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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 12 2007
Journal Name
Iraqi Journal Of Laser
Incident Laser Power and Concentration Effects on the Fluorescence of DCM Dye in PMMA Polymer
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Incident laser power and concentration effects on fluorescence emission from DCM dye in PMMA polymer have been investigated. Different concentrations of the dye were used. It was found that the fluorescence intensity increased with increasing of the concentration of the dye, with a red shift. In addition, it was found that the fluorescence intensity increased with the increase of the incident laser power I0.

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Publication Date
Sun Jan 02 2011
Journal Name
Journal Of Educational And Psychological Researches
Educational Activities and Its Role in Affirm Teaching Subject At The Pupils of Primary Stage
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The first chapter includes introduce the research and the problem of the research that there are negligence of some educational institutions and schools management  , some parents and supervisors .Also there are some educators who believes that school activities are obstacles means to learning and prevent pupils from studying and understanding the subjects. That may due to social , psychological and educational reasons

The purposes of the researches come from the reports of supervision visits which indicate a lot of difficulties faced by pupils and teachers related to education activities  and its influence on in education  and the necessity of indentify these difficulties and remedy them

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Publication Date
Wed May 10 2023
Journal Name
International Journal Of Emerging Technologies In Learning
The Effect of Cognitive Modeling in Mathematics Achievement and Creative Intelligence for High School Students
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Publication Date
Wed Apr 06 2016
Journal Name
Journal Of Water And Health
The effect of chlorine and combined chlorine/UV treatment on coliphages in drinking water disinfection
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Chlorine disinfection is a globally used method to ensure the safety of drinking water. However, it has not always been successful against viruses and, therefore, it is important to find new methods to disinfect water. Seventeen different coliphages were isolated from the treated municipal wastewater. These coliphages and MS2 were treated with different dosages of chlorine in drinking water, and a combined chlorine/ultraviolet irradiation treatment for the chlorine-resistant coliphages. Chlorine disinfection with 0.3–0.5 mg/L total chlorine (free Cl-dosage 0.12–0.21 mg/L) for 10 min achieved 2.5–5.7 Log10-reductions for 11 sensitive coliphages. The six most resistant coliphages showed no reduction with these chlorine concentra

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Stock Exchange and its Impact on Economic Development In the Kingdom of Saudi Arabia (KSA)
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this research paper aims at measuring and analyzing the influence of the stock exchange on the economic development in the Kingdom. This is done through comparing the Gross Domestic Product (GDP) as a changeable factor affiliated with some independent variables in the KSA stock exchange. These variables are (All Share Index {TASI}, Market Value, Trade Volume Index, number of companies and number of shares). The study covers the period from 2003 to 2017 and adapts the measuring method in analyzing this relation using the Multiple Linear Regression (Stepwise) and (SPSS). The study affirmed the validity of the

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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
The prevalence and antimicrobial resistance of Pseudomonas species in patients with chronic suppurative otitis media
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Background: Chronic suppurative otitis media (CSOM) is the result of an initial episode of acute otitis media and is characterized by a persistent discharge from the middle ear through a tympanic perforation for at least 2 weeks duration. It is an important cause of preventable hearing loss, particularly in the developing world.Objective: To get an overview on the bacterial ear infection profile in general and to assess the antibiotic resistance of Pseudomonal infection (PS) particularly since it is usually the commonest infection to cause otitis media and the most difficult to treat due to the problem of multi drug resistance..Methods: A cross sectional study was done which included 405 patients of CSOM patients, 196 (48%) case were mal

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Publication Date
Sat Oct 28 2023
Journal Name
Baghdad Science Journal
Indirect Flow Injection Spectrophotometric and Chromatographic Methods for the Determination of Mebendazole in Pharmaceutical Formulations
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Chromatographic and spectrophotometric methods for the estimation of mebendazole in
pharmaceutical products were developed. The flow injection method was based on the oxidation of
mebendazole by a known excess of sodium hypochlorite at pH=9.5. The excess sodium hypochlorite is then
reacted with chloranilic acid (CAA) to bleach out its color. The absorbance of the excess CAA was recorded
at 530 nm. The method is fast, simple, selective, and sensitive. The chromatographic method was carried out
on a Varian C18 column. The mobile phase was a mixture of acetonitrile (ACN), methanol (MeOH), water
and triethylamine (TEA), (56% ACN, 20% MeOH, 23.5% H2O, 0.5% TEA, v/v), adjusted to pH = 3.0 with
1.0 M hy

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Publication Date
Fri Apr 01 2016
Journal Name
Water
The Effect of UV and Combined Chlorine/UV Treatment on Coliphages in Drinking Water Disinfection
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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
A Proposed Mechanism for Financial Reporting on Sustainable Investment and Its Role in Achieving Value Added - Applied in the Iraqi Midland Refineries Company-
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The research aims to develop a proposed mechanism for financial reporting on sustainable investment that takes the specificity of these investments.

To achieve this goal, the researcher used (what if scenario) where the future financial statements were prepared for the year 2026, after completion of the sustainable project and operation, as the project requires four years to be completed.

The researcher relied on the results of the researchers collected from various modern sources relevant to the research topic and published on the internet, and the financial data and information obtained to assess the reality of the company's activity and its environmental, social, and economic i

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Publication Date
Wed Apr 01 2020
Journal Name
International Journal Of Pharmaceutical Research
Effectiveness of Self-Instructional Strategy and the Traditional Teaching Approach on Nursing Students&#39; Knowledge toward Cardiopulmonary Resuscitation at the College of Nursing in University of Baghdad: Randomized Comparative Trial
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MM ABDUL-WAHHAB, SA AHMED, International Journal of Pharmaceutical Research, 2020 - Cited by 2

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