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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
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Woman’s Identity Crisis in the Clash of Cultures: A Study of Betool Khedairi’s Novel: A Sky So close
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This paper is an attempt to clarify the impact of Postcolonialism, one of the most
challenging fields of study that has emerged in recent years, on representations of women in
once-colonised countries and in Western locations. It discusses the influence of cultural
differences on the status and identity of a woman who experience ‗multiculturalism‘. The
study is an analytical reading of a contemporary novel written by the Iraqi writer Betool Al-
Kudairi. The emphasis lies on the clash between two different cultures and traditions
represented by the British mother and the Iraqi father and its effect on the life and identity of
the protagonist. The main focus is on idea of ‗hybrid identity‘ and the absence of th

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Publication Date
Thu Jun 01 2023
Journal Name
Measurement: Sensors
Improved airborne computer system strategy for swarm drones flying based on skybrush suite and inspired technique
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Publication Date
Sat Dec 31 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
RELATIONSHIP OF LHX3 GENE POLYMORPHISM TO FERTILITY RATE IN LOCAL AND SHAMI GOATS: RELATIONSHIP OF LHX3 GENE POLYMORPHISM TO FERTILITY RATE IN LOCAL AND SHAMI GOATS
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ABSTRACT

The study was conducted at the ruminant research station of the general commission for agricultural research/Ministry of Agriculture, as well as the laboratory of genetic resources of the department of livestock/Ministry of Agriculture and the laboratory of the college of agriculture engineering science, with the aim of determine the genotypic of the expression region (intron 2 and part of exon 3) of the LHX3 gene And its relationship to the fertility rate in local and Shami goats. For this purpose, the RFLP technique was used, and the percentages of genotypes for the LHX3 gene in the local goat sample were 29.17, 50.00, 20.83 for the TT, AT, and AA genotypes, respectively, while in the Shami goa

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Publication Date
Sun Nov 01 2020
Journal Name
The International Journal Of Oral &amp; Maxillofacial Implants
Early Failure Rate and Associated Risk Factors for Dental Implants Placed With and Without Maxillary Sinus Augmentation: A Retrospective Study
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Publication Date
Sat Jul 01 2023
Journal Name
International Journal Of Research In Management
The role of network marketing for the Iraqi cement company in improving entrepreneurial behavior (An exploratory study of the opinions of a sample of company leaders)
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Publication Date
Wed Sep 21 2022
Journal Name
Journal Of Planner And Development
The effect of technology on achieving contemporary levels in the space of Arab Islamic architecture “Mosques is a case study”
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Arab-Islamic architecture has undergone a change at multiple levels affected by modern technology, so the research sought to address the role of contemporary technologies on a fundamental and fundamental component of architecture, which is the architectural space, what is known as the essence of architecture and its ultimate destination, with a focus on the architectural space in the architecture of the contemporary Arab Islamic mosque, because the mosque’s architecture is so important in Islamic law and the belief of the Muslim person himself, where the mosque is the functional style produced by the Islamic faith and embodied in it, whereas, knowing the levels of influence of contemporary technologies in the architectural spac

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Publication Date
Tue Jun 30 2020
Journal Name
Kuwait International Law School Journal
The Duration of the Contract – A Study in Light of French Decree No. 131-2016 Issued on February 10, 2016
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After the Napoleonic Code of 1804 came without any legal rules specific to the duration of the contract, and was content to refer to it in scattered legal texts, Legislative Decree No. 2016-131 came to establish a comprehensive legal system for the duration of the contract, starting from the period of its formation, through the period of its implementation, and ending with its continuation after the expiration of its term, in the third section of the fourth chapter related to the effects of the contract (Articles 1210 - 1215), relying on judicial precedents on the one hand - which are many, as will be shown through the research pages - and contractual practices on the other hand. Perhaps the main motive that prompted the French legislator t

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Publication Date
Thu Feb 19 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An Evaluation of the Efficacy of Different Gingival Retraction Materials on the Gingival Tissue Displacement (A Comparative In Vivo Study)
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Background: An accurate adaptation of the crown to the finish line is essential to minimize cement dissolution and to preserve periodontium in fixed partial denture cases. An accurate adaptation of crown is possible only when preparation details are captured adequately in the impression and transferred to cast. For these reasons, gingival displacement is necessary to capture subgingival preparation details.The aim of the present study is to measure in vivo the horizontal displacement of the gingival sulcus obtained by using three new cordless retraction materials (Magic Foam Cord®, Racegel and Astringent Retraction Paste) in comparison to medicated retraction cord. Materials and method: Thirty-two patients requiring porcelain fused to me

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Publication Date
Fri Jan 01 2021
Journal Name
Annals Of Maxillofacial Surgery
The use of screw retained hybrid arch bar for maxillomandibular fixation in the treatment of mandibular fractures: A comparative study
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Introduction: The use of screw-retained hybrid arch bars (HABs) is a relatively recent development in the treatment of mandibular fractures. The purpose of this study is to compare the clinical outcome between HAB and the conventional Erich arch bar (EAB) in the closed treatment of mandibular fractures. Materials and methods: This study included 18 patients who were treated for mandibular fractures with maxillomandibular fixation (MMF), patients were randomly assigned into a control group (n = 10) in which EAB was used and study group (n = 8) in which HAB was used. The outcome variables were time required for application and removal, gingival inflammation scores, postoperative complications, and incidence of wire-stick injury or gloves perf

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Publication Date
Mon Jan 01 2018
Journal Name
Aip Conference Proceedings
Theoretical study of electronic transfer current rate at dye-sensitized solar cells
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