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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 Sep 03 2021
Journal Name
Tropical Journal Of Natural Product Research
Hematological and Histopathological Changes in the Spleen of Male Albino Rats (Rattus norvegicus) Treated with Meloxicam
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Publication Date
Thu Feb 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluation of the Construction, Build, Operate and Transfer (B.O.T): Applied Research in Southern Cement State Company
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   Form of investment in infrastructure important factor to drive economic growth in any country, with the dwindling ability of governments to provide the necessary funds for such investments, emerged as a rising trend for private sector involvement in public projects and infrastructure, and one of these trends is the build-operate-transfer system (BOT), which commonly used in various developed and developing countries as one of the tools used in the implementation of these investments, as the private sector under this system design, finance, build and operate the project, and are re-administration of the state after a certain period under a contractual agreement between the parties of the contract. As this system provides majo

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Publication Date
Tue Jun 01 2021
Journal Name
Baghdad Science Journal
The Energy Spectra and Heat Capacity of GaAs Gaussian Quantum Dot in an External Magnetic Field
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In this paper, a theoretical study of the energy spectra and the heat capacity of one electron quantum dot with Gaussian Confinement in an external magnetic field are presented. Using the exact diagonalization technique, the Hamiltonian of the Gaussian Quantum Dot (GQD) including the electron spin is solved. All the elements in the energy matrix are found in closed form. The eigenenergies of the electron were displayed as a function of magnetic field, Gaussian confinement potential depth and quantum dot size. Explanations to the behavior of the quantum dot heat capacity curve, as a function of external applied magnetic field and temperature, are presented.

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Publication Date
Fri Aug 21 2009
Journal Name
Arabian Journal Of Geosciences
Mineralogical, geochemical, and geotechnical evaluation of Al-Sowera soil for the building brick industry in Iraq
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Publication Date
Sun May 08 2022
Journal Name
Al-kindy College Medical Journal
Two Decades in the Journey of Al-Kindy College Medical Journal: Key Barriers, Achievements, and Prospects
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Apart from graduating five-star doctors, a particular medical college has the mission to motivate and offer researchers the opportunity to publish high-quality researches on various health problems and disseminate updated medical knowledge to a wide range of local and international readers. This could be accomplished by establishing a medical journal and releasing issues regularly

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Publication Date
Sat Oct 01 2022
Journal Name
The Egyptian Journal Of Hospital Medicine
Metallothionein Protein Concentration in The Liver Tissue of Albino Mice Exposed to Cadmium and Zinc Chloride
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Background Cadmium (Cd), one of the most abundant heavy metals, is extremely toxic to both humans and animals. hIt is well known that zinc (Zn) administration reduces Cd-induced toxicity and that metallothioneins can have a protective effect in biological systems to mitigate Cd toxicity. Objective The aim of the current study to determine if Zn administration affected the induction of MT-1 and MT-2 in the liver tissue in mice exposed to Cd. Materials and methods Metallothionein protein (MT) level in the tissue of male mice were detected using the anion -exchang high-performance liquid chromatography coupled (HPLC)assay and immunohistochemical staining. Results Single treatment to zinc or cadmium increase the level of MT in the liver, but zi

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Publication Date
Sun Dec 31 2023
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
EFFECT OF PARTICLE SIZE AND DIE HOLES DIAMETER IN THE MACHINE ON BROILER FEED PELLETS QUALITY
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Due to the need for controlling and regulating of feed pellet. Pellet that is imported or locally manufactured is accompanied by cracking and crumbling percentage that occur during transporting and distributing to animals, using conveyors and mechanical feeders. This study aimed to determine the effect of particle size and die holes diameter in the machine on broiler feed pellets quality in pellet durability, pellet direct measurement, pellet expansion, and pellet length. Three particle size 2, 4, and 6 mm, and three diameters of die holes in the machine 3, 4, and 5 mm, have been used. The results showed that changing the particle size from 2 to 4 then to 6 mm led to a significant decrease in pellet durability and pellet lengths, pe

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Publication Date
Sun Sep 01 2019
Journal Name
Transylvanian Review
Metacongnitive Thinking Skills Implied in Questions and Activities of Computer Textbook for the Fifth Grade Preparatory
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The research aims to know the availability of supra-cognitive thinking skills in the questions and activities of the computer book for the fifth grade preparatory scientific and literary branches in Iraq for the academic year 2018/2019, as the researcher has prepared a list of supra-cognitive thinking skills included two areas and (6) key skills and (27) A sub - skill, where by the questions and activities of the aforementioned authors were analyzed. The researcher followed the descriptive analytical approach "method of content analysis", and adopted the explicit and implicit unit of analysis, as was verified the validity and stability of the analysis, and the results showed unevenness and imbalance in the distribution of supra-cognitive th

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Publication Date
Thu Jan 01 2026
Journal Name
Modern Sport
relationship between explosive power and length accurately by the performance of weavy sending skill in volleyball
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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Natural Sciences Research
Estimation Arginase Activity in the Serum of Uterine Fibroid Females and its Relationship with Other Parameters
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The research includes a clinical study of Arginase and its relation with uterine fibroid. The normal value of arginase activity in female serum was found to be (0.52 ± 0.02 IU/L) in healthy group at age (35-55) years. The study also showed a highly significant increase in arginase activity (7.99 ± 0.23 IU/L) in serum of uterine fibroid patients group at (35-55years) in comparison to healthy.The results also indicated a highly significant increase in the level of progesterone, estradiol, prolactin, peroxynitrite and malondialdehyde in patients group. While a highly significant decrease in concentration of adiponectin in patients group was found in comparison to healthy.