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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.

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 01 2023
Journal Name
Cureus
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Publication Date
Tue Jan 11 2022
Journal Name
3rd International Scientific Conference Of Alkafeel University (iscku 2021)
Elimination of the broadening in X-ray diffraction lines profile for nanoparticles by using the analysis of diffraction lines method

In this research, the results of the Integral breadth method were used to analyze the X-ray lines to determine the crystallite size and lattice strain of the zirconium oxide nanoparticles and the value of the crystal size was equal to (8.2nm) and the lattice strain (0.001955), and then the results were compared with three other methods, which are the Scherer and Scherer dynamical diffraction theory and two formulas of the Scherer and Wilson method.the results were as followsScherer crystallite size(7.4nm)and lattice strain(0.011968),Schererdynamic method crystallite size(7.5 nm),Scherrer and Wilson methodcrystallite size( 8.5nm) and lattice strain( 0.001919).And using another formula for Schearer and Wilson methodwe obtain the size of the c

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Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Organizational Compliance on High Performance: An Analytical Research in the General Company of Leather Industries / Cotton Factor

This research aims to identify how organizational compatibility, which represents the independent variable, affects higher performance, which is considered a dependent variable, given the importance of these variables in industrial organizations and their clear impact on their stability, survival, and growth in the light of changing environmental challenges.  Where the practical research problem was represented by the weakness of awareness of the importance toward organizational compatibility and its dimensions (organizational loyalty, organizational similarity, affiliation or membership, compatibility with goals, and compatibility with values), which is meant by the individual's compatibility with the organization in which he/she w

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Publication Date
Tue Nov 19 2024
Journal Name
Journal Of Baghdad College Of Dentistry
The association of crevicular albumin level with the severity of periodontal destruction in chronic periodontitis patients after initial periodontal treatment

Background: Gingival crevice fluid (GCF) is a mixture of substances derived from serum, leukocytes, and structural cells of periodontium and oral bacteria. These substances possess a great potential for serving as indicators of periodontal disease and healing after therapy the main purpose of this study was to find if there is a difference in albumin concentration between healthy and diseased periodontal tissues and to compare between diseased group according to pocket depth Materials and methods: total sample composed of 60 pockets found in 35 patients all of them had no history of any systemic disease, The samples were divided in to three main group that include two diseased groups divided according to the depth of the periodontal pocket

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Publication Date
Tue Aug 15 2023
Journal Name
Sumer 1
The effect of silver diamine fluoride on the microleakage of glass ionomer restoration in primary teeth at different time intervals

Silver diamine fluoride (SDF) has shown effectiveness in hardening tooth structure and killing bacteria. Therefore, it can be used to prevent and arrest dental caries. Riva Star (SDF) treatment alone will stop cavities but will not reverse the cavitation. The Silver Modified Atraumatic Procedure, often known as Smart, is the optimum technique for regaining the tooth's structure and function. Glass ionomer was introduced in (1972) as a new material that has become one of the most widely used materials in restorative dentistry. By releasing fluoride ions, this material has a therapeutic impact on the surrounding tooth structure. Microleakage is the ingress of bacteria, its byproducts, toxins, chemicals, oral fluids, and ions between t

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Publication Date
Mon Dec 23 2019
Journal Name
Journal Of Legal Sciences
Settlement Limits of Discounting Bank's Right Across Reversing Entry to his debit in the Bank Account of the Discounted side

In order to facilitate the accounting procedure and accelerate its achievement, commercial banks used to follow reversing entry style in agent’s account opened with them, to settle its debits caused by non-payment of the discounted commercial paper value. The question was raised about: the legal importance to such method for settling the discounting bank debits, particularly when the bank account of the discounted side was debtor and not creditor, as the case of discounted party under bankruptcy.

It is noted that the Jordanian trade legislations is totally silent in this regard, as well as the  other trade legislations which are frankly considering the reversing entry as an organizer for deleting the trust entry which was

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Publication Date
Tue Jun 27 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluating the Benefits of Using Mobile Application (diarrhea management step by step) in the Management of Diarrhea by Community Pharmacists

Diarrhea is one of the most commonly encountered minor ailments in the community pharmacies. It is associated with significant morbidity and mortality. However, the majority of pharmacists in Iraq did not manage diarrheal cases in a proper way. Therefore, the current study aimed to evaluate the benefit of a new mobile application (diarrhea management step by step) to improve the pharmacist's role in the management of diarrhea. The study was conducted from 21th September to 21th October 2021 using a pre-post design via a simulated patient (SP) technique. A validated diarrhea scenario was presented to each pharmacist by the SP twice, once before and the other after giving the mobile application to the pharmacist. Furthermore, pharmaci

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Publication Date
Sat Jan 31 2009
Journal Name
Not Published
Publication Date
Thu Jan 01 2015
Journal Name
Agriculture And Agricultural Science Procedia
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Publication Date
Tue Jan 01 2019
Journal Name
Biochemical & Cellular Archives
Assessment of uric acid in patients of end-stage renal disease with hypertension and diabetic nephropathy and the risk of cardiovascular diseases

The relationship of hyperuricemia to kidney disease, diabetes, hypertension and the risk of cardiovascular diseases remain controversial. The aim of this study is to evaluate the use of uric acid (UA) levels to find the higher risk of cardiovascular disease (CVD) in patients with end stage renal disease that have diabetic nephropathy (DN), nephropathy with hypertension (NH) and patients with both diabetic nephropathy with hypertension (DNH). This study deals with 115 patients with end-stage renal disease under hemodialysis sub-grouped into 35 patients with (DN), 40 patients with (NH), and 40 patients with (DNH). Some biochemical parameters were determined in the serum of all participants such as HbA1c, fasting blood glucose (FBG), UA, urea,

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