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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 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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Sun Aug 01 2021
Journal Name
Journal Of Physics: Conference Series
EEG Motor-Imagery BCI System Based on Maximum Overlap Discrete Wavelet Transform (MODWT) and cubic SVM
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Abstract<p>Communication of the human brain with the surroundings became reality by using Brain- Computer Interface (BCI) based mechanism. Electroencephalography (EEG) being the non-invasive method has become popular for interaction with the brain. Traditionally, the devices were used for clinical applications to detect various brain diseases but with the advancement in technologies, companies like Emotiv, NeuoSky are coming up with low cost, easily portable EEG based consumer graded devices that can be used in various application domains like gaming, education etc as these devices are comfortable to wear also. This paper reviews the fields where the EEG has shown its impact and the way it has p</p> ... Show More
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Publication Date
Mon Mar 11 2019
Journal Name
Baghdad Science Journal
Developing Load Balancing for IoT - Cloud Computing Based on Advanced Firefly and Weighted Round Robin Algorithms
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The evolution of the Internet of things (IoT) led to connect billions of heterogeneous physical devices together to improve the quality of human life by collecting data from their environment. However, there is a need to store huge data in big storage and high computational capabilities.   Cloud computing can be used to store big data.  The data of IoT devices is transferred using two types of protocols: Message Queuing Telemetry Transport (MQTT) and Hypertext Transfer Protocol (HTTP). This paper aims to make a high performance and more reliable system through efficient use of resources. Thus, load balancing in cloud computing is used to dynamically distribute the workload across nodes to avoid overloading any individual r

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Publication Date
Tue Apr 30 2024
Journal Name
Iraqi Journal Of Science
Synthesis, Characterization and Antimicrobial Evaluation for New Esters Derivatives Containing Two 1, 3, 4-Oxadiazole Units
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     This work includes the synthesis of new ester compounds containing two 1,3,4-oxadiazole rings, 15a-c and 16a-c. This was done over seven steps, starting with p-acetamido-phenol 1 and 2-mercaptobenzoimidazole 2. The structure of the products was determined using FT-IR, 1H NMR, and mass spectroscopy. The evaluation of the antimicrobial activities of some prepared compounds was achieved against four types of bacteria (two types of gram-positive bacteria; Staphylococcus aureus and Bacillus subtilis, and two types of gram-negative bacteria, Pseudomonas aeruginosa and E. Coli), as well as against one types of fungus (C. albino). The results show moderate activit against the study bacteria, and the theoretical analysis of the toxi

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Sun May 01 2022
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Optical Fiber Technology
Optical fiber sensor network integrating SAC-OCDMA and cladding modified optical fiber sensors coated with nanomaterial
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Publication Date
Fri Jun 29 2018
Journal Name
Journal Of Engineering
Improving Water Use Efficiency and Water Productivity for Okra Crop by using Subsurface Water Retention Technology
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Utilizing the modern technologies in agriculture such as subsurface water retention techniques were developed to improve water storage capacities in the root zone depth. Moreover, this technique was maximizing the reduction in irrigation losses and increasing the water use efficiency. In this paper, a polyethylene membrane was installed within the root zone of okra crop through the spring growing season 2017 inside the greenhouse to improve water use efficiency and water productivity of okra crop. The research work was conducted in the field located in the north of Babylon Governorate in Sadat Al Hindiya Township seventy-eight kilometers from Baghdad city. Three treatments plots were used for the comparison using surface

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Fri Oct 20 2023
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Bmc Endocrine Disorders
Dietary caffeine intake is associated with favorable metabolic profile among apparently healthy overweight and obese individuals
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Abstract<sec> <title>Background

Recent studies have revealed some conflicting results about the health effects of caffeine. These studies are inconsistent in terms of design and population and source of consumed caffeine. In the current study, we aimed to evaluate the possible health effects of dietary caffeine intake among overweight and obese individuals.

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In this cross-sectional study, 488 apparently healthy individuals with overweight and obesity were participated. Dietary intake was assessed by a Food Frequency Questionnaire (FFQ) and

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Wed Apr 01 2020
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Knowledge and protective health behaviors concerning risk factors for coronary heart disease among baghdad university students
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Publication Date
Thu Sep 01 2022
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Iraqi Journal Of Physics
Producing Hydrogen Energy Using Cr2O3-TNFs Nanocomposite with Animal (Chitosan) Extract via Ultrasonic and Hydrothermal Techniques
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In this study, an efficient photocatalyst for dissociation of water was prepared and studied. The chromium oxide (Cr2O3) with Titanium dioxide (TiO2) nanofibers (Cr2O3-TNFs) nanocomposite with (chitosan extract) were synthesized using ecologically friendly methods such as ultrasonic and hydrothermal techniques; such TiO2 exhibits nanofibers (TNFs) shape struct

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Tue Nov 01 2016
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Renewable And Sustainable Energy Reviews
Dye-sensitised solar cells: Development, structure, operation principles, electron kinetics, characterisation, synthesis materials and natural photosensitisers
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