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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
Fri Nov 21 2025
Journal Name
Asian Journal Of Dairy And Food Research
Anatomical and Histological Study of the Female Reproductive System (Columba oenas) during the Egg-laying Period
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Background: In this study, the female reproductive system of Columba oenas was examined during the egg laying stage, focusing on its general structure and microscopic characteristics. Methods: Obsessive monitoring operations were performed, as well as different parts of the egg canal, which include infundibulum, magnum, isthmus, uterus and vagina. Result: These parts showed clear anatomical differences, each with special textile features that seem to play distinctive roles related to the growth and movement of eggs. In magnum it was found that the bulk contains clear mucous folds and many secretory glands. The isthmus had a star-shaped lumen and was lined with a false cylindrical epithelium. In the uterus, branching tube glands, ric

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Publication Date
Wed Jun 15 2022
Journal Name
Malaysian Journal Of Science
STUDY THE RELATIONSHIP BETWEEN BREMSSTRAHLUNG DOSE RATE AND THE ENERGY OF BETA RAY FOR DIFFERENT TYPES OF SHIELD
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The dose rate for bremsstrahlung radiation from beta particles with energy (1.710) MeV and (2.28) MeV which comes from (32P and 90Y) beta source respectively have been calculated through six materials (polyethylene, wood, aluminum, iron, tungsten and lead) for first shielding material with thickness (x=1) mm which are putting between beta sources and second shield (polyethylene, aluminum and lead) with thickness (1, 2 &4) mm have been calculated. The distance between beta source and second shield is constant (D=1) cm. This dose rate was found by program called Rad Pro Calculator (version 3.26). The results of dose rate of beta particles were plotted as a function to the atomic number (Z) for first shield materials for each

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Publication Date
Wed Jun 15 2022
Journal Name
Malaysian Journal Of Science
STUDY THE RELATIONSHIP BETWEEN BREMSSTRAHLUNG DOSE RATE AND THE ENERGY OF BETA RAY FOR DIFFERENT TYPES OF SHIELD
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The dose rate for bremsstrahlung radiation from beta particles with energy (1.710) MeV and (2.28) MeV which comes from (32P and 90Y) beta source respectively have been calculated through six materials (polyethylene, wood, aluminum, iron, tungsten and lead) for first shielding material with thickness (x=1) mm which are putting between beta sources and second shield (polyethylene, aluminum and lead) with thickness (1, 2 &4) mm have been calculated. The distance between beta source and second shield is constant (D=1) cm. This dose rate was found by program called Rad Pro Calculator (version 3.26). The results of dose rate of beta particles were plotted as a function to the atomic number (Z) for first shield materials for each

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Publication Date
Mon Jan 01 2007
Journal Name
Journal Of Al-nahrain University
STUDY FOR THE GROWTH RATE, VIABILITY AND MORPHOLOGICAL CHANGES OF LEISHMANIA TROPICA IN DIFFERENT CULTURE MEDIA
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This study included the estimation of growth rate, viability and morphological changes in different culture media (NNN, P-Y, RPMI- 1640, and Panmed). Promastigotes cultured in RPMI-1640 showed maximal growth rate after (2, 4, 6) days of cultivation (27.26 ± 0.05), (172.20 ± 0.1) and (343.81 ± 1.48) million parasites / ml for each day respectively, while P-Y media gave the highest mean of growth rat after (8 and 10) days of cultivation (307.16 ± 1.67) and (303.5 ± 4.96) million parasites / ml for each day respectively. P-Y medium showed the maximal percentage of viability after (2, 4, 6, 8, and 10) days of cultivation (99.76 ± 0.5) %, (98.30 ± 0.17) %, (96.1 ± 0.1) %, (92.5 ± 0.52) % and (87.26 ± 0.05) % for each day respectively.

