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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
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
The Reality of Alternative Assessment for Teachers of the First Cycle of the Basic Education in the Sultanate of Oman: Use, Self-Efficacy, and Attitude
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This study aims at identifying the reality of alternative assessment for teachers of the first cycle of the basic education in the Sultanate of Oman with respect to the degree of teachers' use of alternative assessment strategies, level of self-efficacy for alternative assessment strategies, and attitude towards alternative assessment, and their relationship with other variables. To achieve the aims of the study, a descriptive research approach was utilized. A 5-point self-rated questionnaire was developed. It consists of three sections: Actual use of alternative assessment strategies (21 items), self-efficacy for alternative assessment strategies (21 items), and attitude towards alternative assessment (27 items). The psychometric proper

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Publication Date
Thu Jun 20 2030
Journal Name
Al-kindy College Medical Journal
The Functional Results of Surgical Percutaneous Joystick Reduction Therapy for Isolated Severely Angulated Radial Neck Fracture in Children
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Background: Radial neck fractures in children account for 5 to 10% of all elbow fractures in children. They are extra-articular fractures of the radius proximal to the bicipital tuberosity. The physis is typically involved as a Salter-Harris I or II pattern. Alternatively, the fracture sometimes is extraphyseal, through the metaphysis. In children there is considerable potential for remodeling after these fractures. Up to 30° of radial head tilt and up to 3 mm of transverse displacement are acceptable. Many modalities of treatment are available regarding Surgical &Non-Surgical treatments. Objectives: To evaluate the functional outcome after surgical percutaneous joystick reduction therapy of severely angulated radial neck fracture i

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Publication Date
Fri Jul 24 2020
Journal Name
Al-kindy College Medical Journal
The Functional Results of Surgical Percutaneous Joystick Reduction Therapy for Isolated Severely Angulated Radial Neck Fracture in Children
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Background: Radial neck fractures in children account for 5 to 10% of all elbow fractures in children. They are extra-articular fractures of the radius proximal to the bicipital tuberosity. The physis is typically involved as a Salter-Harris I or II pattern. Alternatively, the fracture sometimes is extraphyseal, through the metaphysis. In children there is considerable potential for remodeling after these fractures. Up to 30° of radial head tilt and up to 3 mm of transverse displacement are acceptable. Many modalities of treatment are available regarding Surgical &Non-Surgical treatments. Objectives: To evaluate the functional outcome after surgical percutaneous joystick reduction therapy of severely angulated radial neck fracture i

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Publication Date
Sun Jul 17 2022
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Clinical Characteristics and Antibiotics Sensitivity of Culture Positive Typhoid Fever Patients in Baghdad Teaching Hospital - A Single Center Study
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BACKGROUND: Enteric fever caused by Salmonella Typhi is an endemic disease in Iraq. Variations in presentations make it a diagnostic challenge. If untreated or treated inappropriately then it is a serious disease with potentially life-threatening complications. The recent emergence of drug resistant strains of S. Typhi is a rising public health problem and a clinical concern to the physician. AIM: The objectives of the study were to assess and describe the patterns of antimicrobial resistance, clinical characteristics, epidemiological distribution, and complications of typhoid fever. PATIENTS AND METHODS: Fifty cases of typhoid fever (culture proven) were collected during the period from February 2019 to November 2019 in the me

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Publication Date
Mon Jan 01 2024
Journal Name
Optical Materials
Design and analysis of a high sensitivity open microchannel PCF-based surface plasmon resonance refractometric sensor
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Publication Date
Sun Jan 04 2015
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Instrumental Enrichment in the Acquisition of Geographical Concepts for First Grade Student in Intermediate school
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The present study aims at knowing the effect of instrumental enrichment in the acquisition of geographical concepts for first grade student in intermediate school. The study is restricted in the students of first grade student in intermediate school\ The EducationalDirectorate of Rusafa for academic (2013/2014),for the purpose of achieving the objective, the following hypotheses:

There is no statistical significant different at the level of (0.5) between the scores of the experimental group  who study geography according to the instrumental enrichment and the scores of the control group who learned geographical according to the traditional methods.

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Publication Date
Sun Jul 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The effect of constructivist model of yager in acquiring the geographical concepts among first intermediate students in geography
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The purpose of the study is to investigate the effect of the constructivist model of yager in acquiring the geographical concepts among first intermediate students in geography. The study was carried on based on the null hypothesis, which states, there is no significant difference at the level of (0.05) between the experimental group that follows yager model in learning the principles of geography, and the control group that studies the same subject considering the traditional methods of learning, the. To do so, a sample of (70) first-intermediate student were chosen purposefully from two random class for the academic year (2016-2017) divided into two groups. The selected schools located at Al-rusafa side in the city of Baghdad, as well

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Publication Date
Mon Sep 30 2024
Journal Name
Medical Journal Of Babylon
Effectiveness of Deep Breathing Technique on Pain Level of School Children during Catheterization
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Publication Date
Thu Jun 02 2016
Journal Name
مجلة العلوم التربوية والنفسية
The effect of the K.W.L.Plus strategy in developing the mental skills and reflective thinking of first-year middle school female students
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Publication Date
Sun Jan 01 2017
Journal Name
Journal Of Clinical And Diagnostic Research
Treatment of Fistula-In-Ano with Tight (Cutting) Seton: Analysis of Outcomes and Efficacy Assessment
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