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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 16 2019
Journal Name
Journal Of Research In Medical And Dental Science
Evaluation of the Antibacterial Efficacy of Silver Nanoparticles as an Irrigant against Enterococcus faecalis In vitro Study
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Background: Successful root canal therapy depends on thorough chemo mechanical debridement of pulpal tissue, dentin debris and infective microorganisms. Objective: This study aimed to investigate the antibacterial effect of silver nanoparticles, sodium hypochlorite and chlorhexidine in reducing the bacterial infection of the root canals. Materials and Methods: The root canals of 55 single-rooted teeth were cleaned, shaped, and sterilized. All the teeth samples were inoculated with Enterococcus faecalis and incubated at 37°C for 2 weeks. Then, the teeth were divided into four groups. Group I (n=15): 100 ppm silver nanoparticles, Group II (n=15): 2.5 sodium hypochlorite, Group III (n=15): 2% chlorhexidine, IV (n=10): Normal saline as a contr

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Publication Date
Sun Aug 01 2021
Journal Name
The Journal Of Asian Finance, Economics And Business (jafeb)
The Effect of Social Marketing on Customer Behavior: An Empirical Study of Tourism Companies in Baghdad, Iraq
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Social marketing seeks to develop and integrate marketing concepts with other approaches to social change and aims to influence behaviors that benefit individuals and societies for the social good. The study investigates the type and level of influence of social marketing on customer behavior in tourism companies in Baghdad (Iraq). The sample size of the study is 135 people comprising directors, assistant directors, and marketing staff in tourism companies in Baghdad. A questionnaire was used as a tool to collect data and information, and was prepared by the researcher after it underwent validity, stability, and arbitration tests. The data was analyzed using the statistical program (SPSS v. 25, AMOS v. 23) and statistical methods have been

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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
Proposed mechanism to activate the role of the Federal board supreme Audit in the examination of the federal budget estimates of the state
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The aim of the research is to present and discuss the subject of the budgeting estimates and how to activate the role of the Federal board of supreme audit in examining these estimates through reference to Articles 6 and 10 of the Federal board of supreme Law, which did not restrict Federal board of supreme in Preventive control on examination process for planning which is prepared from the government units, as the result of a large amount  of government units Provisions and the weakness of estimates in most of its items, which rely on personal assessment and not based on scientific and logical basis of the estimate, which leads to the emergence of a deficit is not true in the general budget and this seems clear in most Iraq

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Publication Date
Sun Jan 01 2017
Journal Name
البحوث التربوية والنفسية
The effect of a training program for chemistry teachers on matching both sides of the brain together on the academic achievement of their students
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Publication Date
Mon Nov 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Strategic leadership skills as a moderate of the impact of environmental challenges on effective management of the environment according to the model (VUCA Prime)
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Purpose – The main purpose of this research is to highlight the main role of strategic leadership skills for top managements in accessing to effective management in accordance with the (VUCA Prime) methodology in (VUCA) environment as Miniature virtual environment, which refers to (Volatility), (Uncertainty), (Complexity), and (Ambiguity).

methodology – To achieve the research objective, this study selected the quantitative approach in research design, Questionnaire was used as the main instrument for data collection, the sample comprised the opinion poll (106) individual who functions as a head department. (Structural equation modelling by (Smart Pls3)

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of The College Of Education For Women
Challenges of Spreading the Culture of Peace in Iraq from the point of view of Leaders and Intellectuals Elites
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The research problem lies in identifying the challenges facing spreading the culture of peace in Iraq, and the most important factors of its instability from the point of view of leaders and intellectual elites.The research derives its importance from the fact that the peace imposed by justice leads to a stable Iraq and a prosperous future.

The study aims to identify the most prominent challenges and obstacles created by wars and faced the process of spreading the culture of peace and instability in Iraq, and to shed light on the reasons leading to the employment of the capabilities of community leaders in spreading the culture of peace.The objective of the current research is to identify the challenges of spreading the culture o

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Publication Date
Mon Dec 30 2019
Journal Name
College Of Islamic Sciences
The matter, its wisdom, and models of its applications In Ahmadiyya interpretations Research drawn from a doctoral thesis
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This study examined the tagged (the matter, its ruling, and examples of its applications in Ahmadiyya interpretations), the study of devising formulas of commissioning, especially the matter from the book of interpretation, which is: (Ahmadiyyeh’s interpretations), and the contemplative of the nature of (Ahmadiyya’s interpretations) realizes that the cognitive, linguistic and juristic knowledge product and the verses of judgments And other is the focus of this immortal travel, as it is truly a comprehensive book containing what the students of knowledge, scholars and the general public need in terms of interpreting the legal verses, and it is not possible to reach an understanding of the Book of God Almighty, and to clarify his purpo

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Publication Date
Thu May 01 2025
Journal Name
Microbes And Infectious Diseases
Molecular detection and the frequency of a pore-forming toxin in Enterococcus faecalis isolated from urinary tract infections
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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Integration between Lean Production and sustainable value chain in light of the trend towards a sustainable circular economy
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In a resource-limited world, there is an urgent need to develop new economic models, from the traditional unsustainable industrial model of product consumption and disposal, to a new model based on the concepts of sustainability in its comprehensive sense, the so-called circular economy, using fewer resources in manufacturing processes and changing practices in product disposal to waste, by removing its use, recycling and manufacturing to start another manufacturing process. In an era of intense competition in domestic and global markets, the importance of the circular economy is highlighted in its ability to strengthen the competitiveness of enterprises in those markets, by reducing the cost and increasing the quality of the pro

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Publication Date
Thu Apr 06 2023
Journal Name
International Journal Of Emerging Technologies In Learning (ijet)
The Impact of a Scenario-Based Learning Model in Mathematics Achievement and Mental Motivation for High School Students
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