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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 Jun 01 2021
Journal Name
Journal Of The College Of Languages (jcl)
Definition of the verb in the form of the imperative mood (imperative) - general information about the verb in Russian: Определение глагола в форме повелительного наклонения (императива) - общая сведения о глаголе на русском языке)
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      The article examines the definition of the verb in the form of the imperative mood (imperative) _ general information about the verb in Russian .

       A verb in Russian is one of the parts of speech that unify all parts of speech, expressing the meaning of action, movement, process in grammatical forms of time, type, mood, face and voice. The imperative mood is a grammatical feature of the verb expressed through several forms of the verb that urges someone to do things. In other words, imperative mood or (imperative) : -  one of the single meaning of the form . The form of the imperative expresses a supplicatio

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of Next Generation Information Technology
Face detection and the effect of contrast and brightness
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We propose a system to detect human faces in color images type BMP by using two methods RGB and YCbCr to determine which is the best one to be used, also determine the effect of applying Low pass filter, Contrast and Brightness on the image. In face detection we try to find the forehead from the binary image by scanning of the image that starts in the middle of the image then precedes by finding the continuous white pixel after continuous black pixel and the maximum width of the white pixel by scanning left and right vertically(sampled w) if the new width is half the previous one the scanning stops.

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
Personal Distance and the Feeling of comfort and annoyance
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The aim of the current research is to identify the personal distance between members of society, as well as, to identify the feelings of satisfaction and positivity from respecting the permissible personal distance. The study also aims to identify the feelings of annoyance and comfort from approaching and going beyond personal distance and not respecting it. To achieve these goals, the researchers reviewed previous literature, theories, and studies that dealt with personal distance. The researchers reached a number of results; first, personal distance is not a law but rather a cultural guiding principle for social and professional morals. Second, there are four distances (intimate distance, the distance between friends, social distance,

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Publication Date
Fri Feb 20 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of thermocycling on microleakage analysis of bulk filled base composite in comparison to incrementally placed nanohybrid composite in class II MOD restorations (An in vitro study)
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Background: The study aim was to evaluate thermocycling effect on microleakage of occlusal and cervical margins of MOD cavity filled with bulk filled composites in comparison to incrementally placed nanohybrid composite and to evaluate the difference in microleakage between enamel and dentin margins for the three materials groups. Materials and method: Forty eight maxillary first premolars were prepared with MOD cavities. Samples were divided into three groups of sixteen teeth according to material used: Grandio: Grandio. SDR: SDR +Grandio. X-tra: X-tra base + Grandio. Each group was subdivided into two according to be thermocycled or not. After 24 hrs immersion in 2% methylene blue, samples weresectioned and microleakage was estimated. Res

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Publication Date
Sun Jan 01 2023
Journal Name
Brazilian Dental Science
Wound healing effect of a one-week Aloe Vera mouthwash: a pilot study
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Publication Date
Tue Apr 03 2007
Journal Name
Um-salama Science Journal
A study of adsorption in aqueous solution of p,o,m-Chlorophenol on Iraqi siliceouns rocks powder
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Adsorption of Chlorophenol compounds in aqueous solution on Iraqi siliceouns rocks powder have been investigated. UV technique has been used to determine the adsorption isotherms. The results showed that the adsorption isotherms obeyed Freundlich adsorption equation. The adsorption was endothermic process, increasing temperature leads to increasing adsorption.  H,  S,  G were calculated. The results showed that the adsorption increases with increasing acidity of solutions

Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of Life Events upon Onset of Depression Disorder In AL-Diwanyia Governorate : A Case-Control Study
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Objective: The aim of this study is to find out the impact of life events upon onset of depression, to describe the
prevalence of life events among depressed patients.
Methodology: Retrospective a case-control study conducted in AL-Diwanyia Teaching Hospital, Psychiatric
Department on A non-probability (purposive sample) of (60) depressed patients and (60) of healthy person were matched
with them from general population. The data were collected through the use of semi-structured interview by
questionnaire, which consists of two parts (1) divide, section A. cover letter and B. Sociodemographic data which consists
of 9-items, (2) Life events questionnaire consists of 51-items distributed to six dimensions include, family

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Publication Date
Fri Feb 28 2025
Journal Name
Bmc Psychology
Delving into the Elements Impacting Treatment Acceptance among patients with Substance Use Disorder using Health Belief Model: a qualitative study
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Publication Date
Tue Jan 31 2017
Journal Name
Journal Of Engineering
Determine an Equation to Calculate the Annual Maintenance Cost for Public Hospitals (Al Sader City Hospital as a Case Study)
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Maintenance of  hospital buildings and its management are regarded as an important subject which needs attention because hospital buildings are service institutions which are very important to a society, requiring the search for the best procedure to develop maintenance in hospitals. The research is aimed to determine an equation to estimate the annual maintenance cost for public hospital. To achieve this aim, Al-Sader City Hospital maintenance system in Al-Najaf province has been studied with its main elements through survey of data, records and reports relating to maintenance during the years of the study 2008-2014 and to identify the strengths, weaknesses, opportunities and threat points in the current system through Swat analysi

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Publication Date
Thu Nov 30 2023
Journal Name
Journal Of Language Studies
Investigating the Difference between the Conditionals (In) and (Itha) as Mentioned in the Holy Qur'an with Reference to Translation: Selected Verses
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According to grammarians In ( نإ) and Itha (اذإ) are conditionals and sometimes they may be used interchangeably. However, when they are mentioned in the Holy Qur’an, they have their own specific use. This paper attempts to investigate their meanings in the source language as well as investigate their translations and find out any differences or similarities. The translations that are adopted in this research are as follows: Pickthall, Al-Hilali & Khan, and Shakir.