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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
Fri Jan 15 2021
Journal Name
Plant Archives
STUDY OF THE EFFECT OF SPEED, DEPTH OF THE CULTIVATION AND THE NUMBER OF TIMES THE SPRING – LOADED CULTIVATOR PASSES ON SOME TECHNICAL PARAMETERS OF THE CULTIVATOR AND ON WEED CONTRO
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Publication Date
Tue Jan 01 2019
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees19gr
Study of the effect of using nanomaterial in radiological shielding
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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Legalization of political parties Study in the law of parties
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The political parties are considered to be the basic infrastructure in the political process for their great role in achieving the political movement in the country and to work on implementing the goals and interests of its voters in the event of their coming to power. If the parties that totalitarianism led to monopoly and monopolization, We can not talk in these countries about the liberal concept of the party and can not talk about the existence of a law or laws and regulations governing and regulate the work of parties. But on the other hand, which is represented by the liberal state, we find a lot of talk and practice about the form and nature of the legitimate law in regulating the formation of parties and their work in a manner th

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Publication Date
Sun Mar 06 2016
Journal Name
Baghdad Science Journal
Isolation and Purification of a Cyclooxygenase-2 from the Blood of a Patient Suffering from Rheumatoid Arthritis and Studying the Effect of Natural Products of the Soapwort on the Activity of Purified Enzyme
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In this paper to isolate and study the properties of the cyclooxygenase-2 (EC: 1.14.99.1) enzyme in the blood of a patient suffering from rheumatoid arthritis and study the effect of natural products of the Soapwort on the activity of purified enzyme. The study involves taking 30 ml of blood from an adult woman 40 years old, who suffers from rheumatoid arthritis disease for 13 years. Serum is separated and subjected to a series of purification processes including: precipitation by ammonium sulfate, filtration by centrifugation radiator, dialysis in presence of ammonium bicarbonate, separation using the technology of ion exchange, lipholization and then estimating approximate molecular weight of the enzyme using gel filtration techni

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Publication Date
Wed Jan 04 2017
Journal Name
Iraqi Journal Of Science
Histological study of the Isotretinoin drug effect on the intrauterine prenatal development in the pregnant mice
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Publication Date
Wed Feb 01 2023
Journal Name
South Asian Journal Of Social Sciences And Humanities
The Impact of the Sustainable Strategy on Strategic Performance: Field Study in the Iraqi Tourism Sector
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The tourism industry, with its two sides (recreational and religious), is one of the important investment fields in Iraq, it is represented Iraq as the second economic source after the oil sector. So a need for serious efforts to develop the tourism sector and maintain its sustainability. This paper will be one of the important contributions in this field; the paper aims to explore the extent of the impact of the sustainable strategy on the level of overall performance in the Iraqi tourism sector. The field of research was some Iraqi tourist institutions at Iraqi tourism, Which covers the field of study on the one side, and can be studied on the other side, for the developing study methodology and organizing its main parts, the research pap

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Measuring The Level of Complexity In The Process University – Case Study At The Southern Technical University.
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    Complexity is the inherent characteristic of contemporary organizations. It is characterized by the intertwining and expansion of its relations, by the severe disorder and rapid change in its environment, which makes it suffer from a state of uncertainty in determining the direction of its future or the assessment of the rules governing its paths. All organizations tend to evolve with increasing sophistication, And to take measures that contribute to the simplification of the system as it moves towards complexity, allowing the administration to easily control its movement and directions, and the problem of complexity in the university is based on the entanglement and overlap in the goals and processes betwe

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Publication Date
Mon Dec 30 2019
Journal Name
College Of Islamic Sciences
Among the hadiths of righteous deeds mentioned in the expiation of sins -An analytical study-
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The almighty Al-Bari imposed on Muslims easy and accessible worshipers for every individual who is eligible to commission, so whoever performed it rightfully, God rewarded it with the best reward. From the Muslim, the Almighty made the Almighty to the types of acts of worship and acts of righteousness as a reason for the remission of sins that were advanced and late, so I chose a topic (from the hadiths of righteous deeds mentioned in the atonement of sins) as a research drawn from the master’s thesis called (the hadiths of the atoners of sins that were presented and delayed - An analytical study- ), And collect in this research kinds of acts of righteousness that bring the mercy of God Almighty to His servants and be a reason for the

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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
The effect of uncertainty in adopting the general requirements of strategic environmental assessment /exploratory study
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Abstract                                                                  

The aim of the research is to demonstrate the role of uncertainty in adopting the general requirements for the strategic environmental assessment of service departments in Babil Governorate and the Environment Department. By focusing on a range of environmental problems, despite the efforts exerted to deal with the environme

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
The concept of violence in political thought (Theoretical study, compared with the concept of terrorism)
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The researcher of human history finds that the first social relations on earth were represented by the violence of Adam, peace be upon him, Cain and Abel. Violence has been a phenomenon of life and society. The history of history is full of all forms of violence and its forms. It speaks of cruelty, oppression and states. History began, in some of its chapters, written with the blood of the victims. It is a testimony to the cruelty of human beings. His human nature and his sin have played a major role that can not be overlooked in the development of important and fundamental developments in some historical turning points where violence was a necessity for life, and its launching change, renewal and reform, and major revolutions in human h

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