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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 Oct 07 2020
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Association Between Carbamazepine Toxicity, Liver Bile Duct Injury, Granuloma and Inflammatory Cells Infiltration in Female Mice
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The liver is an important organ in the body that can be affected by many drugs and toxins. The hepatotoxins can cause oxidant stress that lead to activation of inflammatory cells and cause liver damage. Drug induced bile duct injuries are related to drug toxicity, multiple drugs have been known to cause the development of liver granulomas. Carbamazepine (CBZ) among other antiepileptic drugs is believed to cause hepatic injury. In this study we investigated the effect of (CBZ) 20mg/kg/day on female mice liver after 14 and 30 days of treatment. The histological findings showed that (CBZ) can cause histological alterations in the liver components such as bile duct proliferation, biliary hypertrophy, ductopenia, inflammatory cells infiltration

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Publication Date
Sat Jan 31 2015
Journal Name
International Journal Of Advanced Research
BK polyomavirus and Cytomegalovirus Co-infections in renal transplant recipients: a single center study
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Background: Opportunistic viral infections make an important threat to renal transplantation recipients (RTRs), and with the use of more intense newly-developed immunosuppressive drugs; the risk of renal allograft loss due to reactivation of these viruses has increased considerably. At the top priority of these viruses lie BK polyomavirus (BKV) and human cytomegalovirus (CMV). Reactivation of these viruses in these chronically immunosuppressed RTRs can lead to renal impairment and subsequently allograft loss, unless early detected and properly treated. Objectives: The study aimed to detect and quantify plasma viral load of BKV and CMV in RTRs using quantitative real time PCR (qRT-PCR), in order to study the prevalence of these two viruses i

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Publication Date
Sat Dec 31 2022
Journal Name
Mathematical Modelling Of Engineering Problems
Experimental and Numerical Study of Open Channel Flow with T-Section Artificial Bed Roughness
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Experimental and numerical studies have been conducted on the effects of bed roughness elements such as cubic and T-section elements that are regularly half-channel arrayed on one side of the river on turbulent flow characteristics and bed erosion downstream of the roughness elements. The experimental study has been done for two types of bed roughness elements (cubic and T-section shape) to study the effect of these elements on the velocity profile downstream the elements with respect to different water flow discharges and water depths. A comparison between the cubic and T-section artificial bed roughness showed that the velocity profile downstream the T-section increased in smooth side from the river and decrease in the rough side

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Publication Date
Fri Mar 29 2024
Journal Name
Surgical Neurology International
Enhancing neuro-ophthalmic surgical education: The role of neuroanatomy and 3D digital technologies – An overview
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Background:

Neuro-ophthalmology, bridging neurology and ophthalmology, highlights the nervous system’s crucial role in vision, encompassing afferent and efferent pathways. The evolution of this field has emphasized the importance of neuroanatomy for precise surgical interventions, presenting educational challenges in blending complex anatomical knowledge with surgical skills. This review examines the interplay between neuroanatomy and surgical practices in neuro-ophthalmology, aiming to identify educational gaps and suggest improvements.

Methods:

A literature search across databases such as PubMed, Scopus, and W

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
A Study of the Structural and Optical Properties of SnS:F prepared by chemical spray pyrolysis technique
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Thin films of pure tin mono-sulfide SnS and tin mono-sulfide for (1,2,3,4)% fluorine SnS:F with Thicknesses of (0.85 ±0.05) ?m and (0.45±0.05) ?m respectively were prepared by chemical spray pyrolysis technique. the effect of doping of F on structural and optical properties has been studied. X-Ray diffraction analysis showed that the prepared films were polycrystalline with orthorhombic structure. It was found that doping increased the intensity of diffraction peaks. Optical properties of all samples were studied by recording the absorption and transmission spectrum in range of wave lengths (300-900) nm. The optical energy gap for direct forbidden transi

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Oral Medicine And Oral Surgery
Reliability of two difficulty indexes in predicting the surgical extraction difficulty of impacted mandibular third molars
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Introduction: The aim of this study was to compare the reliability and the agreement of the Pederson and Pernambuco difficulty indexes in predicting the surgical extraction difficulty of the impacted mandibular third molars. Materials and methods: A prospective observational cohort study was conducted on 83 patients who had undergone surgical removal of impacted mandibular third molar. The difficulty of extraction was determined preoperatively according to the total scores obtained from the Pederson and Pernambuco difficulty indexes, the operative difficulty was determined by the surgical technique and the duration of extraction. The accuracy of prediction of the surgical difficulty and

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Publication Date
Wed Feb 01 2023
Journal Name
32nd Annual Meeting North American Skull Base Society
Surgical Reexploration of a Cerebral Arteriovenous Malformation Remnant: Literature Review and Illustrative Case
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Publication Date
Tue Jan 09 2018
Journal Name
International Journal Of Medical Research & Health Sciences
Assessing the Period between Diagnosis of Breast Cancer and Surgical Treatment among Mastectomized Female Patients in Iraq
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Introduction: Breast cancer is the most common cancer and the major cause of cancer related deaths among Iraqi women. Due to the relatively late detection of breast cancer, the majority of the patients are still treated by modified radicle mastectomy. Aim: To assess the time lag between diagnosis of breast cancer and mastectomy among Iraqi patients; correlating the findings with other clinicopathological characteristics of the disease. Patients and methods: This retrospective study enrolled 226 Iraqi female patients who were diagnosed with breast cancer. Data were registered on the exact time period between signing the histopathological report and the surgical treatment. Other recorded variables included the age of the patients, their level

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Publication Date
Mon Jul 01 2019
Journal Name
International Journal Of Medical Research & Health Sciences
Assessing the Period between Diagnosis of Breast Cancer and Surgical Treatment among Mastectomized Female Patients in Iraq
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Introduction: Breast cancer is the most common cancer and the major cause of cancer related deaths among Iraqi women. Due to the relatively late detection of breast cancer, the majority of the patients are still treated by modified radicle mastectomy. Aim: To assess the time lag between diagnosis of breast cancer and mastectomy among Iraqi patients; correlating the findings with other clinicopathological characteristics of the disease. Patients and methods: This retrospective study enrolled 226 Iraqi female patients who were diagnosed with breast cancer. Data were registered on the exact time period between signing the histopathological report and the surgical treatment. Other recorded variables included the age of the patients, their level

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Publication Date
Mon Jun 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Use of lower squares and restricted boxes In the estimation of the first-order self-regression parameter AR (1) (simulation study)
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Use of lower squares and restricted boxes
In the estimation of the first-order self-regression parameter
AR (1) (simulation study)

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