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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 Jun 14 2023
Journal Name
Al-academy
The mechanisms of the actor's work between performance and directing style in the contemporary theater show (Western) as a model
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The actor has mechanisms that were applied in the performance، as it formed a style in the theatrical form (weird)، and the researcher deliberately studied these mechanisms and divided them into four chapters.

The researcher divided it into two sections، the first is the actor's performance requirements، and the second is the boring performance methods in the directors' theater، and then the researcher concluded the second chapter with the most important indicators.

As for the third chapter، the researcher determined the society of his research and the method of selecting the sample (strange) and analyzing the sample and concluded with the most important results of the sample analysis.

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Publication Date
Mon Feb 19 2018
Journal Name
Al-academy
The Mechanisms of build up the dramatic construction in the films of the world of nature - National Geographic's films as a model-
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The subject of  research entitled "The Mechanisms of build up the dramatic construction in the films of the world of nature - National Geographic's films as a model" emerges from the importance of the subject of the dramatic construction and its departure from its classic style due to the evolution of the visual  presentation and its instruments and the specificity and emergence of a form of television production represented by the films of the world of nature which began to occupy an important space in the map of television and television channels specialized in this subject, which drove the researcher to study the mechanisms of producing the dramatic construction in this kind of film s. This research came in three  chapt

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Publication Date
Tue Jan 01 2019
Journal Name
World Journal Of Dentistry
Assessment of Implant Stability Changes and Success Rate of Narrow Dental Implants
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Aims: To assess the success rate and implant stability changes of narrow dental implants (NDIs) during the osseous healing period. Materials and methods: This prospective observational clinical study included 21 patients with narrow alveolar ridge of restricted mesiodistal interdental span who received NDIs. The alveolar ridge width was determined by the ridge mapping technique. Implant stability was measured using Periotest® M immediately after implant insertion then after 4 weeks, 8 weeks and 12 weeks postoperatively. The outcome variables were success rate and implant stability changes during the healing period. The statistical analysis included one-way analysis of variance (ANOVA) and Tukey\'s multiple comparisons test, values < 0.05 w

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Publication Date
Mon Oct 15 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY OF THE EFFECT OF MAGNETIC FIELD POLES ON THE GROWTH OF Staphylococcus AND Streptococcus ISOLATED FROM TOOTH DECAY: STUDY OF THE EFFECT OF MAGNETIC FIELD POLES ON THE GROWTH OF Staphylococcus AND Streptococcus ISOLATED FROM TOOTH DECAY
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The study aimed to determine the impact of energy for the north and south magnetic poles on the the growth of bacteria isolated from cases of tooth decay, 68 swabs were collected from surfaces of faulty tooth, the detected of Staphylococcus aureus

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Publication Date
Sat Mar 31 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study of the Performance of Paraffin Wax as a Phase Change Material in Packed Bed Thermal Energy Storage System
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The present work deals with an experimental investigation of charging and discharging processes in thermal storage system using a phase change material PCM. Paraffin wax was used as the PCM which is formed in spherical capsules and packed in a cylindrical packed column which acted as an energy storage system. Air was used as the heat transfer fluid HTF in thermal storage unit. The effect of flow rate and inlet temperature of HTF on the time of charging and discharging process were studied. The results showed that the faster storage of thermal energy can be made by high flow rate of heat transfer fluid HTF and high inlet temperature of heat transfer fluid. It was found that at 65°C HTF inlet temperature, the melting and solidification pr

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Publication Date
Mon Jan 01 2024
Journal Name
Lecture Notes In Electrical Engineering
A Study of the Influence of Steel Brushes in Rail Surface Magnetic Flux Leakage Detection Using Finite Elements Simulation
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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Illegal migration and the European Union " a perusal of securing the phenomenon"
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Abstract This study seeks to deal academically with how the EU treats clandestine immigration, through adopting a purley security approach, based on the European understanding of security threats posed to the security of communities and States in EU at all levels. So they agreed upon criminalizing this threat within the bloc while using repressive tools and steps to limit illegal immigrants flow to European territories. Accordingly, the EU gave the phenomen a security character. So it takes it from low politics level , that of employment and economic field to that of high politics, as a new security problem lying within a new security language embraced by ruling European elites, in other words EU touched on this issue as a speech act emp

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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of Sport Sciences
The school system and its relationship to the evolution of some indicators of physical and functional skills in a lesson and basketball
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Publication Date
Mon Jul 27 2015
Journal Name
Iranian Journal Of Parasitology
Abnormalities of endocytosis, phagocytosis, and development process in Dictyostelium cells that over-express Acanthamoeba castellanii metacaspase protein
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Scopus
Publication Date
Mon Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
Optimization and Prediction of Process Parameters in SPIF that Affecting on Surface Quality Using Simulated Annealing Algorithm
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Incremental sheet metal forming is a modern technique of sheet metal forming in which a uniform sheet is locally deformed during the progressive action of a forming tool. The tool movement is governed by a CNC milling machine. The tool locally deforms by this way the sheet with pure deformation stretching. In SPIF process, the research is concentrate on the development of predict models for estimate the product quality. Using simulated annealing algorithm (SAA), Surface quality in SPIF has been modeled. In the development of this predictive model, spindle speed, feed rate and step depth have been considered as model parameters. Maximum peak height (Rz) and Arithmetic mean surface roughness (Ra) are used as response parameter to assess th

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