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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 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 09 2019
Journal Name
International Journal Of Drug Delivery Technology
The comparative study among the MRSAcin, Nisin A and vancomycin, on biofilm formation by Methicillin resistance Staphylococcus aureus isolated from food sources.
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Biofilms formation by pathogens microbial Control considered important in medical research because it is the hazarded virulence factor leading to becoming difficult to treat because of its high resistance to antimicrobials. Glycopeptide antibiotic a (Vancomycin) and the commercial bacteriocin (Nisin A) were used to comparative with purification bacteriocin (MRSAcin) against MRSA biofilm. One hundred food samples were collected from Baghdad markets from July 2016 to September 2016, including (cheese, yogurt, raw milk, fried meat, grilled meat, and beef burger). All samples were cultures; S. aureus was confirmation by macroscopic culture and microscopic examination, in addition to biochemical tests. Methicillin resistance S. asureus (

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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of the Interaction between the Use of the Improve Strategy in Teaching Mathematics and Achievement Levels on the Acquisition of Algebraic Concepts and Habits of Mind among Tenth Grade Students in Oman
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The current study aims to investigate the effect of the interaction between the use of the improve strategy in teaching mathematics and the level of academic achievement on the acquisition of algebraic concepts and habits of mind among tenth-grade students in Oman. The study adopted the experimental method, based on a quasi-experimental design with two groups: experimental and control groups and pre-post-measurement. The study sample consisted of (28) 10th-grade students as an experimental group and 26 of 10th-grade students as a control group in Al-Tufail bin Amr School in South Al Batinah. The differences in the pretest and posttest gains were analyzed using mean, standard deviation, ANCOVA, t-test, effect size (eta-square), and two-wa

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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Engineering
Study the Effect of Particle Sizes and Concentration on the Rheological Properties of Iraqi Bentonite for Using as Drilling Fluids
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The aim of this study is to identify the effect of particle size and to increase the concentration of Iraqi bentonite on rheological properties in order to evaluate its performance and to know if it can be used as drilling fluid without additives or not. In this study, Iraqi bentonite was carried out by mineral composition (XRD), chemical composition (XRF) and Particle size distribution (PSD), and its rheological properties were measured at different particle size and concentration. The results showed that when the particle size of Iraqi bentonite decreased, and the rheological properties were increased with increased concentration of Iraqi bentonite. Also, Iraqi bentonite was unable to use as drilling fluid without certain additives.

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Publication Date
Tue Sep 01 2015
Journal Name
Journal Of Engineering
Experimental Study on the Effect of Using Metallic Brushes on the Charging and Discharging Time of Thermal Energy Storage Unit
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Phase change materials are known to be good in use in latent heat thermal energy storage (LHTES) systems, but one of their drawbacks is the slow melting and solidification processes. So that, in this work, enhancing heat transfer of phase change material is studied experimentally for in charging and discharging processes by the addition of high thermal conductive material such as copper in the form of brushes, which were added in both PCM and air sides. The additions of brushes have been carried out with different void fractions (97%, 94% and 90%) and the effect of four different air velocities was tested. The results indicate that the minimum brush void fraction gave the maximum heat transfer in PCM and reduced the time

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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of Economics And Administrative Sciences
The impact of strategic foresight on strategic decision-making- Analytical study at the Ministry of Higher Education and Scientific Research
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Publication Date
Sun Apr 30 2017
Journal Name
Journal Of Engineering
Study the effect of microbial factor on the qualities and characteristics of Novolak composite material, reinforced glass fibers / Asbestos fibers.
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The study was reflection of the impact of the widespread use of polymer Novolak composite reinforced  Glass fiber and Asbestos fiber once again with weight fraction 60% on the physical properties, which included (Hardness, Compressive deformation, compressive modulus of elasticity, Flexural modulus of elasticity, Resilience modulus, the maximum of Flexural strength, Flexural strain energy and Shear strength inner layers); it is known how much important the media as a source of bacterial contamination, which contributes directly or indirectly in the process of aging of these materials. These Novolak composite reinforced,  prepared by weight fraction of (10%) and (14%) of the Hexamethylene-tetraamine (HMTA) hardener material. It

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Publication Date
Wed Dec 28 2022
Journal Name
Al–bahith Al–a'alami
Topics and political frameworks for the news of the Iraqi Ministry of Foreign Affairs on its website: an analytical study
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This is a descriptive study that used the survey method, it’s aimed to identify the topics and frameworks of diplomatic and political issues covered by the news of the website of the Iraqi Ministry of Foreign Affairs, through the content analysis method applied on a sample selected in a systematic random manner for news published in the year 2021. The sample included (191) news equivalent to (20%) of the total study population of (942). The study reached some results, the most important of which were as follows: The political issue, in its general sense, grabbed the most prominent attention among the various issues and events focused on by Iraqi diplomacy: "international cooperation", "bilateral cooperation", and then "regional politic

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The impact of strategic foresight on strategic decision-making- Analytical study at the Ministry of Higher Education and Scientific Research
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The current study aims at the extent of determining the interest of the Ministry of Higher Education and Scientific Research and its various departments in the process of strategic foresight, and whether this interest is reflected in its strategic decisions if the study relies on an exploratory and analytical approach and has targeted managers in the higher management within this ministry, and the questionnaire has also been used as a basic tool for collecting For data, the study population was (94), (89) questionnaires were distributed, (86) questionnaires were retrieved, and usable questionnaires amounted to (83). The sub-variable had the highest impact on strategic decision-making (intuition), as this research demonstrated the

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Grace in the Holy Quran: Objective study
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God is the source of every grace in which man lives and enjoys, and there is no one in the world told himself that created and destined and ridiculed and found out of nothing God Almighty alone.
The grace is an affliction from God Almighty, when God Almighty blesses his servant with money or children and others, the slave thinks the acceptance of God Almighty, but may be a source of affliction and scrutiny.

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