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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
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
The development of imaginal thinking and its relation with adults' problems
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The behavior of thinking is consider one of the modern concepts that appear in the last 20 years, this concept has attracted the attention of psychologists and researchers for thinking has a great role in many fields like teaching ,educational,economical,cultural and social fields.
One of thinking manner is imaginal thinking that has a great role in human civilization. imaginal thinking lead to innovation ,poems, inventions and arts. imaginal thinkingled to highscores in talented schools by escalating their thinking range and solving problems that consider one of organized and free assumption thinking.
The development of problems thinking strategies reflect the development of organized brain process ability.
That studies assumes

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Publication Date
Mon Feb 01 2021
Journal Name
Journal Of Engineering
Assessing the Moisture and Aging Susceptibility of Cold Mix Asphalt Concrete
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Laboratory experience in Iraq with cold asphalt concrete mixtures is very limited. The design and use of cold mixed asphalt concrete had no technical requirements. In this study, two asphalt concrete mixtures used for the base course were prepared in the laboratory using conventional cold-mixing techniques to test cold asphalt mixture (CAM) against aging and moisture susceptibility. Cold asphalt mixtures specimens have been prepared in the lab with cutback and emulsion binders, different fillers, and curing times. Based on the Marshal test result, the cutback proportion was selected with the filler, also based on the Marshal test emulsion. The first mixture was medium setting cationic emulsion (MSCE) as a binder, hydrate

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Publication Date
Sun Jul 20 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of cigarette smoking on salivary IgA and periodontal disease
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Background: Chronic periodontitis is an inflammatory disease of tissues supporting the teeth. Salivary compositions have been most intensely studied as a potential marker for periodontal disease. In this study, analysis of saliva provides a simple and non-invasive method of evaluating the role of salivary IgA (s-IgA) levels in periodontal disease by detecting the level of (s-IgA) in patients with chronic periodontitis smokers and non smokers patients and correlate the mean (s-IgA) levels with clinical periodontal parameters Plaque index (PLI) gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL). Materials and Methods: The study samples consists of (15) patients with chronic periodontitis who were non smokers (

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Publication Date
Tue Nov 01 2022
Journal Name
Journal Of Medicinal And Chemical Sciences
Echocardiographic Assessment of the Aortic Stenosis Valve Area: Parameters and Outcome
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Background: Among individuals who have a stenotic aortic valve, a precise assessment of aortic valve area is essential for clinical judgment. So far, no studies have been conducted to investigate and assess the role of the three dimensional echo-cardiography in the assessment of the valve stenosis. This study aims to compare and assess the precision of the measurement of the stenosis area of the aortic valve by 2D versus 3D echo-cardiography.

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of The College Of Education For Women
The Historical effect of Conflict between North and South (1945-1995)
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The Historical effect of Conflict between North and South

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Publication Date
Sat Nov 02 2013
Journal Name
Arabian Journal Of Geosciences
Facies architecture and basin development of the Qamchuqa succession, NE Iraq
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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of Brucellosis on Lipid Profile and Oxidant-Antioxidants Status
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The activation of inflammatory cells, the release of their mediators, and the excessive production of free radicals may affect circulating lipids, but no evidence supports a role for peroxidation in the pathogenesis of Brucellosis disease. The aim of this work is to study the effect of Brucellosis on lipid profile concentration and oxidant-antioxidant status. We studied 20 Brucellosis patients (18 Females and 2 males) and 15 healthy controls (age average from 16 to 60 years old). Significant differences were noted between the serum lipids of Brucellosis patients and control group. Mean total cholesterol and low density lipoprotein cholesterol (LDL-cholesterol) concentrations were higher in patients than in control group (mean ± SE 197

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Publication Date
Sat Aug 31 2019
Journal Name
Iraqi Journal Of Physics
Investigate Salts type and concentration on the conductivity of Polymer Electrolyte
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Polymer electrolytes systems compose of (PEO+KI+I2) and (PEO+RbI+I2) with different concentration, and a fixed amount of ethylene carbonate (EC) and propylene carbonate (PC) over temperatures range 293-343 K prepared by solution cast me

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Publication Date
Tue Jan 01 2019
Journal Name
Current Research In Microbiology And Biotechnology
Determination of the relationship between Celiac disease and recurrent spontaneous abortion
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To determine the relationship between celiac disease and reproductive disorder, twenty two women with recurrent spontaneous abortion (18-35) years have been investigated from the period 2017/11/1 – 2018/2/1 and compared wih twenty two parentally healthy women. All studied groups were carried out to measure antitissue transglutaminase IgA and IgG antibodies by Enzyme linked immunosorbent assay (ELISA) technique, There were a highly significant differences (P < 0.01) in the concentration of anti TtG IgA and IgG Ab compared to control group, while there was non-significant differences (P > 0.05) in the concentration of anti TtG IgA according to the age group and there was a significant difference (P < 0.05) in the concentration of anti TtG I

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Publication Date
Sat Jul 01 2023
Journal Name
Chalcogenide Letters
Investigating the optical and electrical characteristics of As60Cu40-xSex thin films
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In this work, As60Cu40-xSex thin films were synthesized, and the pulsed laser deposition method was used to study the effected partial replacement of copper with selenium. The electrical characteristics and optical characteristics, as indicated by the absorbance and transmittance as a function of wavelength were calculated. Additionally, the energy gap was computed. The electrical conductivity of the DC in the various conduction zones was calculated by measuring the current and voltage as a function of temperature. Additionally, the mathematical equations are used to compute the energy constants, electron hopping distance, tail width, pre-exponential factor, and density of the energy states in variation zones (densities of the energ

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