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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 Jun 25 2022
Journal Name
International Journal Of Drug Delivery Technology
Assessment of Serum Levels of the WNT Pathway Antagonist (Dickkopf-1) in a Sample of Type 2 Diabetic Patients with Retinopathy using Two Groups of Antidiabetics
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Objectives: Dickkopf-1 (DKK-1) is WNT/b-catenin pathway antagonist which plays a detrimental role in the development of diabetic retinopathy (DR). This research aimed to assess serum DKK-1 levels in diabetic patients who have and have not developed DR and, compare them with the control subjects finding out whether we can use it as an indicator for DR early diagnosis and to find out which one of the widely used two groups of antidiabetic treatments had the greater effect on this biomarker and hence on the progression of DR. Methods: The study participants were divided into two subgroups: First, 70 patients (36 male, 34 female) with type 2 diabetes mellitus, among them 35 patients diagnosed with DR and 35 with no evidence of DR, and s

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Publication Date
Sun Oct 21 2018
Journal Name
Al-kindy College Medical Journal
Evaluation of the clinical examination in thediagnosis of acute medial collateral ligament injury of the knee joint in comparism with examination under general anesthesia
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Background: Tear of MCL of the knee is a frequent problem among knee ligaments injuries.Injuries to the MCL are usually caused by contact on the outside of the knee and are accompanied by sharp pain on the inside of the knee. Contrary to most other knee ligaments the medial collateral ligament (MCL) has an excellent ability to heal, being fairly large and well vascularised structure. The vast majority of isolated medial ligament injuries heal without significant long-term problems

Objectives: is to compare between the early clinical examination, and assessment under general anesthesia (GA), and to find out the best methods to assess the MCL tear especially in suspected cases.

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Publication Date
Wed Aug 16 2023
Journal Name
Journal Of Humanities And Social Sciences Research
The impact of the use of hydromassage rehabilitation exercises on the recovery of certain motor potentials of knee roughness sufferers
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The research included the introduction to the research and its importance as knee joint is an important joint in the human body that is prone to injury. One such injury is knee roughness injury that occurs as a result of the stress of the knee joint and age. The importance of examining the need for the use of rehabilitation exercises, especially in the watercourse system, is highlighted by the fact that the aquatic environment is one of the most important factors helping to alleviate pain and rehabilitate the knee joint and thereby improve the mobility of those with knee roughness. The problem of research is that rehabilitation exercises have been developed in the watercourse system on the basis of scientific bases with a repetitive and sys

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Publication Date
Sun Mar 10 2024
Journal Name
Journal Of Sport And Health Research
Personal social and self-intelligence and its relationship to the performance of the individual and collective kinetic formation rhythmic gymnastics of school students.
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The study aims to follow modern methods in teaching rhythmic gymnastics skills by directing learners to develop their perceptions and absorb what the world deals with today and develop intelligence among learners, the researchers searched for the strengths of the learner by providing them with an opportunity to form their kinetic formation, hence the problem came by introducing a method of self-intelligence and social to guide the learner in the search for ways and solutions to overcome boredom and economy Time and effort in the educational process in learning and give them the freedom to express their ideas And their skills and here came the role of social and self-intelligence to teach the individual and collective kinetic formati

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Publication Date
Fri Jan 01 2016
Journal Name
Arpn Journal Of Engineering And Applied Sciences
Implementation And Evaluation Of Apm 2.6 - Controlled Quadcopter With Aerial Imagery As A Case Study
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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Competitiveness of an enterprise under a flexible manufacturing system. Manufacturing strategy and flexibility - Case study
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The research has designed for studying the relationship between manufacturing strategy and its flexibility under the flexible manufacturing system with their reflection on the competitive environmental performance of the firm. To interpret and tackle the problem, a hypothesis has formulated stating that “ the competitive performance of a firm is interpreted by the manufacturing strategy and flexibility which are derived from the firm and its business  strategies under the flexible manufacturing system”. Related literatures with their theoretical dissertations, which enhanced the thoughtful content, have analyzed. An illustrative case study on the flexible manufacturing system at Toyota Motors Corporation working at the g

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Publication Date
Sat Feb 11 2023
Journal Name
Applied Sciences
A Preliminary Study and Implementing Algorithm Using Finite State Automaton for Remote Identification of Drones
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Electronic remote identification (ER-ID) is a new radio frequency (RF) technology that is initiated by the Federal Aviation Authorities (FAA). For security reasons, traffic control, and so on, ER-ID has been applied for drones by the FAA to enable them to transmit their unique identification and location so that unauthorized drones can be identified. The current limitation of the existing ER-ID algorithms is that the application is limited to the Wi-Fi and Bluetooth wireless controllers, which results in a maximum range of 10–20 m for Bluetooth and 50–100 m for Wi-Fi. In this study, a mathematical computing technique based on finite state automaton (FSA) is introduced to expand the range of the ER-ID RF system and reduce the ene

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Publication Date
Sat Oct 01 2022
Journal Name
The Egyptian Journal Of Hospital Medicine
Impact of Vitamin D Status on Pregnant Women and Their Neonates: A Cross-Sectional Study
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Publication Date
Mon Mar 11 2019
Journal Name
Baghdad Science Journal
A Spectral, Optical, Microscopic Study, Synthesis and Characterization of PVC Films Containing Schiff Base Complexes
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In this work, synthesis of conducting polymeric films namely, PVC thin films was carried out containing Schiff base (L) with Cu2+, Cr3+, Ni2+, Co2+, in addition to inspecting the possibilities of measuring energy gap values of PVC-L-M with variety metal ions. These new polymeric films (PVC-L-M) were characterized by FTIR spectrophotometry, energy gap and surface morphology. The optical data recorded that the band gap values are influenced by the type of metals. All modified films have a red shift in optical properties in the ultraviolet region. The PVC-L-Co(II) was the lowest value of the optical band gap, 3.1 eV.

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Publication Date
Fri Nov 22 2019
Journal Name
Chalcogenide Letters
CONCENTRATION EFFECTS ON ELECTRONIC AND SPECTROSCOPIC PROPERTIES OF ZnCdS WURTZOIDS: A DENSITY FUNCTIONAL THEORY STUDY
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