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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
Wed Apr 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation,
The Effect of Using Resistance and Medical Ozone Training on Testosterone and Some Physiological Variables in Swimmers
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م.د. فاطمة حميد ،أ.م.د وفاء صباح محمد الخفاجي, International Journal of Psychosocial Rehabilitation,, 2020 - Cited by 1

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Publication Date
Tue Jan 01 2019
Journal Name
Biochemical & Cellular Archives
Assessment of uric acid in patients of end-stage renal disease with hypertension and diabetic nephropathy and the risk of cardiovascular diseases
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The relationship of hyperuricemia to kidney disease, diabetes, hypertension and the risk of cardiovascular diseases remain controversial. The aim of this study is to evaluate the use of uric acid (UA) levels to find the higher risk of cardiovascular disease (CVD) in patients with end stage renal disease that have diabetic nephropathy (DN), nephropathy with hypertension (NH) and patients with both diabetic nephropathy with hypertension (DNH). This study deals with 115 patients with end-stage renal disease under hemodialysis sub-grouped into 35 patients with (DN), 40 patients with (NH), and 40 patients with (DNH). Some biochemical parameters were determined in the serum of all participants such as HbA1c, fasting blood glucose (FBG), UA, urea,

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Scopus
Publication Date
Sat Mar 03 2018
Journal Name
International Journal Of Science And Research
In Vivo Mechanical and Histological Evaluation of the Effect of Vacuum Storage and Ultra Violet Light Treatment of Titanium Implants on Osseointegration
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Background: Titanium implant is widely used in dentistry because of its extraordinary biocompatibility and mechanical properties. To increase bone–implant connection and provide early loading after placement, implant is stored in different storage medium and treated with UV light. Both of them are applicable methods to increase the bioactivity of titanium and overcome the biological aging. This study was designed to assess the effect of vacuum storage method and air storage with and without UV light treated of Cp Ti implant mechanically and histologically. Materials and methods: Titanium screws were acid etched and prepared in four different modes using different storage methods (air or vacuum and, with or without UV treatment. The implan

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Publication Date
Sun Dec 07 2014
Journal Name
Baghdad Science Journal
Effect of alcoholic and cold aqueous extracts of Melia azedarch(L.) and Actellic insectiside in the second larval instars of Oryzaephilus surinamensis
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The effect of alcoholic extract (2%,4%, 12%) and the fruits aqueous extract (12%,15%,25%,35%) of Melia azedarach and actellic insecticide of 0.01 concentration were tested on the second instar larvae ofOryzaephilus surinamensis .The obtained resuls were reveated that the highest kill ratio 80% at the concentration 12% of the alchoholic extract and 85% of the aqueous extract this was reflected effect abstracts on low rate of age adult emerging of larve treated and low productivity

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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Administrative control procedures and their relation to evaluating the job performance: in the companies department
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The study sought to highlight the importance of applying the administrative control procedures which play an important role in assessing the performance of the employees of the tax administration and specifically the companies department by setting the standards and objectives of the department on the basis of which in the implementation of its work and identify deviations and errors and find appropriate solutions and evaluate the results according to appropriate solutions, The study of the problem of research, namely the extent to which the tax administration applied to the administrative control procedures in view of its importance in evaluating the performance of its employees and the extent of their application to the legislations an

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Publication Date
Sun Oct 27 2024
Journal Name
Thi-qar University Journal Of Physical Education Sciences
Arab participation and achievements for men in the Summer Paralympics for the period (2004-2012)
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This research addresses the necessity due to the scarcity of historical studies in the field of sports, especially those indicating the activities and achievements of Arab countries in the Paralympic movement. This study aims to document the participation of Arab countries in the Paralympic Games, explore the prominent sports in which Arab athletes with disabilities participated, and analyze their achievements during the Paralympic Games from 2004 to 2012. The research methodology adopted an analytical, historical approach, collecting and analyzing data objectively through the official website of the International Paralympic Committee, in addition to scientific and historical sources from research papers, journals, and websites. The key fi

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Publication Date
Thu Feb 01 2024
Journal Name
Journal Of Engineering
Evaluating the Knowledge for Integrating RM and VM Using BIM in the Iraqi Construction Sector
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The construction industry plays a crucial role in the countries' economy, especially in the developed country. This point encourages the concerned institution to use new techniques and integrate many techniques and methods to maximize the benefits. The main objective of this research is to evaluate the use of risk management, value management, and building information modeling in the Iraqi construction industry. The evaluation process aims at two objectives. The direct objective was to evaluate the knowledge in risk management (RM), value management (VM), and building information modeling (BIM). The indirect objective was to support the participants with information related to the main items mentioned. The questionnaire

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
The directing vision and two display technologies in the Iraqi Child Theater: عباس قاسم كاظم
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  The current research contains four chapters. The first topic included the methodological framework that included the problem of research and the need for it, and then the importance of the research, and then the aim of the research, its limits and the definition of terms linguistically, conventionally and procedurally. The second chapter (the theoretical framework) contained two topics, the topic The first is titled: The Outward Vision in Child Theater Performances, while the second topic was titled: Presentation Technology in Child Theater, Chapter Four (Research Procedures), which organized the research community and analyzed its sample, and the fourth chapter contained research results, conclusions and recommendations. The prop

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Publication Date
Fri Sep 01 2023
Journal Name
Cureus
The Evaluation of Dihydropyrimidine Dehydrogenase Enzyme Level in the Serum of Colorectal Cancer Iraqi Males on Fluoropyrimidine-Based Chemotherapy (Capecitabine)
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Publication Date
Sat Jan 31 2009
Journal Name
Not Published
Assessment of the pediatric nurse's knowledge about the nosocomial infection in neonatal intensive care unit of Baghdad pediatric teaching hospitals
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