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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
Mon Feb 08 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
AWN-similarity: Towards developing free open-source frameworks for measuring Arabic semantic similarity under Windows / Linux operating systems
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Publication Date
Mon Jan 26 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Management of Independent Middle Mesial Canal in Mandibular First Molar Using Cone Beam Computed Tomography Imaging as an Adjunct – A Case Report
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The primary objective of root canal therapy is adequate biomechanical preparation of root canal system followed by 3D obturation.in clinics we are encountered with several anatomical variations, which we need to manage efficiently. One of the major factors responsible for failure of root canal therapy is missed canals. Recent technological advances have given the clinician opportunity to identify anatomical variations and treat them to satisfaction.

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Publication Date
Sun Jul 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Teaching Using Adey- Shire Model and its Effect in Achievement and Critical Thinking for first intermediate students in Mathematics
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The aim of this research is to measure the effect of Adey- Shire model in the achievement and critical thinking of first intermediate female students in mathematics. The researcher adopted the experimental method with a post-test, the research of sample consists of (60) female students, divided into two groups with (30) students in the experimental group, that studied with Adey- Shire model, and (30) students in the control group who studied in the usual way. The two groups are equivalent in many variables. The researcher makes two tests of multiple choices, the first one is an achievement test consists (30) items and another test was for a critical thinking test with (25) items. The statistical analysis make to both tests is made with s

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Teaching According to the Augmented Reality Technique on theVisual Thinking Skills to Scientific Fifth-Grade Students for Biology
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The research aims to identify the effect of teaching according to the augmented reality on the technique of the visual thinking skills among scientific fifth-grade students in a biology course. In order to achieve the goal of the research, the researcher adopted the experimental approach with the partial set of the two equal groups with the dimensional test of visual thinking skills, The research population represented all the scientific students of the fifth grade for morning government schools affiliated to the General Directorate of Education of Baghdad / Karkh II, alshakerin preparatory for boys was chosen intentionally, in which two groups were chosen for this study, one group is chosen randomly as the control group via lottery, whe

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Publication Date
Mon May 01 2023
Journal Name
Journal Of Engineering
Experimental Investigation of Heat Transfer Enhancement in a Double Pipe Heat Exchanger Using Compound Technique of Transverse Vibration and Inclination Angle
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Numerous tests are recently conducted to assess vibration's role in accelerating the heat transfer rate in various heat exchangers. In this work, the enhancement of heat transfer by the effect of transfer vibration and inclination angles on the surface of a double pipe heat exchanger experimentally has been investigated. A data acquisition system is applied to record the data of temperatures, flow rates, and frequencies over the tests. A compound technique was adopted, including the application of a set of inclination angles of (0°, 10°, 20°, and 30°) under the effect of frequency of vibration ranging from sub-resonance to over-resonance frequencies. The results showed that the overall heat transfer coefficient enhan

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Oscillation of the per capita growth rate
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in this paper cquations of the per capita growth rate are considered sufficient conditions for oscillation of all solutions are obtained the asymptotie behavior of the nonoscillatory solution of all souliotions are obtained

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Publication Date
Tue May 16 2023
Journal Name
Journal Of Engineering
Experimental Investigation Utilizing Thermal Image Technique to the Heat Transfer Enhancement Using Oscillated Fins
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Heat transfer around a flat plate fin integrated with piezoelectric actuator used as oscillated fin in laminar flow has been studied experimentally utilizing thermal image camera. This study is performed
for fixed and oscillated single and triple fins. Different substrate-fin models have been tested, using fins of (35mm and 50mm) height, two sets of triple fins of (3mm and 6mm) spacing and three frequencies
applied to piezoelectric actuator (5, 30 and 50HZ). All tests are carried out for (0.5 m/s and 3m/s) in subsonic open type wind tunnel to evaluate temperature distribution, local and average Nusselt number (Nu) along the fin. It is observed, that the heat transfer enhancement with oscillation is significant compared to without o

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Bowel Cleansing Quality in Morning Versus Evening Preparation Regimens for colonoscopy; a Prospective Study
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Background :Evening preparation for colonoscopy is often unsatisfactory and inconvenient. This study was performed to compare the efficacy of bowel preparation at two different timings: night before and morning of endoscopy and to compare the cecal intubation rate and disturbance of sleep hours between these two groups.
Methods: In this prospective randomized endoscopist- blinded trial, 150 patients were enrolled between March 2010 and August 2011. Patients aged between 18 to 80 years needing colonoscopy were included. Patients with prior bowel surgery, suspected bowel obstruction or those who didn't completely fulfill the preparation instructions were excluded. Patients received polyethyelen glycol electrolyte preparation in a mornin

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Taboo Words Vs. Social Deixis: A sociolinguistic Analysis of La Justice or The Cock that Crew: A Play from the Theatre of Ridiculous
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Linguistic taboos exist in most cultures. Tabooed words are generally being culturespecific
and relating to bodily functions or aspects of a culture that are sacred. Such words are
avoided, considered inappropriate and loaded with affective meaning and failing to adhere to.
Strict rules, often, governing their use and lead to punishment or public shame. These taboo
words can be used as a way of violating social deixis represented by four types of honorifics;
addressee, referent, bystander, and finally setting honorifics. This paper shows how these
taboo words are used in Kenneth Bernard's play La Justice or The Cock that Crew from the
theatre of the Ridiculous as means of violating social deixis in its four types. Th

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Publication Date
Sat Jul 01 2017
Journal Name
Journal Of Physical Education
Special Exercises According to Refereeing and It's Effect on Developing Some Physical Abilities Of First Class Basketball Referees in Baghdad
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Basketball is one of the most popular and popular games that have a large audience both globally and locally because of the magic it contains in terms of performance. For this sport to be a success, fundamental factors must exist and these factors is the referee. The referee plays a large and important role in the success of the game and the establishment and application of rules.The research aimed at identifying the effect of special on the development of referee's physical abilities. The researcher used the experimental method. The subjects were (12) first class basketball referees. The researcher recommended using special exercises due to their great role in developing the physical abilities of first class basketball referees

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