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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 Mar 20 2023
Journal Name
Liquid Crystals
Synthesis and study the mesomorphic behaviour of some new 1,3,4-thiadiazoline derivatives
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Investigation of mesomorphic properties of new 1,3,4-thiadiazolines (which are synthesised via many steps in Scheme 1) was carried out in this study. These compounds are designed to have a heterocyclic unit, a carboxylate linkage group and a polar ether chain at the end of the molecule adjacent to the benzene ring, which enhance the dipolar interactions forces (varied from one to eight carbons) to investigate the association properties of their phases. The structure of the target compounds and the intermediates were confirmed by 1H NMR, 13C NMR, mass and FTIR spectral techniques. Polarised microscopic studies revealed that all the compounds in the series exhibited enantiotropic liquid crystalline properties. This was further confirmed using

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Indication of body overtones and movements at The Holy Quran (Descriptive study)
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That communication between people is not only through speech but includes other images of the most important body inspiration. And that the Koran worked on the diversity of ways in which the meanings of the hearer and did not stop at the limit of speech, but included situations where the use of body inspiration and indicate its importance in communication. However, signals and organ movements play a major role in the process of communication between people. Facial and hands movements play an important role in the communication process as they are a tool for communicating ideas to others.

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Publication Date
Sun Jun 30 2024
Journal Name
Anbar Journal Of Agricultural Sciences
TEST AND STUDY THE WORK EFFICIENCY OF LOCALLY MANUFACTURED PALM SERVICE EQUIPMENT
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A hydraulic platform was manufactured to serve palm trees and to enhance palm tree services, with a height of 12 meters, by the General Company for Hydraulic Industries, one of the Ministry of Industry's formations. This platform was tested in the field after being manufactured according to a randomized complete block design using split-split plots with three factors. The first factor represented the shape of the orchard land, with two levels (flat land and uneven land), serving as the main plots. The second factor had three levels representing palm tree heights (4, 8, and 12 meters), which served as the sub-plots. The third factor was the palm tree services, represented at three levels (pruning, pollination, and harvesting), with each trea

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Publication Date
Wed Nov 03 2021
Journal Name
International Journal Of Energy Research
Simulation and experimentation study on the performance of metal hydride storage vessels
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Publication Date
Mon Jan 01 2018
Journal Name
Aip Conference Proceedings
The study of behavior titanium pure commercially coated with hydroxyapatite and zirconia
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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effects of different concentrations of Alum solutions on Mutans streptococci (in vitro study)
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Background: Alum has been used as a treatment medication in cases of oral and gingival ulcers, and also as antiseptic mouthwash. This study aimed to examine the effects of different concentrations of Alum on inhibition zone, viability counts and adherence ability of Mutans streptococci compared with deionized water and chlorhexidine gluconate in vitro. Materials and methods: The study dealt with an in vitro study to establish a concentration of Alum mouthrinse that would have the minimum inhibitory concentration and minimum bacteriocidal concentration. The second part evaluated the anti-adherence ability of the experimental agents. Results: This study found that the antibacterial effect of Alum increases with its concentration from 50 to 1

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Publication Date
Sat Nov 22 2025
Journal Name
Iraqi Journal Of Embryos And Infertility Researches
Study of Interleukin-6 (IL-6) Profile in the Seminal Fluid of Oligozoospermia Men
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Publication Date
Thu Dec 26 2019
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
ANATOMICAL STUDY OF SOME SPECIES BELONGING TO THE PAPAVERACEAE FAMILY IN NORTH OF IRAQ
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    The anatomical features of leaves and stems of seven species belonging to five genera of the Papaveraceae family were studied, including: Fumaria bracteosa Pomel, 1875; Glaucium grandiflorum Boissier & A. Huet,1856; Hypecoum pendulum Linnaeus, 1753; Papaver fugax Poiret,1804; Papaver macrostomum Boissier & A. Huet, 1867; Papaver rhoeas Linnaeus, 1753 and Roemeria refracta de Candolle,1821. The results showed that the anticlinal cell walls of the adaxial surface were more thickened in P. fugax, H. pendulum, P. macrostomum and R.refracta, while it was thin in P. rhoeas. The cur

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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of the effect of ER: YAG laser on apical microleakage (in vitro study)
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Background: Apicoectomy and retrograde filling is indicated when conventional endodontic treatment is impossible or failed to achieve apical seal. The aim of this study was to evaluate the effect of ER: YAG laser on apical microleakage. Materials and Methods: Sixty extracted single-rooted teeth were used in this study. The roots were divided into six groups. Group 1: apicoectomy by fissure bur, and apical cavities prepared by round bur, then cavities were filled with MTA. Group 2: the roots preparations and fillings were the same as group 1, then the apical areas were treated by Er:YAG Laser. Group 3: apicoectomy by fissure bur, and apical cavities prepared by ultrasound retrotip and cavities were filled with MTA. Group 4: the roots prepara

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Publication Date
Sat Jan 07 2023
Journal Name
Transportation Infrastructure Geotechnology
Numerical Study of the Seismic Response of Closed-Ended Pipe Pile in Cohesionless Soils
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