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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
Thu Aug 31 2023
Journal Name
Journal Of Legal Sciences
The Legal Characterization of the Marriage Mediation Contract
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Although the profession of a marriage mediator is dominated by a social character, and it is also characterized by its practice in the midst of strict secrecy, because Eastern societies innately reject this method of searching for a life partner. The two parties play a prominent role of the will in the events of legal effects, and the obligations and rights owed by the contracting parties, which leads us to consider the agreement between the mediator and the one who wants to marry going to the purely contractual nature, and thus requires the correct legal adaptation on the contractual relationship that is achieved between the marriage mediator and his clients from Those who want to get married and therefore we will divide this research into

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Publication Date
Thu May 31 2012
Journal Name
Al-khwarizmi Engineering Journal
The Stability Conditions of the Pump Structure Vibration
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 The general approach of this research is to assume that the small nonlinearity can be separated from the linear part of the equation of motion. The effect of the dynamic fluid force on the pump structure system is considered vibrates at its natural frequency but the amplitude is determined by the initial conditions. If the motion of the system tends to increase the energy of the pump structure system, the vibration amplitude will increase and the pump structure system is considered to be unstable. A suitable MATLAB program was used to predict the stability conditions of the pump structure vibration. The present research focuses on fluid pump problems, namely, the role played by damping coefficient C, damping factor

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Publication Date
Fri Dec 22 2006
Journal Name
Journal Of Planner And Development
Optimizing the location of banks using the Gis
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the banks are one of the public services that must be available in the city to ensure easy financial dealings between citizens and state departments and between the state departments with each other and between the citizens themselves and to ensure easy access to it, so it is very important to choose the best location for the bank, which can serve the largest number of The population achieves easy access. Due to the difficulty of obtaining accurate information dealing with the exact coordinates and according to the country's specific projection, the researcher will resort to the default work using some of the files available in the arcview program

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The impact of concentrations of inorganic salts to compromise in rooting branches Genuine apples and apple architecture in vitro
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Took apple branches Genuine and Architecture tissue cultured in vitro 3 cm long and planted in the middle of food MS that contains different concentrations of inorganic salts and of Mntmat free growth and incubated Transplanter to study their effect on rooting Aalavra

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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Therapeutic Use of Silymarin in the Management of Suspected Renal and Hepatic Injury Produced by NSAIDs in Osteoarthritis Patients
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Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) mostly associated with renal and hepatic adverse effects, and the adjunct use of compounds with potent protective effects, like silymarin, may be one of the choices to avoid these effects. This project was designed to evaluate the protective effect of silymarin against the suspected renal and hepatic injury induced with long term use of NSAIDs; 220 patients with osteoarthritis were randomized into 5 groups and treated with either silymarin 300mg/day alone, piroxicam 20mg/day alone, meloxicam 15mg/day alone or the combination of each of them with silymarin for 8 weeks. The renal and hepatic functions were evaluated before starting treatment and after 8 weeks including assessm

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Publication Date
Mon Mar 27 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Isolation and Characterization of Triterpenoid Saponin Hederacoside C. Present in the Leaves of Hedera helix L. Cultivated in Iraq
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Hedera helix L. plant belongs to the family Araliaceae that provide a host of bioactive compounds (mainly saponins) of important biological activities, like spasmolytic, secretolytic, anti-inflammatory, and antibacterial activities. Literature survey revealed that there was no previously study concerning H. helix L. which is cultivated in Iraq, so we decided to carry out this study which include extraction, isolation, purification and identification of biologically important triterpenoid saponin hederacoside C from leaves of H. helix L. Extraction of hederacoside C was carried out using two methods; in the first method maceration  was done with methanol 99.8% and in the second method soxhlet extraction wit

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Weightings of Imam Ibn al-Mundhir               In his middle book in Sunan, unanimity and difference - the book of prayer
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The Imam Ibn al-Mundhir is likely in Shafi'i school. He has outlined some issues and disagreed with his doctrine. And that the vocabulary on which he relied on the weighting is correct and correct and I choose which I say. One of the most likely issues is the delay of Isha prayer to the darkness. And other issues simplified in the folds of research and study.

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Publication Date
Sun Jun 11 2017
Journal Name
Al-academy
Regularity Relations Signals According Pillars Expressive Between the Narrator and Narrative Discourse Alcinmatugrave Legend Movie In 1900 A Model
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This study is concerned with the concept of offering a point of view as a narrative construction element, especially the element and point of view of the novel to the letter Alcinmatugrave both business taken from masterpieces and literary works in the foundation or set of cinema. On the whole, the narrator participate in mock narrative process and support the narrator visual image, especially stories that need to exist scenes prove added to the image that uses signs of reality to take those marks a new dimension not only across the image, but also the intervention of the narrator in the re-formation of this realism marks surrounding Palms perceived and visible and put markers regularly between what the narrative of privacy and image, fo

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Publication Date
Tue May 01 2012
Journal Name
Journal Of Engineering
Study on wind loads coefficients and flow field characteristics around the parabolic trough with stiffeners
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Publication Date
Thu Mar 19 2015
Journal Name
Al-academy
Theatrical Visual System between the Cultural Identity and Globalization Culture Iraqi Theatre as Case Study
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