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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 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
The new industrial cities and resources sustainability - case study: industrial zone in Ramady city
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Abstract<p>The modern industrial projects and complexes that adopt ecological systems, and renewable, clean and environmentally friendly energy, not only contribute to the development of an environmentally friendly production method but can achieve long-term economic and industrial development by preserving environmental resources. The ecological industrial systems and modern industrial technologies are the ideal solutions to rationalize excessive use and preserve the elements of the environment and natural resources, the most important of which is the existence of several methods and programs for the development of industrial sites, and there is important to adopt mechanisms and programs to sol</p> ... Show More
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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The level of evaluation of the educational counselors ’performance as a predictor of their level of satisfaction with their evaluation
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The current research aims to reveal the level of satisfaction of the mentors with the evaluation of their performance according to gender (male - female) and to formulate the predictive equation for the level of performance (dependent variable) from knowing the level of satisfaction with the evaluation (independent variable). (16 paragraphs) contains alternatives to the answer that measures the level of satisfaction (weak, medium, and high) (1,2,3), that is, with a hypothetical average of (32). It consisted of 100 educational counselors consisting of 45 males and 55 females, the results of the research concluded that the level of satisfaction with performance is below the mean when compared with the hypothetical average of the scale of s

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Publication Date
Fri Sep 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
An Analysis of the Efficacy of Platelet-Rich Plasma Injections on the Treatment of Internal Derangement of a temporomandibular Joint
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Background: A Temporomandibular joint (TMJ) internal derangement (TMJID) is a disruption within the internal aspects of the TMJ in which the disc is displaced from its normal functional relationship with the mandibular condyle, after which the articular portion of the temporal bone causes joint dysfunction, joint sound, malocclusion, and locking of the mouth. Conservative and invasive techniques can be used for the treatment of TMJID. A platelet-rich plasma (PRP) injection is a simple, less invasive surgical procedure for the treatment of internal derangement. The objective of this study was to evaluate the efficacy of PRP injections in decreasing or eliminating pain, clicking, and limitation of mouth opening in patients with TMJID after th

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
The question of demand: definition, divisions, and examples from the controversy of the scholars of jurisprudence.
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research summary

Praise be to Allah، and prayers and peace be upon His Messenger and His chosen one، his family، companions and his family and his family.

After that، this is a study on the question of the claim، as one of the controversial questions that are the mainstay of debates، and I looked at it: the limit of the question of the claim، its importance، its impact، its aspects of corruption، its sections، and the representation of its sections of the fundamentalist controversy;

The research was according to the following plan:

Introduction، in which she mentioned: the importance of the research topic and the reason for its selection، its questions، its l

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Publication Date
Sun Dec 01 2024
Journal Name
Iraqi Journal Of Physics
Study of the Sensitivity of Carbon Quantum Dots for NO2 Gas Sensor and improve it using Graphene
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Gas sensors are essential for detecting noxious gases that have a detrimental effect on people's health and welfare. Carbon quantum dots (CQDs) are the fundamental component of gas detectors. CQDs and graphene (Gr) were prepared using the electrochemical method. The gas sensitivity of these materials was evaluated at different temperatures (150, 200, 250 °C) to assess their effectiveness. Subsequently, experiments were conducted at different temperatures to ascertain that the combination of CQDs and Gr, with various percentages of Gr and CQDs, exhibited superior gas sensitization properties compared to CQDs alone. This was evaluated based on criteria such as sensitivity, recovery time, and reaction time. Interestingly, the combination was

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Publication Date
Fri Apr 21 2023
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees22fr
Study of the x-ray diffraction lines of calcium titanate nanoparticle using SSP method and Scherrer method
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In this study, the modified size-strain plot (SSP) method was used to analyze the x-ray diffraction lines pattern of diffraction lines (1 0 1), (1 2 1), (2 0 2), (0 4 2), (2 4 2) for the calcium titanate(CaTiO3) nanoparticles, and to calculate lattice strain, crystallite size, stress, and energy density, using three models: uniform (USDM). With a lattice strain of (2.147201889), a stress of (0.267452615X10), and an energy density of (2.900651X10-3 KJ/m3), the crystallite was 32.29477611 nm in size, and to calculate lattice strain of Scherrer (4.1644598X10−3), and (1.509066023X10−6 KJ/m3), a stress of(6.403949183X10−4MPa) and (26.019894 nm).

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Publication Date
Sun Nov 23 2025
Journal Name
Sciences Journal Of Physical Education
Analytical study of the causes of winning and losing according to some technical indicators among young boxers
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Publication Date
Tue Jul 11 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of The Round Robin Strategy in Logical Thinking the Fourth in Chemistry
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The study aims to identify the impact of the round-robin strategy on the logical thinking of fourth-year middle school students in chemistry. Two groups were employed:  an experimental group consisted of (30) students who were taught according to the round-robin strategy, and the control group consisted of (30) students who were taught according to the traditional method. The researcher adopted the experimental design with partial control by preparing the visual thinking test tool, which consists of (20) multiple-choice items, it was applied as a post-test on the research sample. The result showed that there was a statistically significant difference in favor of the experimental group, which was taught according to the Round Robin s

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The adoption of ISO 45001: 2018 in the civil aviation establishment test and its accessibility to the standard
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The current research aims to analyze the extent of the adoption of the standards of ISO 45001: 2018 for occupational safety and health management by the General Establishment of Civil Aviation. The research problem was the extent to which the General Establishment of Civil Aviation approved ISO 45001: 2018 for occupational safety and health management. The questionnaire was used as a primary data collection tool, the sample was distributed (50) form, they were selected from the category of employees of the establishment at different levels to represent the research community. Data were analyzed using the statistical package (SPSS), a number of vector statistical methods were used as well as arithmetic mean, standard deviation, an

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Local Food Crisis in Iraq Between Thoughts of the Malthusian Theory and the Agricultural Section Regression Reality
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Most countries in the world particularly developing countries, including Iraq,  facing  extremely dangerous problem with social and political dimensions, which is the emergence of the food crisis  problem ,the decrease in domestic food production in Iraq isn't meet the needs of its population food, due to the fact that the agricultural sector suffers from multiple natural ,economic  and human   problems .It is still below the level required to meet the needs of the population  of  food ,since food  at the forefront of priorities needed by the human . This represents indispensable  basic  necessity , so the responsibility of its availability permanently  in appropriate&nb

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