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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
Tue Oct 25 2022
Journal Name
Vi. International Scientific Congress Of Pure, Applied And Technological Sciences
Study the effect of adding alcoholic and aqueous extract of turmeric to processed chees as natural antioxidant and in improving its physicochemical properties
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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
EVALUATING THE EFFECTIVE CREATIVE LEADERSHIP ROLE OF THE DEAN AND HEADS OF SCIENTIFIC DEPARTMENTS IN THE COLLEGE OF PHYSICAL EDUCATION AND SPORTS SCIENCES AL-MUSTANSIRIYAUNIVERSITY
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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
EVALUATING THE EFFECTIVE CREATIVE LEADERSHIP ROLE OF THE DEAN AND HEADS OF SCIENTIFIC DEPARTMENTS IN THE COLLEGE OF PHYSICAL EDUCATION AND SPORTS SCIENCES AL-MUSTANSIRIYAUNIVERSITY
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Publication Date
Tue May 01 2018
Journal Name
Journal Of Global Pharma Technology
Evalution of the effect of Gigaspora margarita and Glomus desriticola fungi in stimulating the resistance of the capsicum annuum L. plant towards chromium and lead
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The present study was conducted to evaluate the effect of fungi Gigaspora margarita and Glomus desriticola in stimulating the resistance of the capsicum annuum L. towards the chromium and lead after 60 days, planting and using the pots in the glass house. The highest concentration of chromium and lead in the root was found in the presence of the mycorrhizal mixture (194.93, 150.40) μg / g, respectively, compared to the lowest concentration (90.69, 79.37) μg / g respectively, while the highest concentration of chromium and lead in the shoot was found in the presence of the mycorrhizal mixture (94.63, 79.33) μg / g respectively, compared with the lowest concentration in the control treatment (72.58, 60.70) μg / g respectively. The results

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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
EVALUATING THE EFFECTIVE CREATIVE LEADERSHIP ROLE OF THE DEAN AND HEADS OF SCIENTIFIC DEPARTMENTS IN THE COLLEGE OF PHYSICAL EDUCATION AND SPORTS SCIENCES AL-MUSTANSIRIYAUNIVERSITY
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Publication Date
Wed Feb 15 2017
Journal Name
International Journal Of Poultry Science
Effects of Ionized Water on Certain Egg Quality Traits and the Levels of Proteins and Enzymes in the Blood of the Japanese Quail Coturnix japonica
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Objective: This experiment was conducted to study the effects of ionized water on certain egg quality traits and the levels of proteins and enzymes in the blood of the Japanese quail Coturnix japonica . Materials and Methods: One hundred 42-day-old quail were randomly distributed among five treatment groups with four replicates for each group. The following treatments were used: T1 (control): The birds were provided normal water, T2: The birds were provided alkaline water (pH = 8), T3: The birds were provided alkaline water (pH = 9), T4: The birds were provided acidic water (pH = 6) and T5: The birds were provided acidic water (pH = 5). A Complete Randomized Design (CRD) was used to investigate the effects of the studied treatments on diffe

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Publication Date
Wed Jan 01 2025
Journal Name
Aip Conference Proceedings
Determination of cefotaxime-sodium at nanoscale level by a microflow injection cell via measuring turbidity using five irradiation sources (WSLEDs) with a single solar cell
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This work presents a completely new develop an analyzer, named NAG-5SX1-1D-SSP, that is simple, accurate, reproducible, and affordable for the determination of cefotaxime sodium (CFS) in both pure and pharmaceutical drugs. The analyzer was designed according to flow injection analysis, and conducted to turbidimetric measurements. Ammonium cerium nitrate was utilized as a precipitating agent. After optimizing the conditions, the analysis system exhibited a linear range of 0.008-27 mmol. L-1 (n=29), with a limit of detection of 439.3 ng/sample, a limit of quantification of 0.4805 mg/sample, and a correlation coefficient of 0.9988. The repeatability of the responses was assessed by performing six successive injections of CFS at concentra

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Publication Date
Sun Jul 01 2018
Journal Name
القانون المقارن
The mechanism for selecting the President of the Republic and his constitutional powers under the Constitution of the Republic of Iraq
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The mechanism for selecting the President of the Republic and his constitutional powers under the Constitution of the Republic of Iraq

Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Article The problem of nuclear proliferation and its impact on the formula of strategic balance in the Middle East after the events of September 11, 2001
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The issue of nuclear proliferation is one of the most vital issues as it reflects a form of dealing in the field of international relations. Therefore, the Middle East region has taken great interest in reducing the levels of nuclear armament and acquiring nuclear power within the strategic framework of the international and regional powers. The establishment of a nuclear-weapon-free zone in the Middle East region is currently one of the most important international and regional arrangements for controlling the levels of nuclear proliferation and attempting to build a state of stability and balance. In the Middle East and the world. The importance of the research comes from the fact that it deals with an important and vital issue

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The Role Of Intellectual Capital In The Performance Of Small And Medium Enterprises Research filed In Small And Medium Enterprises In Baghdad
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The Research aims to determine role of The Intellectual capital in the performance of small and medium enterprises , to achieve this goal through a researcher from the theoretical literature and studies related to the construction of the scheme shows the hypothetical relationship between the variables, which was adopted by the independent variable intellectual capital, distributed four variable are:( human  capital, structure capital ,customer capital, innovation capital) as well as four variable (the financial perspective, the customer perspective, process perspective ,the learning & growth perspective) The  study were getting to  many results as bellow :the intellectual capital in the small and intermediate p

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