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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
Fri Apr 26 2024
Journal Name
Mathematical Modelling Of Engineering Problems
Solving Tri-criteria: Total Completion Time, Total Earliness, and Maximum Tardiness Using Exact and Heuristic Methods on Single-Machine Scheduling Problems
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Publication Date
Wed Apr 28 2021
Journal Name
Journal Of Engineering
Post-occupancy evaluation Correlated with Medical Staffs' Satisfaction: A Case Study of Indoor Environments of General Hospitals in Sulaimani City
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This study aims at identifying the notion of Post-Occupancy Evaluation (POE) pertinent to the performance of three general hospitals constructed inside the Sulaimani City, tracing the relationship between the quality of the indoor environments and medical staff (doctors and nurses) satisfaction level. Using some indoor environment elements in the right way will positively influence the mood, stress level of the medical staff, and patient recovery as a result. The POE toolkits (AEDET and ASPECT) have been implemented on targeted wards at the selected hospitals. AEDET and ASPECT questionnaires were distributed among 152 medical staff to obtain their perspectives. In total, 112 valid questionnaires were received. The medica

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Publication Date
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Testing Different Properties of A Light-Cured Denture Base Material After Addition of Silicon Oxide Nanofiller (An in Vitro Study)
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ABSTRACT Background: Improving the properties of heat- cured and self-cured acrylic resin have been studied by many researchers. However, little studies concerned with visible light cured resin (VLCR) improved through addition of nanofiller are available. The purpose of this study was to evaluate some properties of (VLCR) after addition of SiO2 nanofiller. Materials and Methods: SiO2 nanofiller were added to (VLCR) tray material after being dissolved in tetrahydrofuran (THF) solvent. According to the pilot study 2% SiO2 nanofiller addition exhibited better properties than the other percentages (1%, 3%). The main study conducted involved (100) specimens divided into 5 groups according to the test included. (20) Specimens were selecte

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Publication Date
Tue Nov 18 2014
Journal Name
Conference: First International Engineering Conference (iec2014)at: Ishik University, Erbil, Krg, Iraq
Visualization of People Attraction from Mobile Phone Trace Database: A Case study on Armada 2008 in French City of Rouen
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The mobile phone is widespread all over the world. This technology is one of the most widespread with more than five billion subscriptions making people describe this interaction system as Wireless Intelligence. Mobile phone networks become the focus of attention of researchers, organizations and governments due to its penetration in all life fields. Analyzing mobile phone traces allows describing human mobility with accuracy as never done before. The main objective in this contribution is to represent the people density in specific regions at specific duration of time according to raw data (mobile phone traces). This type of spatio-temporal data named CDR (Call Data Records), which have properties of the time and spatial indications for th

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Publication Date
Mon Jun 20 2022
Journal Name
International Journal Of Early Childhood Special Education
The Impact of the Visual Teaching Strategy by using Infographic in mathematics achievement for intrmediate grade students
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The research aims to identify the impact of the visual teaching strategy by using infographics mathematics achievement for intermediate grade students. The experimental research method was adopted, as the experimental design of two independent and equal groups with a post test was used, whereas the experiment was applied on a sample consisting of (52) male students from first- intermediate grade students in (Al-Haq Al-Mubin intermediate school for Boys) of the General Directorate in Anbar Governorate - Department Education in Fallujah for the academic year (2021-2022), and the research sample was distributed equally on the two research groups, and Division (B) was chosen randomly to be the experimental group, while Division (A) was the cont

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Publication Date
Thu Dec 23 2021
Journal Name
Review Of International Geographical Education Online
Idyllic Pastoral: Environmental Scenic Remedial Sublimes for Apocalyptic Ecophobia in Margaret Atwood's The Year of the Flood.
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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of The College Of Education For Women
Difference in distribution of the labor force by occupation for Sulaymaniyah governorate residents for the year 2013
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The study aims to elucidation Difference distribution of the labor force by occupation in Sulaymaniyah governorate for the year 2013 by result field study to governorate and explain different Spatially for labor force by career. and The study reaches That Executive staff and Scribes and who join their high ratio from Total the labor force And the second Grade to Specialists and Technicians and who join their While Occupied career Production workers and who join their and Operators Transport Equipment and Engaged the third Grade from the total labor force and Continued Height in career Executive staff and who join their on the male labor force too . while Production workers in second Grade for male labor force , while the female labor for

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Publication Date
Sat Dec 02 2017
Journal Name
8th International Conference On Agricultural, Environment, Biology And Medical Sciences
Histological Structure of the Kidney in the Iraqi Weasel, Small Asian Mangoose, (Herpestes Javanicus ) (E.Geoffroy Saint.Hilaire,1818)
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The present study aims to describe the histological structure of kidney of, (Herpestes javanicus ) that inhabits Iraqi lands. Transverse sections of kidney stained with hematoxylin and eosin showed two distinct regions, the outer thin darkly stained cortex and inner thick lightly stained medulla, which further subdivided into external and internal medullary zones linked with one conical renal papilla. The lateral margin of the outer medullary tissue forms a secondary renal pyramid with a specialized fornix. All the nephrons in the kidney start with the renal corpuscle [Malpighian], which is formed from two distinct parts, these are a centrally located glomerulus, which represented by a tuft of blood capillaries and an outer Bowman’s capsu

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Publication Date
Fri Jul 05 2024
Journal Name
Pakistan Journal Of Life And Social Sciences (pjlss)
Evaluation of the Gully Erosion Risks in the Mamran Basin within Sulaymaniyah Governorate using GIS &amp; RS
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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The tax examination by using some statistical methods: An applied research in the General Commission of taxes
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this research aims at a number of objectives including Developing the tax examination process and raise its efficiency without relying on comprehensive examination method using some statistical methods in the tax examination and Discussing the most important concepts related to the statistical methods used in the tax examination and showing its importance and how they are applied. the research represents an applied study in the General Commission of taxes. In order to achieve its objectives the research has used in the theoretical side the descriptive approach (analytical), and in the practical side Some statistical methods applied to the sample of the final accounts for the contracting company (limited) and the pharmaceutical industry (

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