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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 24 2021
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Assessing Patient Preoperatively and Role in Decreasing Risks on Patients and Preventing Post-Operative Complications for Cholecystectomy
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Background: Laparoscopic cholecystectomy has many difficulties which include port Insertion, Dissectionof the Calot’s Triangle , Grasping of the Gallbladder , Wall thickness, Adhesion and extraction of theGallbladder. Aim of the Study: To predict how difficult cholecystectomy will be from assessing the patientpreoperatively which, in turn, help in decreasing the risks on the patients and preventing post-operativecomplications. Patients and Methods: A prospective study conducted in the department of General Surgeryat Al-Ramadi Teaching Hospital for the period of nine months from 15th of May 2018 till the 15th of February2019. It included 60 patients, all of them were undergone laparoscopic cholecystectomy for Gallstone. Patientswit

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
Laparoscopic versus open appendectomy in patients with acuteappendicitis
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Background: Laparoscopic surgery for
appendicitis is now a well established and
advanced method of performing general surgical
procedures.
Objectives: To compare the outcome of
laparoscopic and open appendectomies in terms
of operative time, analgesic requirement,
postoperative complications, hospital stay, return
to normal activity and condition of scar.
Methods: This prospective study was carried
out from 1stMay 2008-1st January 2010, involving
110 patients (45 male and 65 female) with
features suggestive of acute appendicitis were
divided into 45 patients laparoscopic
appendectomy (LA) group and 65 patients open
appendectomy (OA) group, after taking informed
consent. LA was done with the

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Engineering
Flow Measurements in Open Channels Using Integrating-Floats
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The flow measurements have increased importance in the last decades due to the shortage of water resources resulting from climate changes that request high control of the available water needed for different uses. The classical technique of open channel flow measurement by the integrating-float method was needed for measuring flow in different locations when there were no available modern devices for different reasons, such as the cost of devices. So, the use of classical techniques was taken place to solve the problem. The present study examines the integrating float method and defines the parameters affecting the acceleration of floating spheres in flowing water that was analyzed using experimental measurements. The me

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Publication Date
Sat Feb 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Performance of piled raft foundations under the effect of dewatering nearby an open pit
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Abstract<p>The dewatering arrangement is required in execution works and it needs more attention due to the additional vertical settlement produced on the adjacent pile foundations. Raft foundations are being increasingly utilized for construction in cases of subsoil conditions with a high water table. Also, soil displacements in adjacent un-braced deep open pit may be a reason for high damages to the close buildings and foundations systems. The aim of this study is to examine the behaviour of piled raft foundations considering different pile locations under the effect of line drain and stage drilling of nearby open foundation pit. The line drain was used as dewatering process through the soil i</p> ... Show More
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Publication Date
Sun Nov 01 2020
Journal Name
Systematic Reviews In Pharmacy
Systematic Reviews in Pharmacy | open access Journals
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Systematic Reviews in Pharmacy is a monthly Peer-review open access Journal,different scientists involved in Pharmaceutical research and development

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Publication Date
Sat Apr 01 2023
Journal Name
Full Text Book Of Minar Congress8
REGULARITY VIA PRE- GENERALIZED OPEN SETS
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By use the notions pre-g-closedness and pre-g-openness we have generalized a class of separation axioms in topological spaces. In particular, we presented in this paper new types of regulαrities, which we named ρg­regulαrity and Sρg­regulαrity. Many results and properties of both types have been investigated and have illustrated by examples.

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Publication Date
Sat Apr 04 2020
Journal Name
Journal Of Xi'an University Of Architecture & Technology
Regularity via semi-generalized open set
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In this work the concept of semi-generalized regular topological space was introduced and studied via semi generalized open sets. Many properties and results was investigated and studied, also it was shown that the quotient space of semi-generalized regular topological space is not, in general semi-generalizedspace.

Publication Date
Sun Nov 27 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
open-source enterprise resource planning system Odoo roll in rationalizing the costs of the Ishtar Sheraton Hotel/ applied research
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The Accommodation industry in Iraq suffers from many problems, especially after 2003, when the Accommodation industry was exposed to many crises due to the security and political situation in Iraq, which negatively affected the administrative operations inside the industry and created many problems, the most important of which are deterioration, high costs and poor performance, so some hotel administrations sought To find alternative solutions that help in the advancement of hotels, one of the proposals is to go to technology, as technology is currently one of the most important solutions to solve large complex problems, as the world has turned to automation to solve complex problems such as increasing production, reducing costs, and rai

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Publication Date
Fri Dec 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Cavity preparation model in rat maxillary first molars: A pilot study
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Objective: To conduct a standardized method for cavity preparation on the palatal surface of rat maxillary molars and to introduce a standardized method for tooth correct alignment within the specimen during the wax embedding procedure to better detect cavity position within the examined slides. Materials and methods: Six male Wistar rats, aged 4-6 weeks, were used. The maxillary molars of three animals were sectioned in the frontal plane to identify the thickness of hard tissue on the palatal surface of the first molar which was (250-300µm). The end-cutting bur (with a cutting head diameter of 0.2mm) was suitable for preparing a dentinal cavity (70-80µm) depth. Cavity preparation was then performed using the same bur on the tooth

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Publication Date
Fri Dec 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Cavity preparation model in rat maxillary first molars: A pilot study
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Objective: To conduct a standardized method for cavity preparation on the palatal surface of rat maxillary molars and to introduce a standardized method for tooth correct alignment within the specimen during the wax embedding procedure to better detect cavity position within the examined slides. Materials and methods: Six male Wistar rats, aged 4-6 weeks, were used. The maxillary molars of three animals were sectioned in the frontal plane to identify the thickness of hard tissue on the palatal surface of the first molar which was (250-300µm). The end-cutting bur (with a cutting head diameter of 0.2mm) was suitable for preparing a dentinal cavity (70-80µm) depth. Cavity preparation was then performed using the same bur on the tooth surf

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