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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 Sep 30 2024
Journal Name
The Scientific World Journal
Relationship Between the Level of Vitamin D3 Deficiency and Successful Osseointegration: A Prospective Clinical Study
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Purpose: This study aimed to evaluate the influence of vitamin D3 levels on bone density, primary dental implant stability, and successful osseointegration.

Materials and Methods: Clinical and radiological examination with a standardized cone‐beam computed tomography (CBCT) machine and laboratory investigation for serum levels of vitamin D3 were performed for all patients. Only patients in need of single or multiple straightforward dental implant surgery in either jaw with no history of systemic disease or condition that may interfere with bone healing were included in this study to receive the dental implant by the same oral and maxillofacial surgeon, which re‐opened

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Publication Date
Mon Sep 30 2024
Journal Name
The Scientific World Journal
Relationship Between the Level of Vitamin D3 Deficiency and Successful Osseointegration: A Prospective Clinical Study
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Purpose: This study aimed to evaluate the influence of vitamin D3 levels on bone density, primary dental implant stability, and successful osseointegration.

Materials and Methods: Clinical and radiological examination with a standardized cone‐beam computed tomography (CBCT) machine and laboratory investigation for serum levels of vitamin D3 were performed for all patients. Only patients in need of single or multiple straightforward dental implant surgery in either jaw with no history of systemic disease or condition that may interfere with bone healing were included in this study to receive the dental implant by the same oral and maxillofacial surgeon, which re‐opened

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Publication Date
Mon Dec 09 2019
Journal Name
Periodicals Of Engineering And Natural Sciences
The philosophy of the workplace spirituality in the third millennium organizations: A field study at the ministry of health center
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Purpose: The research aims to build an integrated knowledge framework for the basic research topic. The spirituality of the workplace is through access to the most important scientific proposals on these topics. In management thought framing, the knowledge within them in a serious attempt is to provide the appropriate answers about the intellectual dilemma of research by diagnosing the nature of the relationship with the influential elements and its historical development . Methodology: The study is relied on the analytical survey method. The research sample targeted (88) managers in the center of the Iraqi Ministry of Health exclusively from the researched senior leaders (general manager, assistant general manager, and head of department),

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Publication Date
Sun Feb 23 2020
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
The philosophy of the workplace spirituality in the third millennium organizations: A field study at the Ministry of Health Center
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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of thinking Skills in Developing Life Skills among First Year Students at Al- Bisha University
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     The aim of this research is to identify the effectiveness of thinking skills in developing the life skills of the students of the first Academic year, particularly the differences in life skills according to the variable of study specialization (human-scientific). To achieve the research objectives, the life skills scale was constructed on the classification of (WHO). The psychometric properties of the scale were examined. The validity of the scale, which is the final form of (60) items, was valid for measuring the life skills. The scale was then applied to the research sample of (112) students of the first year of the University of Bisha.  The SPSS program processed statistical analysis.  Resul

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Publication Date
Fri Dec 26 2025
Journal Name
Foro De Profesores De Ele(universitat De València)
Study of the difficulties and strategies of learning atonic pronouns in ELE teaching in Iraq
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The objective of this study is to analyze the difficulties faced by intermediate-level Iraqi students in the use of Spanish unstressed pronouns as a foreign language (ELE). Through a mixed methodology, a descriptive and explanatory analysis was conducted based on written and oral productions of B1-level students at the University of Baghdad.The results show that factors such as interference from the native language (Arabic) and English, as well as grammatical differences between Spanish and Arabic, generate difficulties in the correct use of unstressed pronouns. A contrastive teaching approach is proposed that takes advantage of students' cognitive abilities to highlight similarities and differences between both languages.This stu

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Publication Date
Fri Sep 01 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Assessing the Radiopacity of Three Resin Composite Materials Using a Digital Radiography Technique
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Background: Radiopacity is one of the prerequisites for dental materials, especially for composite restorations. It's essential for easy detection of secondary dental caries as well as observation of the radiographic interface between the materials and tooth structure. The aim of this study to assess the difference in radiopacity of different resin composites using a digital x-ray system. Materials and methods: Ten specimens (6mm diameter and 1mm thickness) of three types of composite resins (Evetric, Estelite Sigma Quick,and G-aenial) were fabricated using Teflon mold. The radiopacity was assessed using dental radiography equipment in combination with a phosphor plate digital system and a grey scale value aluminum step wedge with thickness

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Publication Date
Tue Jun 01 2021
Journal Name
Jpras Open
The utility of a novel vacuum-assisted foreign body extraction technique from wounds
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Retained soft tissue foreign bodies following injuries are frequently seen in the Emergency and Plastic Surgery practice. The patients with such presentations require a watchful and detailed clinical as- sessment to overcome the anticipant possibility of missing them. However, the diagnosis based on the clinical evaluation is usually challenging and needs to be supported by imaging modalities that are suboptimal and may fail in identifying some types of foreign bodies. Owing to that, serious complications such as chronic pain, infection, and delayed wound healing can be faced that necessitate a prompt intervention to halt those detrimental consequences. The classical method of removal is a surgical exploration which is not free of risks.

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Publication Date
Fri Sep 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Assessing The Radiopacity of Three Resin Composite Materials Using a Digital Radiography Technique
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Background: Radiopacity is one of the prerequisites for dental materials, especially for composite restorations. It's essential for easy detection of secondary dental caries as well as observation of the radiographic interface between the materials and tooth structure. The aim of this study to assess the difference in radiopacity of different resin composites using a digital x-ray system. Materials and methods: Ten specimens (6mm diameter and 1mm thickness) of three types of composite resins (Evetric, Estelite Sigma Quick,and G-aenial) were fabricated using Teflon mold. The radiopacity was assessed using dental radiography equipment in combination with a phosphor plate digital system and a grey scale value aluminum step wedge with thickness

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Publication Date
Mon Mar 15 2021
Journal Name
Egyptian Journal Of Chemistry
Assessment of follicular fluid paraoxonase activity with pregnancy outcomes in women undergoing IVF/ICSI
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