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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
Thu Nov 01 2012
Journal Name
Journal Of Craniofacial Surgery
Inferior Alveolar Nerve Injuries Associated With Mandibular Fractures
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The study evaluates the incidence of inferior alveolar nerve injuries in mandibular fractures, the duration of their recovery, and the factors associated with them. Fifty-two patients with mandibular fractures involving the ramus, angle, and body regions were included in this study; the inferior alveolar nerve was examined for neurological deficit posttraumatically using sharp/blunt differentiation method, and during the follow-up period the progression of neural recovery was assessed. The incidence of neural injury of the inferior alveolar nerve was 42.3%, comminuted and displaced linear fractures were associated with higher incidence of inferior alveolar nerve injury and prolonged recovery time, and recovery of inferior alveolar nerve fun

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Publication Date
Fri Oct 25 2024
Journal Name
The Review Of Contemporary Scientific And Academic Studies
The Representation of Men and Women in the Black and White Streams of the Second Wave of Feminism: A Corpus Stylistic Analysis
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Publication Date
Thu Dec 15 2022
Journal Name
Al-academy
The art of adornment and make-up in the ancient civilizations of Mesopotamia and the old country of Yemen as a model
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This research sheds light on those discrepancies in the use of ornaments, adornment and perfumes, as well as the art of cosmetics, in two important civilizations, namely, the Mesopotamian civilization as the earlier civilization, and the civilization of Yemen, which represents the first Arab civilization. Through the foregoing, our research includes two topics, the first topic included the history of the use of decorations, ornaments and perfumes in the civilization of Mesopotamia, while the second topic included the study of ornaments, adornment and cosmetic art in the ancient civilization of Yemen. And then the research came out with a number of conclusions that the researcher considers very important to highlight the differences and f

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Publication Date
Fri Nov 21 2025
Journal Name
Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte, Issn 1886-8576, Vol. 17, Nº. 5, 2022, Págs. 269-271
The effect of a suggested rehabilitation curriculum in the treatment of partial rupture of the gluteal muscles and strengthening the working muscles of the pelvic joint in football players
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Autorías: Imad Kadhim Khlaif, Israa Gameel Hussein, Talib Faissal Shnawa. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 5, 2022. Artículo de Revista en Dialnet.

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Publication Date
Tue Jun 30 2020
Journal Name
Membranes
Experimental and Theoretical Analysis of Lead Pb2+ and Cd2+ Retention from a Single Salt Using a Hollow Fiber PES Membrane
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The present work reports the performance of three types of polyethersulfone (PES) membrane in the removal of highly polluting and toxic lead Pb2+ and cadmium Cd2+ ions from a single salt. This study investigated the effect of operating variables, including pH, types of PES membrane, and feed concentration, on the separation process. The transport parameters and mass transfer coefficient (k) of the membranes were estimated using the combined film theory-solution-diffusion (CFSD), combined film theory-Spiegler-Kedem (CFSK), and combined film theory-finely-porous (CFFP) membrane transport models. Various parameters were used to estimate the enrichment factors, concentration polarization modulus, and Péclet number. The pH values signif

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Publication Date
Fri Sep 01 2023
Journal Name
Al-khwarizmi Engineering Journal
A Study on the Effect of Multistage Toolpath in Fabricating a Customized Cranial Implant in Incremental Sheet Metal Forming
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Incremental sheet forming (ISF) process offers a high degree of flexibility in the manufacturing of different sheet parts, which makes it an ideal candidate for prototype parts as well as efficient at fabricating various customized products at low production costs compared to traditionally used processes. However, parts produced in this process exhibit notable geometrical inaccuracy and considerable thickness reduction. In this paper, the single point incremental sheet forming variant of the process has been implemented to manufacture a highly customized cranial implant starting from the computed tomography (CT) scan data of the patient's anatomy. A methodology, from the modeling to the realization of the implant, is presented and discus

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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Capability to a chive An Effective Marketing Performance In Banks: applied Study in a sample of Iraqi Banks
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The marketing of banking service is considered to be one of the impotent fields which showed a universal inebriates . He research showed the comparison between the application of marketing in ideas and application for loot government and private Iraqi bank. The research comets of four parts; Mythology / the concept and the importance of Banking Marketing / Research applichlion/ Conelnion and  recommendation.

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Publication Date
Wed Jun 30 2021
Journal Name
College Of Islamic Sciences
the Employing Quranic studies in the social aspect: (The verses of Hudud, the limit of murder and theft as a model)
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Research Summary

Praise be to God, and may blessings and peace be upon the Messenger of God. As for:

The Noble Qur’an is the constitution of life, and a comprehensive educational approach that deals with individuals comprehensively, as it organizes worldly and eschatological life, and it is a curriculum concerned with organizing life starting with individuals and the family until the establishment of states, and from its comprehensiveness is reform, guidance and establishing boundaries. They have a disease in their hearts. They are exposed to this and are trying, by falsehood, to subjugate the Islamic world with man-made laws set by the West. Their aim is to distance people from

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Publication Date
Mon Aug 25 2014
Journal Name
Biology
Vesicular Trafficking Defects, Developmental Abnormalities, and Alterations in the Cellular Death Process Occur in Cell Lines that Over-Express Dictyostelium GTPase, Rab2, and Rab2 Mutants
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Publication Date
Thu Nov 03 2022
Journal Name
Res Militaris
Prose of Sons of Imam Ali Al-Rida (Peace Be Upon Them): A Study Regarding the Structure of the Image and Its Implications - Simile as a Model
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Praise be to God, Lord of the Worlds, and prayers and peace be upon the most honorable of creation, Muhammad, whom God sent as a mercy to the worlds, and his pure God and his faithful companions. The Islamic heritage was replete with texts issued from among the pure infallibility, which constituted a prominent teacher that takes the student to stop there in search of its goals, purposes and beauty. The choice was made from those texts that were issued by the imams of Muslims in the Abbasid era, namely Imam Muhammad al-Jawad, his son Imam Ali al-Hadi and his grandson Imam Hassan Zaki al-Askari. (Peace be upon them), and scholars have called them (sons of satisfaction), and researchers have shed light on these texts from rhetorical, artistic

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