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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 Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Gravimetric Estimation of Caffeine in Different Commercial Kinds of Tea Found in the Iraqi Market
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          Caffeine (1,3,7-trimethylxanthine), which is the most widely consumed stimulant in the world, had been isolated and estimated gravimetrically in fifteen  different commercial kinds of tea found in the Iraqi market.The kinds of tea were chosen according to their differences in the degree of fermentation and the method of processing i.e. black , gray and  green . The isolated caffeine was identified by melting point, sublimation, TLC, chemical tests, UV , IR , HPLC and CHNO analysis.                                 &nb

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Strategic audit in detection of financial corruption cases in Iraq - Proposed Framework
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This research focuses on detecting the financial corruption cases in Iraq in light of adoption the strategic audit, the paper deals with the problem of the proliferation corruption cases particularly financial in Iraq and dramatically in the presence of audit and control devices as well as inspection and integrity devices, which indicates the existence of deficiencies and weaknesses in those devices in the implementation of audit and control functions in order to detect the corruption cases in the economic units in Iraq.

Stems objective of this research through the provision of approach of strategic audit concepts and indicate the extent importance of adopting of strategic audit as a means to detect the f

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Publication Date
Mon Apr 15 2019
Journal Name
Journal Of Global Pharma Technology
The dual role of Gentamicin in gene expression of fibronectin binding proteins in Staphylococcus aureus
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Objectives: The current work aimed to reveal the impact of gentamicin on the fibronectin binding proteins (fnbp) gene expression and its relation to biofilm and agr type in Staphylococcus aureus. Materials and Methods: A total of 25 S. aureus isolates were enrolled in this study previously isolated from different specimens. Identification confirmation and methicillin resistance were achieved by amplification of 16SrRNA and mecA. Multiplex polymerase chain reaction (PCR) based assay was employed to evaluate the agr typing. The gene expression of fnbA and fnbB genes was tested by real-time PCR technique. Minimum inhibitory concentration was estimated by micro broth dilution methodology. Microtiter plate method was performed to determine the a

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Publication Date
Fri Feb 28 2025
Journal Name
Energies
Synergizing Machine Learning and Physical Models for Enhanced Gas Production Forecasting: A Comparative Study of Short- and Long-Term Feasibility
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Advanced strategies for production forecasting, operational optimization, and decision-making enhancement have been employed through reservoir management and machine learning (ML) techniques. A hybrid model is established to predict future gas output in a gas reservoir through historical production data, including reservoir pressure, cumulative gas production, and cumulative water production for 67 months. The procedure starts with data preprocessing and applies seasonal exponential smoothing (SES) to capture seasonality and trends in production data, while an Artificial Neural Network (ANN) captures complicated spatiotemporal connections. The history replication in the models is quantified for accuracy through metric keys such as m

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Publication Date
Mon Feb 01 2021
Journal Name
Meta Gene
Association analysis of FTO gene polymorphisms rs9939609 and obesity risk among the adults: A systematic review and meta-analysis” Meta Gene (2020) 7–7/100832
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Background: Obesity typically results from a variety of causes and factors which contribute, genetics included, and style of living choices, and described as excessive body fat accumulation of body fat lead to excessive body, is a chronic disorder that combines pathogenic environmental and genetic factors. So, the current study objective was to investigate the of the FTO gene rs9939609 polymorphism and the obesity risk. Explaining the relationship between fat mass and obesity-associated gene (FTO) rs9939609 polymorphism and obesity in adults. Methods: Identify research exploring the association between the obesity risk and the variation polymorphisms of FTO gene rs9939609. We combined the modified odds ratios (OR) as total groups and subgro

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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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Publication Date
Tue May 16 2017
Journal Name
Iosr Journal Of Pharmacy And Biological Sciences(iosr-jpbs)
The relationship between Rheumatoid Arthitis and prevalence of Cytomegalovirus and Helicobacter pylori
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Publication Date
Wed Aug 21 2019
Journal Name
Journal Of Global Pharma Technology
Synthesis and characterization of new heterocyclic compounds and studying the biological activity
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Publication Date
Mon Feb 24 2020
Journal Name
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
Thu Dec 01 2022
Journal Name
Al-kut University College Of Humanities
The values ​​of environmental sustainability among the student-teacher at the College of Education for Pure Sciences, Ibn al-Haytham
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