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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
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The Experience of Disabled Female Students at Academic Study in Saudi Universities
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The current study aims to examine the experience of female students with disabilities who studying in university in kingdom of Saudi Arabia. To this end, the researcher used semi-structured interview as an instrument to collect the study data which regards as one of the descriptive approach tools. The sample comprised (12) disabled-female students from multidiscipline within both college of arts and college of education. To analyze the collected data, the author utilized a thematic analysis method following six steps as stated by (Braun and Clark, 2006). The findings revealed that disabled students have a high self-confidence which push them forward to take part in activities that hold on campus. Besides, significant variation were shown

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Publication Date
Fri Dec 15 2023
Journal Name
Al-academy
The Aesthetics of Lumia Art in Contemporary Textile Arts, An Analytical Study
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The research (The Aesthetics of Lumia Art in Contemporary Textile Arts: An Analytical Study) included four chapters, the first to explain the research problem summarized by the question: Does the art of Lumia achieve aesthetic values in contemporary textile arts?, and aims to: Identify the aesthetics of Lumia art and its applied uses in contemporary textile arts, within the time period (2013-2022). The third chapter included: research procedures and sample analysis (4) models according to the descriptive analytical approach, and the fourth chapter dealt with: results, conclusions and recommendations as well as sources.

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Publication Date
Sat Jun 01 2019
Journal Name
Prensa Medica Argentina
The effect of niclosamide in acetic-acid induce colitis: An experimental study
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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
ORGANIZATIONAL ENERGY ITS ROLE IN THE RELIABILITY OF MANAGEMENT STRATEGIES (APPLIED STUDY)
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     This aims tackles the importance of the organizational energy of the hotel organizations that search the success in the business field to penetrate in the whole tourist markets, and to draw the policies and firm rules which must be framed with the administrative strategies that contributed in creativity and achievement the targets besides provide a future vision due to its position among the competitive henceforth achieving the activity. This is what the chapters tackle in the theoretical side. Also many general questions have been arisen to determinate the importance of the research and many other special questions that express the problem of the study. To limit the levels of study alter

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Publication Date
Tue Mar 01 2016
Journal Name
Al-academy
Harmonization formative in the design of interior spaces Hall of discussions in the design department (a model): بدريا محمد حسن فرج
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Can not reach a comprehensive concept for interior design through the use of Harmonization term according transformations experienced by the terms of the variables associated with the backlog of cultures that characterize concepts according to the nature of the users of the spaces in the design output, which necessitates the meaning of the combination of knowledge, art, science, such as the type of perceptions design the Harmonization cognitive science with art to create products of the use of design configurations that help the designer to put such a product within the reality and like the fact that reliable, as well as the rational knowledge tend somehow to the objective specifically in facilitating the substance subject to perceptible

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Publication Date
Mon Feb 06 2023
Journal Name
Journal Of Toxicology
Zinc Chloride Can Mitigate the Alterations in Metallothionein and Some Apoptotic Proteins Induced by Cadmium Chloride in Mice Hepatocytes: A Histological and Immunohistochemical Study
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The heavy metal cadmium is extremely harmful to both humans and animals. Zinc supplementation protects the biological system and reduces cadmium-induced toxicity. This study aimed to determine whether zinc chloride (ZnCl2) could protect male mice with the damaged liver induced by cadmium chloride (CdCl2). The protective role of zinc chloride and expression of the metallothionein (MT), Ki-67, and Bcl-2 apoptotic proteins in hepatocytes were studied after subchronic exposure of mice to cadmium chloride for 21 days. Thirty male mice were randomly categorized into 6 groups (5 mice/group) as follows: a control group that did not receive any treatment, a group given ZnCl2 at 10 mg/kg alone, and two groups received ZnCl2 (10 mg/kg) i

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Publication Date
Thu Jun 30 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY OF SOME GROWTH CRITERIA AND YIELD OF SOYBEAN CROP WITH THE EFFECT OF BORON AND SOME GROWTH REGULATORS: STUDY OF SOME GROWTH CRITERIA AND YIELD OF SOYBEAN CROP WITH THE EFFECT OF BORON AND SOME GROWTH REGULATORS
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The study was conducted at research station A, department of field crops, college of agricultural engineering sciences, university of Baghdad during summer 2021 to evaluate the effect of boron and some growth regulators on some growth criteria and yield of soybean crop (cv. shimaa). The experiment  was carried out according to split plots by using randomized complete block design with three replications. The main plots included three concentrations of boron (75, 150 and 225) mg.L-1, the sub-plots included three levels of growth regulators, spraying kinetin (100 mg. L-1), spraying ethrel (200 mg.L-1) and spraying kinetin (100 mg.L-1) + spraying ethrel (200 mg.L-1) as

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Publication Date
Fri Oct 02 2020
Journal Name
International Development Planning Review
COMPARISON OF THE PERFORMANCE OF THE FOREHANDKICK (STRAIGHT AND ACCOMPANIED BY FORWARD ROTATION) IN TERMS OF ACCURACY AND SPEED AMONG THE PLAYERS OF THE NATIONAL TEAM (ADVANCED CATEGORY) IN TENNIS
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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
COMPARISON OF THE PERFORMANCE OF THE FOREHANDKICK (STRAIGHT AND ACCOMPANIED BY FORWARD ROTATION) IN TERMS OF ACCURACY AND SPEED AMONG THE PLAYERS OF THE NATIONAL TEAM (ADVANCED CATEGORY) IN TENNIS
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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
COMPARISON OF THE PERFORMANCE OF THE FOREHANDKICK (STRAIGHT AND ACCOMPANIED BY FORWARD ROTATION) IN TERMS OF ACCURACY AND SPEED AMONG THE PLAYERS OF THE NATIONAL TEAM (ADVANCED CATEGORY) IN TENNIS
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