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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
Sat May 16 2009
Journal Name
Journal Of Planner And Development
Information technology and replacement system in decision-making in the city
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IT has its impact on all aspects of life, including its planning and operations. Based on the assumption that the plan can adapt any technique as an analytical tool within broader dimensions to include society in general and meet the requirements of that society. They have neutral values, meaning and usefulness rather than being adopted as abstract goals or objectives so that the planner or the decision-maker can benefit greatly from them. This information technology is summarized in three main axes: First: Geographic Information Systems. Second: computer modeling. Third: visual simulation and the Internet. The problem of research is that the decision-making environment of the plan is surrounded by uncertain information-planning conditio

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Publication Date
Tue Oct 06 2020
Journal Name
College Of Islamic Sciences
Distress Tolerance among the Employees in Media and Communication in Baghdad.
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Abstract: The aim of this study was to identify the Distress Tolerance among the Employees in  Media and Communication in Baghdad.and to identify the significance of the differences between sex ,scientific specialization ,age,and marital status. and the researcher used the Distrees  Tolerance measure for Simon &Gahar 2005.  The sample of the study consisted of(37)Employees.The Scale of Distrees Tolerance were used as the study tools after being checked for their Validity and Reliability. The research results indicated that employees have high scores on the scale of stress tolerance and that there are statistically significant differences between the age groups and between married and unmarried people a

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Sat Jan 01 2022
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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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Tue May 16 2017
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The relationship between Rheumatoid Arthitis and prevalence of Cytomegalovirus and Helicobacter pylori
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Wed Aug 21 2019
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Synthesis and characterization of new heterocyclic compounds and studying the biological activity
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Publication Date
Mon Feb 24 2020
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Sustainability
State-of-the Art-Powerhouse, Dam Structure, and Turbine Operation and Vibrations
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Dam and powerhouse operation sustainability is a major concern from the hydraulic engineering perspective. Powerhouse operation is one of the main sources of vibrations in the dam structure and hydropower plant; thus, the evaluation of turbine performance at different water pressures is important for determining the sustainability of the dam body. Draft tube turbines run under high pressure and suffer from connection problems, such as vibrations and pressure fluctuation. Reducing the pressure fluctuation and minimizing the principal stress caused by undesired components of water in the draft tube turbine are ongoing problems that must be resolved. Here, we conducted a comprehensive review of studies performed on dams, powerhouses, a

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Publication Date
Mon Feb 01 2021
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Study and Investigation of Hard Photons Emission in Heavy Ion Collisions
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This work involves hard photon rate production from quark -gluon plasma QGP interaction in heavy ion collision. Using a quantum chromodynamic model to investigate and calculation of photons rate in 𝑐𝑔 → 𝑠𝑔𝛾 system due to strength coupling, photons rate, temperature of system, flavor number and critical. The photons rate production computed using the perturbative strength models for QGP interactions. The strength coupling was function of temperature of system, flavor number and critical temperature. Its influenced by force with temperature of system, its increased with decreased the temperature and vice versa. The strength coupling has used to examine the confinement and deconfinement of quarks in QGP properties and inf

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of waste sorting and recycling laboratory in Mahmudiya (case study)
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The daily practices of humans produce various types of waste, which are a threat to the health and environment surrounding it, especially after the increase in quantities as a result of population growth and technological development, and here came the need for recycling solid waste as one of the modern concepts that achieve environmental benefits, The aim of the research is to evaluate the project of sorting and recycling of solid waste in the district of Mahmoudiya and whether its work is sustainable ,Conforming to modern standards, using standard checklists to determine the gap between the current laboratory reality and the requirements of those standards , Using the case study methodology as the most appropriate approach

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Wed Jan 01 2020
Journal Name
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Morphological and histological study of trachea in Iraqi Weasel, Herpestes Javanicus
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Sun Jun 05 2016
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Study of total Immunoglobulin E and Eosinophil count in allergic disease
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The present study aimed to evaluate the levels of total immunoglobulin E and percentage count of eosinophil in some of allergic disease. Blood sample collected from 210 patients (110 female, 100 male) with allergic disease (allergic asthma, allergic rhinitis, and urticaria) their age between 10-70 years and 50 healthy control their age between 23-52 years. A highly significant (P<0.01) increase in the mean serum total IgE in patients with asthma (503.54 ± 63.49 IU/ml), Allergic rhinitis (442.77 ± 95.76 IU/ml) and urticaria (489.53 ± 69.68 IU/ml) as a compared with healthy controls (23.67 ± 5.81 IU/ml).There was a significant difference in percentage count of eosinophil in patients groups allergic asthma 4.37 ± 0.52% ,allergic rhinitis

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