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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
Sat Jan 01 2022
Journal Name
The 2nd Universitas Lampung International Conference On Science, Technology, And Environment (ulicoste) 2021
Study the effect of size variation and stability on the electronic and spectroscopic properties of BN wurtzoids- diamantane nanostructure via density functional theory
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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of gender, age and tooth loss on the dimensions of incisive canal, and buccal bone anterior to the canal (Computed Tomography study)
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Background: The incisive canal is an anatomical structure with an important location in the anterior maxilla, analyzing this canal and its relation to the bone anterior to the canal is necessary during dental implant. Aim of this study is evaluated effect of gender, age and tooth loss in area of maxillary central incisors teeth on the dimensions of incisive canal and buccal bone anterior to the canal using spiral computed tomography. Materials and Methods: Sample consists of prospective study for 156 subjects for both gender, they divided into two groups, 120 dentate group (60 male and 60 female) with age ranging from (20-70) and 36 edentate group (with missing maxillary central incisors) (18 male and 18 female) with age ranging from (50-70

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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of the Financial Reporting of Liabilities and Assets of Deferred Income Tax in the quality of Accounting Information
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Abstract

The research problem Focused about extent adoption of the financial reporting obligations and assets of the deferred income tax attributable to the concepts of accounting theory and whether the tax laws or accounting principles as well as local accounting rules to recognize the obligations and assets of deferred income tax in the financial statements, and what is the impact of the financial reporting of liabilities and assets Deferred tax in the quality of accounting information, and research aims to the statement of the accounting concepts of the theory of financial reporting obligations and assets of deferred income tax, view and analyze the differences in reporting, resulting from a discrepanc

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Publication Date
Sun May 11 2025
Journal Name
Journal Of Information Systems Engineering And Management
The Effect of the Learning Mastery Strategy using Interactive Learning Techniques as a Therapeutic Method on the Achievement of Secondary School Students in Mathematics
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  The current research aims to identify the effect of the learning mastery strategy using interactive learning as a therapeutic method on the achievement of secondary school students in mathematics. To achieve the research objective, the researcher selected second-grade middle school students at Al-Haybah Intermediate School for Boys and determined his research sample, which consisted of (77) students distributed into two sections: Section (A) the experimental group, with (38) students, and Section (B) the control group, with (39) students. The statistical equivalence of the two research sample groups was confirmed in the variables (intelligence test, previous achievement, and previous knowledge test). The researchers chose the par

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Publication Date
Wed Jul 04 2012
Journal Name
مجلة العلوم التربوية والنفسية
The effect of a teaching program on oral classroom communication skills in the performance of practical education students at the College of Education, Bin Al-Haytham.
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Publication Date
Fri Dec 01 2023
Journal Name
Advances In Science And Technology Research Journal
Experimental Investigation and Fuzzy Based Prediction of Titanium Alloy Performance During Drilling Process
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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Experimental and Numerical Investigation for Simulation of Thermophysical Properties for Polypropylene 575 Polymer Melts in Single Screw Extruder
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A numerical model for Polypropylene 575 polymer melts flow along the solid conveying screw of a single screw extruder under constant heat flux using ANSYS-FLUENT 17.2 software has been conducted. The model uses the thermophysical properties such as Viscosity, thermal conductivity, Specific heat and density of polypropylene 575 that measured as a function of temperature, and residence time data for process simulation. The numerical simulation using CFD models for single screw extruder and the polymer extrusion was analysed for parameters such as (thermal conductivity, specific heat, density and viscosity) reveals a high degree of similarity to experimental data measured. The most important outcome of this study is that geometrical, parame

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Publication Date
Mon Dec 02 2024
Journal Name
Iranian Society Of Parasitology
Single Nucleotide Polymorphism of IL-18 (Rs 1946519) in Recurrent Aborted Iraqi Women and Its Association with Toxoplasmosis
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Publication Date
Fri Jul 01 2022
Journal Name
Resmilitaris
The right to property is a constitutional restriction on the work of the tax legislator
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The study aims to reach a common point that achieves a balance between two interests, which are generally in conflict with the public interest and the interest of the individual owner of private property, by extrapolating the provisions of the constitutional judiciary that include the protection of private property, and this protection extends to every right of financial value and is not limited to a specific type, but It included everything that can be estimated with money, as ownership is no longer an advantage for the owner, but rather has become a right for him and a social function. The tax is imposed on what is derived from it, but if there is a need to prejudice it, the conditions, limits and restrictions expressly stipulated in the

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The evaluation a proposed strategy for the Ministry of Planning for the years 2018-2022 .
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abstract

the research discussed a stage of strategic management. The strategic of the evaluation of the proposed strategy through feedback is to ensure that it is implemented with the least possible variation. The research aims at evaluation  a proposed strategy for the Ministry of Planning for the years 2018-2022 in line with the orientations of the state, taking into account the surrounding environmental conditions. It relies on scientific bases and steps to formulate the strategy The extent of the strategy suitability was tested through a set of statistical means and its objectivity was verified through a survey of a number of specialized experts who were selected in accordance with the principle

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