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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 Jul 01 2016
Journal Name
Infection And Immunity
The Periodontal Pathogen Porphyromonas gingivalis Preferentially Interacts with Oral Epithelial Cells in S Phase of the Cell Cycle
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ABSTRACT<p> <named-content content-type="genus-species">Porphyromonas gingivalis</named-content> , a key periodontal pathogen, is capable of invading a variety of cells, including oral keratinocytes, by exploiting host cell receptors, including alpha-5 beta-1 (α5β1) integrin. Previous studies have shown that <named-content content-type="genus-species">P. gingivalis</named-content> accelerates the cell cycle and prevents apoptosis of host cells, but it is not known whether the cell cycle phases influence bacterium-cell interactions. The cell cycle distribution of oral keratinocytes was characterized by flow cytometry and BrdU (5-bro</p> ... Show More
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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Six Thinking Hats Strategy on Improving Creative Thinking Skills" Field research in the Medical City "
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Abstract  

   The research problem focuses on studying the interest of the Medical City Department of the Ministry of Health in improving the creative thinking skills of the administrative leadership through parallel & comprehensive thinking according to the of six thinking hats strategy. The research sample consisted of (170) administrative leaders in the upper & middle organizational levels, The questionnaire was used as a main tool for data collection, In addition to the observation & Interview, The research sought to answer the following questions: What is the extent to which the administrative leadership (Tpp & middle) in the organization investigated the concept of the six thinkin

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Publication Date
Thu Mar 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
Using the Critical Path Method to Find Time of Constriction for Helicopters Airport Project in the Oil Fields
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This research is considered one of the important researches in Maysan Governorate, as it focuses on the construction of helicopter airport project in the oil fields of the Maysan Oil Company, where the oil general companies in Maysan Governorate suffer from the cost of transporting the foreign engineering experts and the governing equipment of sustaining oil industry from Iraq's international airports to oil fields and vice versa. Private international transport companies transport foreign engineering from the oil fields to Iraqi airports and vice versa, and other international security companies take action to provide protection for foreign engineering experts during transportation. Hence, this process is very costly.

 &nbs

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Publication Date
Sun Aug 18 2019
Journal Name
Political Sciences Journal
The challenges of precision axes for futuristic regional relations in the middle east (Iraq after post triumph's period)
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The research has tackled about an important transformation within the whole region of middle east, especially there were more challenges which revealed under the huge pivotal interests of global powers that ruled the new world order by United states of America ; being very affected over the international and regional relations than any situations appeared previously within political realities. So that, many of variables inside the international scene which happened during of this period of contradicting strategic policies by the process of reforming and restructuring of difficult equations that imposed by international and regional allies and blocs . This article had concentrated over various strategic and political studies which reflect

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
The Combined Effect of Q-Switched Nd:YAG Laser (532 Nm) and Safranin O on the Growth of Pseudomonas Aeruginosaand its Susceptibilityto Antibiotics and Pyocyanin Production
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Twenty five samples out of sixty wound swabs taken from burn patients were identified as P. aeruginosabacteria by conventional methods. Antibiotics susceptibility tests were performed against thirteen antibiotics. P. aeruginosa samples were treated with 0.5 mg/ml of Safranin O solution then irradiated with 532nm Q-switched Nd:YAG laser at four energy densities (0.324, 0.704, 1.380, and 1.831 J/cm2) for different times of 5, 8 and 11 minutes with 5Hz repetition rate. The viability, susceptibility to antibiotic and production of pyocyanin were determined before and after irradiation. The results showed that the number of CFU/ml of P. aeruginosa decreased with increasing the dose of irradiation. Complete killing of cells was observed at 1.8

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Publication Date
Tue Mar 01 2022
Journal Name
Iraqi Journal Of Physics
Effect of pH on the Structural and Optical Properties of Cadmium oxide Thin Films Prepared Using the Successive Ionic Layer Adsorption and Reaction (SILAR) Method
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Cadmium oxide (CdO) thin films were deposited using the sequencing ion layer adsorption and reaction (SILAR) method. In this study, the effect of the pH value of an aqueous solution of cadmium acetate at a concentration of 0.2 mol of the cadmium oxide film was determined. The solution source for the cadmium oxide film was cadmium ions and an aqueous ammonia solution. The CdO films were deposited on glass substrates at a temperature of 90 ℃. The cadmium oxide film thickness was determined by the weight difference method at pH values ​​(7.2, 8.2). X-ray diffraction (XRD) and scanning electron microscopy (SEM) showed that the size of the crystals increased with the increase in the solution (pH). While the UV-visible spectra of the fil

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of The College Of Languages (jcl)
The article deals with the marked vocabulary of Russian and Arabic language, extrapolated to the phraseological: Маркировка арабского и русского языков: На примере фразеологии
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  The paper deals with the marked vocabulary of Russian and Arabic language, and the extrapolated to the phraseological layer of the mentioned language systems. Specificity of the functioning of this process is presented against the backdrop of the peculiarities of the existence of Russian and Arabic languages. Attention is focused on the fact that linguistic markers should be considered as a kind of keys that represent the specificity of the experience of being experienced by an individual in ontological reality. It is asserted that marking can be revealed practically at all levels of the language polysystem, but it is especially productive on its lexical layer, in particular, on the basis of lexicology and ph

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Analyzing the content of the two science books (the two chemistry units) for the intermediate stage according to environmental problems
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    The main goal of the current research is to know -Environmental problems included in the content of the two science books (chemistry units) for intermediate stage

A list of environmental problems had been prepared  and  consisting of (8) main areas which are (air and atmosphere pollution, water pollution, soil pollution, energy, disturbance of biodiversity and environmental balance, waste management, food and medicinal pollution, investment of mineral wealth). Of which (60) sub-problems,  at that time the researcher analyzed the two science books (two chemistry units) for the intermediate stage of the academic year (2020-2021) in light of the list that was prepared, and the validity and consisten

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Publication Date
Sat Aug 30 2025
Journal Name
Iraqi Journal Of Science
The role of Matrix metalloproteinase (MMP-9) and its tissue inhibitor (TIMP1) in Cutaneous Leishmaniasis patients and their role in prognosis
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Cutaneous leishmaniasis (CL) is a widespread, yet often overlooked, parasitic disease caused by the Leishmania protozoan, which is prevalent in numerous countries, including Iraq. This condition is marked by the appearance of skin lesions on various exposed areas of the body. In most old-world regions, sodium stibogluconate (SSG) is the classical widely used drug to treat CL. The progression of skin ulceration is controlled by different inflammatory modulators including cytokines and enzymes. In this study, the possible role of the enzyme Matrix metalloproteinase9 (MMP-9) and its inhibitor Metallopeptidase inhibitor-1 (TIMP-1) as immunological markers was evaluated in CL patients suffering from cutaneous leishmaniasis before and aft

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Publication Date
Sat Jan 01 2022
Journal Name
3rd International Scientific Conference Of Alkafeel University (iscku 2021)
Simulation and investigation of the ICP plasma torch’s electrical and thermal properties
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