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Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Engineering
Historical Paths and the Growth of Baghdad Old Center
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Urban growth of cities is connected with three related problems, the first one, is the deterioration of the center, which is a mark for historical origin. The second is the emergence of city edge, which contradicts by the center. The third one is the rapid semi urbanism of the edge. Literature review showed that Baghdad historical center (Old Rusafa and Karkh) had grown in four morphological stages, during which main paths had been changed from those which were perpendicular to the river front to those parallel to it. Research problem is that “there is a knowledge gap about the direction and origin of paths within Baghdad old center, after its growth”. The first research hypothesis is, “the direction of paths within old Baghdad cen

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Publication Date
Sat Dec 28 2024
Journal Name
Journal Of Physical Education
The Effect of a Psychological Counseling Program to reduce irrational ideas and the causal attribution of the coaches of the gymnasium sports care center
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The research aimed to prepare a psychological counseling program for the coaches of the Sports Care Center in the gymnasium, and to learn about the impact of the psychological counseling program in reducing irrational ideas and causal attribution of the coaches of the Sports Talent Care Center in the gymnasium, to assume that there are statistically significant differences between the results of the tribal and posttests of the research group Experimental in the scale of irrational ideas, and there are statistically significant differences between the results of the tribal and posttests of the experimental research group in the scale of the causal attribution scale, The experimental approach was adopted by designing one experimental

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Publication Date
Thu Jun 01 2023
Journal Name
Australian Dental Journal
Debonding of LDSVs utilising Er,Cr:YSGG laser irradiation with fractional technique: an in vitro study
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Publication Date
Sat Jan 05 2019
Journal Name
Iraqi Journal Of Physics
Study of nuclear structure for carbon isotopes using local scale transformation technique in shell model
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This work is devoted to study the properties of the ground states such as the root-mean square ( ) proton, charge, neutron and matter radii, nuclear density distributions and elastic electron scattering charge form factors for Carbon Isotopes (9C, 12C, 13C, 15C, 16C, 17C, 19C and 22C). The calculations are based on two approaches; the first is by applying the transformed harmonic-oscillator (THO) wavefunctions in local scale transformation (LST) to all nuclear subshells for only 9C, 12C, 13C and 22C. In the second approach, the 9C, 15C, 16C, 17C and 19C isotopes are studied by dividing the whole nuclear system into two parts; the first is the compact core part and the second is the halo part. The core and halo parts are studied using the

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Publication Date
Thu Jan 01 2015
Journal Name
The Iraqi Postgraduate Medical Journal
Aesthetic results of superomedial pedicle technique in reduction mammaplasty
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ABSTRACT: BACKGROUND: Breast reduction for mammary hypertrophy is a highly effective procedure with high degree of patient satisfaction. There are many methods of breast reduction which involve removal of excess tissue with reshaping of overlying skin while maintaining a viable nipple areolar complex. OBJECTIVE: The purpose of this study is to evaluate the use of the superomedial technique as an effective method for reduction mammoplasty. PATIENTS AND METHODS: A total of 30 patients underwent reduction mammoplasty by utilizing superomedial pedicle technique between 2010 and 2013. Those patients were evaluated postoperatively in terms of their aesthetic and functional satisfaction, viability of nipple – areolar complex and nipple sensory p

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Publication Date
Mon Nov 27 2023
Journal Name
Journal Of Periodontal Research
Ability of gingival crevicular fluid volume, E‐cadherin, and total antioxidant capacity levels for predicting outcomes of nonsurgical periodontal therapy for periodontitis patients
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Abstract<sec><title>Objectives

To determine the potential of gingival crevicular fluid (GCF) volume, E‐cadherin and total antioxidant capacity (TAC) levels to predict the outcomes of nonsurgical periodontal therapy (NSPT) for periodontitis patients.

Background

NSPT is the gold‐standard treatment for periodontal pockets < 6 mm in depth, however, successful outcomes are not always guaranteed due to several factors. Periodontitis‐associated tissue destruction is evidenced by the increased level of soluble E‐cadherin and reduced antioxidants in oral fluids which could be used as predictors for success/failure of N

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