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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 Jan 01 2017
Journal Name
International Journal Of Latest Trends In Engineering And Technology
Study the effect of number of nozzle on optical and structural properties of sno2 films grown by (apcvd)
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Publication Date
Sun Oct 02 2016
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Driver and Posner Models in correcting Alternative Perceptions in Educational Psychology Material for the Students at the Institute of Fine Arts
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To achieve the goals, the researcher followed the design of equal and   independent groups of partial control and post-test . The research has chosen the Institute of Fine Arts in the area Almansour area as deliberate sample where three sections of students have been chosen and the   number of students is (69) students. The researcher conducted equivalence in the variables (age, and IQ , and the overall rate for grade III). in diagnostic phase,  (21) concepts of alternative    image out of (46) concepts have been identified in addition to the goals of formulation of acquisition concepts according to the three processes (definition, discrimination and application). Achievement test has been

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Publication Date
Fri Mar 28 2025
Journal Name
Journal Of Physical Education
Special exercises using tools and their effect on teaching the skill of a front shoulder circle on the rings apparatus in artistic gymnastics for students
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Sports skills in some individual games require physical and motor qualities to facilitate the process of skill performance and also require the instructor or trainer to use more than one strategy, method and way to bring the performance to the level of mastery and avoid injury. The aim of the research is to know the effect of using special exercises using tools and their effect on teaching the skill of a front shoulder circle. The research hypothesis is that using special exercises with tools has a positive effect on teaching the skill of a front shoulder circle on the rings apparatus. Research method: - The researchers used the experimental method by designing two equal groups, the control and the experimental, to suit the research

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
Transformations of the form of postmodern arts in the projects of students of the Department of Art Education
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The art of postmodernism has undergone a number of changes in the course of art and art schools, as art has left the traditional means and paved the way for this artistic transformation to change the materials, techniques, methods and visions as a result of the changes that occurred in the thought and this change played an important role in the artist's vision, To demolish and destroy all of the above and to reconsider the formal systems and intellectual contexts and expressive modes, so it is necessary for the whole art to keep up with the variables of the era and its elements. The current research aims to: "Detect the transformations of form in postmodern art in the projects of students of the Department of Art Education".

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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The reality of quality in the SAI reports: Applied research in the Federal Board of Supreme Audit
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The research aims to shed light on the role of SAIs and the nature of their work, with the definition of the concept of quality reports and to clarify the reality of quality in the FBSA reports, the researchers reached to conclusions, including: The quality of the SAI reports is a requirement seeks to achieve any regulatory system in order to develop audit work output of the form in which its impact is reflected positively on the performance of the entities controlled, and researchers gave a set of recommendations, including: the need to increase community awareness of the importance of the FBSA Supervisory reports through conferences, seminars and workshops and that FBSA to follow-up reports, and check the quality continuously to the fa

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Publication Date
Wed Jan 23 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of accountability measures in enhancing the results of the federal budget in government spending units
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The role and procedures for accountability in the spending units significant impact in enhancing the results of the budget it is found by studying and comparing the results of the implementation of the budget for the research sample for a period of two years to repeat the same deviations and irregularities of Guanyin, regulations and instructions that have occurred in implementation results and two consecutive Kaltjaoz customizations and low rates of implementation and the lack of exchange of allocations Finance despite the presence budget note that such remarks are always indicate in regulatory reports, but these observations repeated Bostmr in the results of the implementation of the budget. Which clearly reflects the absence of the ro

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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
Social Support and Its Relationship to Psychological Rigidity in a Sample of Breast Cancer Patients In the Ramallah and Al-Bireh Governorate
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This study aims to identify the impact of social support on breast cancer patients’ psychological rigidity using a sample in Ramallah and al-Bireh. A descriptive correlative approach was adopted to fulfill the goals of the study and a questionnaire consisted of two criteria: social support and psychological rigidity, which was adopted as a tool for data collection for the study. In order to achieve the goals of the study, the researcher selected a convenient sample that consisted of 123 female breast cancer patients in Ramallah and al-Bireh. This sample represented 50% of the original patient population. The study showed that the average estimated percentage of social support and psychological rigidity for women with breast cancer, in

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Publication Date
Sun Nov 20 2022
Journal Name
Journal Of New Zealand Studies
The Impacts of Environmental-Geomorphology of the Kut Barrage on the Tigris Waterway and the Neighboring regions
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The research dealt with the effect of Kut Barrage on the geomorphological processes and the natural environment system in the course of the Tigris between the cities of Al-Ahrar and Kut in central Iraq. It was clear from the research the contribution of Kut Barrage in changing the surface runoff system between the front and back of the barrage, as well as changing the type of processes and the prevailing geomorphic forms, as the sedimentation activates the front of the barrage and erosion at its back, which affected the change in the morphology of the river, sediment retention at the front of the barrage, the burial of the bottom and reducing the validity of the stream. This also affects the efficiency of the barrage’s work and coastal er

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Publication Date
Thu Mar 31 2016
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Synergistic Effect of Potassium Iodide on Inhibitive Performance of Propyl Alcohol during Corrosion of Mild Steel in 1.0M HCl
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   The inhibition of mild steel corrosion in 1.0M HCl by 1-propanol and the synergistic effect of potassium iodide (KI) was investigated using weight loss and polarization techniques in the temperature range (30 ‒ 50) ̊ C. A matrix of Doelhert to three factors was used as the experimental design, adopting weight loss results as it permits the use of the response surface methodology which exploited in determination of the synergistic effect as inhibition on the mild steel. The results were confirmed using electrochemical polarization measurements. Experimental results showed that the inhibition efficiency (IE%) increases with increase in concentration of inhibitor and with increasing of temperature. The addition iodide ions t

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Publication Date
Tue Jan 01 2013
Journal Name
Journal Of Genetic And Environmental Resources Conservation
The study of food preference of Callosobruchus maculatus to five types of fabaceae
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