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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
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The priority of government investment for companies manufacturing sector in Iraq
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The study aimed at clarifying the contradictions of the general industrial companies despite the investment allocations and the government investment expenditure on manufacturing activities under the so- called rehabilitation programs. However, this did not contribute to a certain extent in the growth and industrial leap in the direction of developing the activities of the sector Industrial sector in Iraq because of the lack of adoption of a number of basic principles towards the need to take priority of investment in the field of manufacturing and industrial decision-making in the restructuring of industry according to the priorities of investment in light of the international industrial trend, Tosmarah available to the manufact

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Mon Jan 01 2024
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Papaverine attenuates the progression of alpha naphthylisothiocyanate induce cholestasis in rats
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Sun Apr 02 2023
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Current concepts in the pathogenesis of periodontitis: from symbiosis to dysbiosis
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Sun Jan 01 2017
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Lecture Notes In Computer Science
The Art of Using Cross-Layer Design in Cognitive Radio Networks
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Wed May 18 2016
Journal Name
Al-academy
The Role of Phenotypic Traits in Interior Spaces: سهير ياسين احمد
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The phenotypic characteristics in the interior spaces are seeing the result of the ability of the designer in his handling of the vocabulary and the elements to deliver a specific meaning for the recipient , and is working to stir up the receiver and make it effective in the process of perception of space. So the theme of the role of phenotypic characteristics is of great significance in the process of analyzing spaces to reach the goal of the main idea , and show those qualities through relationships design in terms of shape, color and texture ... etc. , to reach also designs more beautiful , and creating an internal environment , creative and continuous with its external environment , Hence the importance of research in that it tries t

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Green Human Resources Management in Achieving Sustainable Development
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The research aims at clarifying the role of green human resource management practices in achieving sustainable development. The research problem is that the health sector is less concerned with environmental aspects, specifically green human resource management practices, Which are reflected on sustainable development with their economic, environmental and social dimensions as well as reducing costs, waste minimization and recycling, And the research started from two main hypotheses to explore the correlation and influence between the variables of the research by analyzing the answers of the research sample, which included (136) employees of the Al-Imamein Al-kadhemein medical city, Data and information were collected using quest

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Thu Jan 01 2015
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Mj Journal On Applied Mathematics
Mathematical models for estimation the concentration of heavy metals in soil
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Mon Jan 28 2019
Journal Name
Journal Of The College Of Education For Women
War in the Novels of Abroad Iraqi Women Between 2003 – 2010
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This research dealt eith the effect of wars experienced bythe Iraqi people in the abroad Iraq women novels between 2003 – 2010, where this issye dominated on Iraqi women novels at this stage until it became the main subject that events revolved aroud in the novels of this stage.
The research also highlighted on the impact of continuous tough wars in human life and psyche, especially in the lives of women – and this is the privacy of feminist novel – where the Iraqi women novels focused on the impact of war on psychological of women and what it caused of misfortunes as women. Iraqi women have suffered from the bitterness of the loss caused by war as – any loss – a natural of her – the loss of father, son, husband, brother a

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Sun Jun 01 2014
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The Effect of Magnetic Water for Chemical Fertilizer in Tomato Plant
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The research aims to find ways to minimize the use of quantities of chemical fertilizers in agriculture in order to get to an environment that is free of contaminants. Magnetized water technology used in the experience of planting seeds of tomatoes Thomson type to obtain a higher efficiency to absorb fertilizer NRK in the protected environment of the period from February to June. Magnetized water system used locally made levels Gaues (4800,2500,1500) concentrations of 50 to 100% for each level and the rate of (4) replicates, and results indicated that the severity of the magnet (4800 Gaues) and a concentration of 50% gave the highest percentage of tomato fruit size and intensity ( 1500 Gaues) and a concentration of 100% did not give any inc

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Publication Date
Fri Oct 30 2020
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The Role Of Knowledge Innovation In Managing Strategic Momentum (Field Research)
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The Research Aims To Clarify The Role Of Knowledge Innovation On The Administrative Process Represented by Managing Strategic Momentum, The Research Problem Focuses on Administrative leader Interest In And Implementation Of The Innovation Element Of Knowledge In The Organization By " Managing Strategic Momentum" As Well As The Focus By Management About The Innovators And Makers Of Knowledge And Strategic Planners In The Design And Formulation Of Strategic. Research does Contribute In Solving Part Of The Organizational Problems Of Vision, Innovation And Their Impact On The Momentum Management To Determine The Extent On Which The Procedures Of The Assessed Companies And Plan To Regulate Innovation Under The Momentu

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