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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
Tue Aug 01 2023
Journal Name
Journal Of Ecological Engineering
Assessment of the Pressure Driven Membrane for the Potential Removal of Aniline from Wastewater
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Publication Date
Mon Dec 03 2018
Journal Name
Journal Of Engineering
The Influence of Clay Bricks Dust Incorporation on the Self-Curing of Cement Mortar
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Self- curing is the potential of lightweight aggregate to absorption great amount of water thru mixing which prominently can moves to the paste during hydration process. Self- curing empowers a water to be distributes more evenly act out the cross section. Whereas, the external curing water is only able to penetrate several millimetres into concrete with low water cement ratio. Brick dust accumulates in the demolish site creates serious environmental contamination. This study investigates the effect of brick dust recovered from construction site on the Properties of mortar cured in three curing conditions. Mortar in this study produced using BD as cement additive with (2, 4, 6, and 8) % by weight of cement. BD was used a

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of the proposed strategy of Maysan Oil Company for the years 2020-2024
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ناقش البحث في طياته عدداً من القضايا الرئيسة المتعلقة بالتقييم الاستراتيجي والإطار العام للخطة الاستراتيجية المقترحة لشركة نفط ميسان للسنوات الخمس المقبلة (2020_2024)، وهدف هذا البحث يتمحور في تقييم عملية صياغة استراتيجية شركة نفط ميسان لتحديد نقاط القوة وتعضيدها ومواطن الضعف ومحاولة معالجتها لتجنب الوقوع بها عند وضع استراتيجية للسنوات القادمة، وعلى هذا الاساس فان مشكلة البحث تكمن في مدى نجاح الاستراتي

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of Educational And Psychological Researches
Evaluation Tasks of Performance Quality of the University Students According to the Developmental Environment
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 Education is a process of learning and education at the same time. As the conditions of modern life necessitate every person to keep learning, education has become a necessity to meet life needs. The society today is concerned with the educational process and aims to live up the expectations. Since education is an integral part of education and its means, it has become as a mean to achieve its purposes. The educational environment was a traditional environment limited to specific inputs, possibilities and stimulus of both teacher and student. Due to the latest advancement, the educational environment has been expanded to become a rich, with strong connections. It has expanded to encompass the entire global environment. The current

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Publication Date
Mon Dec 29 2025
Journal Name
Sciences Journal Of Physical Education
The relationship of future anxiety to the level of academic ambition among female students
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Publication Date
Mon Dec 29 2025
Journal Name
Al–bahith Al–a'alami
The communicative content of "Israeli" popular diplomacy from the perspective of international public relations
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This study deals with the conceptual rooting of the practical relationship between the practice of international public relations and popular diplomacy, as the latter sought - as a legitimate extension of traditional diplomacy - to involve foreign residents in international public relations capable of drawing a positive image of the state among people of other countries, by employing modern communication technology. Especially social media, which led to a shift from old diplomacy to digital public diplomacy. The research paper seeks to analyze the communicative content of the Facebook page (Israel in the Iraqi dialect), which a page is belonging to the "Israeli" Ministry of Foreign Affairs that aims, according to its messages, to encoura

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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of Temperature on the Synthesis of Nano-Gamma Alumina Using Hydrothermal Method
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Nano gamma alumina was prepared by double hydrolysis process using aluminum nitrate nano hydrate and sodium aluminate as an aluminum source, hydroxyle poly acid and CTAB (cetyltrimethylammonium bromide) as templates. Different crystallization temperatures (120, 140, 160, and 180) 0C and calcinations temperatures (500, 550, 600, and 650) 0C were applied. All the batches were prepared at PH equals to 9. XRD diffraction technique and infrared Fourier transform spectroscopy were used to investigate the phase formation and the optical properties of the nano gamma alumina. N2 adsorption-desorption (BET) was used to measure the surface area and pore volume of the prepared nano alumina, the particle size and the

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Publication Date
Tue Sep 03 2024
Journal Name
Tropical Parasitology
Investigation the effect of the aqueous extract of Chara vulgaris (L.) on visceral leishmaniasis
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Abstract<sec><title>Background:

Visceral leishmaniasis (VL) is a parasitic disease that affects public health. It is described by weight reduction, irregular fever bouts, anemia, and amplification of the spleen and liver.

Materials and Methods:

Three concentrations (15.6, 31.2, and 62.5 μg/mL) were used to find the potency of an aqueous extract ofChara vulgarisalgae in the treatment of VL. A cytotoxicity assay was performed to show the cytotoxic effect of this extract on human cells. High-performance liquid chromatography (HPLC) test was done to determine the active compounds in the ext

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Publication Date
Fri Dec 01 2023
Journal Name
Asian Pacific Journal Of Cancer Prevention
Effect of Laetrile Vinblastine Combination on the Proliferation of the Hela Cancer Cell Line
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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Investigations about the characteristic behavior of the linear mode of quantum acoustic waves ion
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The dispersion relation of linear quantum ion acoustic waves is derivate according to a fluid approach that depends on the kinetic description of the systems of charged particles model. We discussed the dispersion relation by changing its parameters and graphically represented. We found through graphs that there is full agreement with previous studies on the subject of interest. That motivates us to discuss the dispersion relation of waves depending on the original basic parameters that implicitly involved in the relationship which change the relationship by one way or another, such as electron Fermi temperature and the density at equilibrium state.

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