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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
Sun Sep 01 2013
Journal Name
Baghdad Science Journal
Comparing Study of The Stability and spectral properties vibrations for some Tellurium (IV) compounds containing cycloctadienyl group by Quantum Mechanical Calculations
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Density Functional Theory (DFT) with B3LYP hybrid exchange-correlation functional and 3-21G basis set and semi-empirical methods (PM3) were used to calculate the energies (total energy, binding energy (Eb), molecular orbital energy (EHOMO-ELUMO), heat of formation (?Hf)) and vibrational spectra for some Tellurium (IV) compounds containing cycloctadienyl group which can use as ligands with some transition metals or essential metals of periodic table at optimized geometrical structures.

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Publication Date
Tue Jan 01 2019
Journal Name
Desalination And Water Treatment
Effect of synthesis parameters on the formation 4A zeolite crystals: characterization analysis and heavy metals uptake performance study for water treatment
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Publication Date
Fri Jan 01 2021
Journal Name
Macromolecular Characterization Of Hydrocarbons For Sustainable Future
Feasibility of the Gas and Downhole Water Sink-Assisted Gravity Drainage (GDWS-AGD) Process to Enhance the Recovery of Oil in Reservoirs with Strong Aquifer
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Gas and Downhole Water Sink, Gravity Drainage, GDWS-AGD, Enhance the Recovery of Oil

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Publication Date
Thu Mar 02 2023
Journal Name
East European Journal Of Physics
Evaluation of the Influence of Body Mass Index and Signal-to-Noise Ratio on the PET/CT Image Quality in Iraqi Patients with Liver Cancer
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Image quality has been estimated and predicted using the signal to noise ratio (SNR). The purpose of this study is to investigate the relationships between body mass index (BMI) and SNR measurements in PET imaging using patient studies with liver cancer. Three groups of 59 patients (24 males and 35 females) were divided according to BMI. After intravenous injection of 0.1 mCi of 18F-FDG per kilogram of body weight, PET emission scans were acquired for (1, 1.5, and 3) min/bed position according to the weight of patient. Because liver is an organ of homogenous metabolism, five region of interest (ROI) were made at the same location, five successive slices of the PET/CT scans to determine the mean uptake (signal) values and its standard deviat

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Publication Date
Sun Feb 15 2026
Journal Name
Philosophy Journal
Philosophy of Civilization Read and critique and analysis of the selected models
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Publication Date
Wed Jun 16 2021
Journal Name
Application Of Optical Fiber In Engineering
Modified Single Mode Optical Fiber Ammonia Sensors Deploying PANI Thin Films
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Modified optical fiber sensors received increasing attention because of their superior properties over electrical sensors. These properties include their immunity towards electromagnetic interference and the ability to be deployed in corrosive and volatile environment. Several optical fiber platforms have been developed for chemical sensing applications based on modifying optical fiber cladding layer such as etched, tapered, D-shaped and etched-tapered. The modifications purpose is to extend the evanescent wave propagating out of the core physical dimensions. Thus, evanescent wave interaction with analyte is enhanced. Modified optical transducing platforms are integrated in gas sensing applications, such as ammonia. Modified optical

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Publication Date
Sat Feb 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Principles of Learning Organizations and It`s Role to achieve Group Working: A Viewed Study in Public Company for Webbing Industries in Hilla
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     Organizations must interact with the environment around them, so the environment must be suitable for that interaction. These companies are now trying to become Learning Organizations because it try to face that challenges may rise from its environments. The Learning Organization is a concept that is becoming an increasingly widespread philosophy in modern companies, from the largest multinationals to the smallest ventures. What is achieved by this philosophy depends considerably on one's interpretation of it and commitment to it. This study gives a definition that we felt was the true ideology behind the Learning Organization and Group Working. A Learning Organization is one in which people at all levels

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Publication Date
Tue Oct 29 2024
Journal Name
Retos
The effect of special exercises using some auxiliary tools to develop some bio-kinetic abilities and the accuracy of the crushing and snatch forehand strikes among badminton players
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The best means and ways to develop an athlete's physical and skill capabilities, and among these means is the use of training aids that help develop some bio-kinetic abilities, and prepared exercises have had an important role in improving athletic performance in badminton, where the player must possess physical fitness, explosive power, and strength. Characterized by speed as well as accuracy, awareness, and focus while playing on the court, the badminton player must be physically fit through a continuous movement of small and large muscles to achieve good performance, which requires special physical abilities and skills, and the most important of these bio-kinetic abilities are agility, coordination, and measuring the coordination

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Publication Date
Tue Jan 01 2013
Journal Name
Bio-genetics Journal
Measuring the toxicity of Heat Stable Enterotoxin (a) produced by Enterotoxigenic Escherichia coli on human blood lymphocyte from normal and colorectal cancer patients in vitro
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This research was conducted to measure the safety of heat stable enterotoxin a (STa) produced by enterotoxigenic Escherichia coli, through studying its toxic effect on human blood lymphocyte, since it showed a promising effect in reducing the proliferation of colorectal cancer cells. the cytogenetic effects of (STa) by using five different concentrations (100, 200, 400, 800 and 1600μg/ml) in comparison with negative (PBS, Phosphate buffer saline) and positive (MMC, Mitomycin C) at concentration of 5μg/ml, controls on human blood lymphocytes obtained from both (10) normal healthy persons and (20) colorectal cancer patients was measured by employing the following parameters: mitotic index, blast index, chromosomal aberrations and micronucle

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Publication Date
Sun Aug 01 2021
Journal Name
Turkish Journal Of Physiotherapy And Rehabilitation
BUILDING AND RATIONING SCALE MANAGEMENT CONSTRAINTS OF E-LEARNING FROM THE PERSPECTIVE OF TEACHING THE FACULTY OF PHYSICAL EDUCATION AND SPORTS SCIENCE UNIVERSITY OF BAGHDAD
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