject of numerous studies during the past decade in developed and emerging economies. In the contemporary competitive, complex and changing global business environment, firms are being challenged to adopt business models that enable them to address the strategic uncertainties and risks they face in their business environments. The main issue of this study is that management accounting researchers argue that one of the ways firms can continually rejuvenate themselves to survive and succeed in these complex and uncertain environments is to understand the role of management control systems in Formulating a b

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Publication Date
Wed Feb 01 2023
Journal Name
Ecotoxicology And Environmental Safety
The role of environmental trace element toxicants on autism: A medical biogeochemistry perspective
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Publication Date
Sun Dec 13 2020
Journal Name
Clinical And Experimental Dental Research
The efficacy of polyether‐ether‐ketone wire as a retainer following orthodontic treatment
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Abstract<sec><title>Objectives

To investigate the efficacy of polyether‐ether‐ketone (PEEK) wire as a fixed orthodontic retainer, by comparing its performance to other retainer wires and optimizing its adhesion to composite bonding materials.

Materials and methods

Retainer wires of 15 mm segments were used, PEEK wires were prepared in cylindrical form with 0.8 mm diameter, and had two surface treatments namely air‐abrasion and conditioning with adhesive system. Three different metallic retainer wires were used for comparison and three tests were performed; two tests measured debonding force and associated wire deflec

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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of Engineering
Evaluating the Moisture Susceptibility of Asphalt Mixtures Containing Aluminum Dross as a Filler
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One of the most essential components of asphalt pavements is the filler. It serves two purposes. First, this fine-grained material (diameter less than 0.075 mm) improves the cohesiveness of aggregate with bitumen. Second, produce a dense mixture by filling the voids between the particles. Aluminum dross (AD), which is a by-product of aluminum re-melting, is formed all over the world. This material causes damage to humans and the environment; stockpiling AD in landfills is not the best solution. This research studies the possibility of replacing part of the conventional filler with aluminum dross. Three percent of dross was used, 10, 20, and 30% by filler weight. The MarshallMix design method was adopted to obtain the op

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Publication Date
Tue Oct 13 2015
Journal Name
Plos Medicine
P2RX7 Purinoceptor: A Therapeutic Target for Ameliorating the Symptoms of Duchenne Muscular Dystrophy
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Publication Date
Sun Dec 22 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Belief about Medicines among a Sample of Iraqi Patients with Rheumatoid Arthritis
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Rheumatoid arthritis is a chronic, progressive, inflammatory autoimmune disease of unidentified etiology, associated with articular, extra-articular and systemic manifestation that require long-standing treatment. Taking patient’s beliefs about the prescribed medication in consideration had been shown to be an essential factor that affects adherence of the patient in whom having positive beliefs is an essential for better adherence. The purpose of the current study was to measure beliefs about medicines among a sample of Iraqi patients with Rheumatoid arthritis and to determine possible association between this belief and some patient-certain factors. This study is a cross-sectional study carried out on 250 already diagnosed rheumatoid

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
The recepient’s beauty in the algerian theatre and the recepient’s hypothetical bet , reading in stop theater by m’hammed ben gataf
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Meditationsuggetsthat the theatrical world and the receiptindicatethattherie a thread connection or relationshipbetweenthembecausetheateris an art thatfailsinto the abyss of the humanfield ,receivingis a practice thatisreffered to by corners of society and islocated in the context of thisfield. Thus, the relationshipbetweenalgeriantheater and the recepientissanctified by the nature of theaterwhichisbased on a social basis thatbuildsitsexistance and continuityfrom the recepient.Its impossible to imagine a real theaterthatwillbeestablishedunlessit’sassociatedwith an audience so one hand never claps to makesound. This connectionis the first phenomenonthatcanbecome accessible to all people and itremains the second phenomenonthatrequires th

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Publication Date
Tue Feb 26 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Relationship's Impact Between the External and Internal Auditor in Preventing the Administrative & Financial Corruption: Applied Research in Sample Entities
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    This research discusses one of the most important means of reducing corruption in public sector companies and government departments, a relationship of cooperation and coordination between the external auditor and internal auditor, in the light of ISA (610), the recommendations of the International Organization of Supreme Audit Institutions (INTOSAI) and the National Strategy to combat corruption. The research was based on two assumptions: the first was weak relationship of cooperation and coordination between the external auditor and internal auditor leads to weakne

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Digital transformation technology in the insurance service in the National Insurance Company and the Iraqi General Insurance Company : applied research
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The aim of this research is to identify the impact of the effectiveness of digital transformation technology in improving the efficiency of the insurance service in the public insurance companies in Iraq through digital transformation technology in the insurance process "promotion of the insurance product, submission of insurance application, underwriting, settlement of losses" and to achieve this goal a questionnaire was designed A survey distributed in the surveyed community Which represents the decision makers in the researched companies under study, and one of the most important results of the research was the existence of a relationship between digital transformation and improving the efficiency of the insurance process, whether thr

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