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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 Dec 29 2022
Journal Name
Journal Of The College Of Languages (jcl)
Construction Grammar in Kurdish Language: ڕێزمانی بونیادنان لە زمانی کوردیدا توێژینەوەیەکی هەڵهێنجراو(مستل)ە لەنامەی دکتۆراوە وەرگیراوە
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This research is under the title (Construction Grammar in the Kurdish language), which in turn is an attempt to present grammar and Kurdish grammar from the perspective of the constructive of Cognitive Linguistics. The construction as a term in the Kurdish language base was not recent, as it was discussed in other schools in a specific way from the perspective of language schools, but the subject of construction with a perceived background includes specific purposes, which is how to build the linguistic base by being a template accessible to its speakers, and in the cases of speaking it, not to mention how it is perceived and the level it is familiar with by its speakers. The nominal purpose of the Construction is Unification of form-mea

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Publication Date
Mon Jun 30 2025
Journal Name
Modern Sport
Visual Tracking and its Relationship to Dynamic Visual Acuity Among National Youth Foil Fencing Team Athletes
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Publication Date
Tue Sep 14 2021
Journal Name
International Journal Of Advanced Biological And Biomedical Research
Candida Berkh. (1923) Species and Their Important Secreted Aspartyl Proteinases (SAP) Genes Isolated from Diabetic Patients
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Candida Berkh. (1923) occurs naturally in the body. But it becomes opportunistic fungi, meaning that it infects humans when there is any weakening of the immune system, such as exposure to chemotherapy, diabetes, or organ transplantation. Most species of Candida grow at a temperature between 20-40 °C and have a pH of 3-8. Human pathogens of Candida species include C. albicans, C. glabrata, C. lusitaniae, C. parapsilosis, C. tropicalis and C. utili. C. albicans has many virulence factors that facilitate injury process. Virulence factors are considered as a measure of pathogenicity, and it is in the form of fungal toxins, enzymes, or cell structures that facilitate infection, as well as pathogen resistance in different conditions. This study

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Publication Date
Wed Nov 12 2025
Journal Name
Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte, Issn 1886-8576, Vol. 17, Nº. 6, 2022, Págs. 405-407
Bullying behavior and its relationship to achievement motivation for young football players under (19) years old
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Autoría: Muwafaq Obayes Khudhair. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 6, 2022. Artículo de Revista en Dialnet.

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Publication Date
Fri Jan 05 2018
Journal Name
International Journal Of Science And Research (ijsr)
Image Steganography Based on Discrete Wavelet Transform and Chaotic Map, IJSR, Call for Papers, Online Journal
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'Steganography is the science of hiding information in the cover media', a force in the context of information sec, IJSR, Call for Papers, Online Journal

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Publication Date
Mon Oct 31 2022
Journal Name
Iraqi Geological Journal
Formulating Inhibited Fluids for Stable Drilling Operations into Tanuma and Zubair Shales, Zubair Oilfield, Southern Iraq
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Tanuma and Zubair formations are known as the most problematic intervals in Zubair Oilfield, and they cause wellbore instability due to possible shale-fluid interaction. It causes a vast loss of time dealing with various downhole problems (e.g., stuck pipe) which leads to an increase in overall well cost for the consequences (e.g., fishing and sidetrack). This paper aims to test shale samples with various laboratory tests for shale evaluation and drilling muds development. Shale's physical properties are described by using a stereomicroscope and the structures are observed with Scanning Electron Microscope. The shale reactivity and behavior are analyzed by using the cation exchange capacity testing and the capillary suction test is

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Publication Date
Wed Jul 27 2022
Journal Name
Journal Of Chemical Technology &amp; Biotechnology
Broad‐ranging review: configurations, membrane types, governing equations, and influencing factors on microbial desalination cell technology
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Abstract<p>Seawater might serve as a fresh‐water supply for future generations to help meet the growing need for clean drinking water. Desalination and waste management using newer and more energy intensive processes are not viable options in the long term. Thus, an integrated and sustainable strategy is required to accomplish cost‐effective desalination via wastewater treatment. A microbial desalination cell (MDC) is a new technology that can treat wastewater, desalinate saltwater, and produce green energy simultaneously. Bio‐electrochemical oxidation of wastewater organics creates power using this method. Desalination and the creation of value‐added by‐products are expected because of this ionic mov</p> ... Show More
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Publication Date
Wed Jan 01 2020
Journal Name
Soil Science Society Of America Journal
Agroforestry, grass, biofuel crop, and row‐crop management effects on soil water dynamics for claypan landscapes
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Soil water use and water storage vary by vegetative management practices, and these practices affect land productivity and hydrologic processes. This study investigated the effects of agroforestry buffers (AB), grass buffers (GB), and biofuel crops (BC), relative to row crops (RC) on soil water use for a claypan soil in northern Missouri, USA. The experiment located at the Greenley Memorial Research Center included RC, AB, GB, and BC established in 1991, 1997, 1997, and 2012, respectively. Soil water reflectometer sensors installed at 5‐, 10‐, 20‐, and 40‐cm depths monitored soil water from April to November in 2017 and 2018. Results showed significant differences in weekly volumetric water content (VWC) among treatments for all fou

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Publication Date
Tue Oct 01 2019
Journal Name
Comparative Immunology, Microbiology And Infectious Diseases
Zataria Multiflora bois as an auspicious therapeutic approach against Echinococcus granulosus: Current status and future perspectives
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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Comparison between Linear and Non-linear ANN Models for Predicting Water Quality Parameters at Tigris River
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In this research, Artificial Neural Networks (ANNs) technique was applied in an attempt to predict the water levels and some of the water quality parameters at Tigris River in Wasit Government for five different sites. These predictions are useful in the planning, management, evaluation of the water resources in the area. Spatial data along a river system or area at different locations in a catchment area usually have missing measurements, hence an accurate prediction. model to fill these missing values is essential.
The selected sites for water quality data prediction were Sewera, Numania , Kut u/s, Kut d/s, Garaf observation sites. In these five sites models were built for prediction of the water level and water quality parameters.

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