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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 Mar 10 2021
Journal Name
Baghdad Science Journal
the kincetic studies of lh binding in benign an malignant uterine
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kinetic studies were carried out the uterine homogenate time course of the association of with LH in benign and malignant uterine

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
Teaching Competencies Required For Teachers of History in the Preparatory Stage
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         This study attempts to determine the necessary teaching competencies for teachers and the level of their importance in the development of their performance professionally and scientifically, and the progress towards a better future to achieve an effective level. Accordingly, the research community consists of the morning-preparatory schools for boys at the General Directorate of Education of Baghdad \ Rusafa2. The study sample included (68) teachers constituted 88.31% of the total community of teachers. As for the research tools, the researcher adopted the descriptive method by using the observation method in which the researcher prepared a list of teaching. For verifying the re

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Engineering
The Use of Bracing Dampers in Steel Buildings Under Seismic Loading
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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Role Of Knowledge Innovation In Managing Strategic Momentum (Field Research)
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The Research Aims To Clarify The Role Of Knowledge Innovation On The Administrative Process Represented by Managing Strategic Momentum, The Research Problem Focuses on Administrative leader Interest In And Implementation Of The Innovation Element Of Knowledge In The Organization By " Managing Strategic Momentum" As Well As The Focus By Management About The Innovators And Makers Of Knowledge And Strategic Planners In The Design And Formulation Of Strategic. Research does Contribute In Solving Part Of The Organizational Problems Of Vision, Innovation And Their Impact On The Momentum Management To Determine The Extent On Which The Procedures Of The Assessed Companies And Plan To Regulate Innovation Under The Momentu

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Publication Date
Tue Mar 01 2016
Journal Name
Al-academy
The Function of Comic Relieve in Shakespearean Tragedy: عباس فاضل عباس
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The comedian scenes which Shakespeare has entered in some of his tragedies(Hamlet, King Lear, and Macbeth), constantly the wrath of conservative critics and theorists of Western Drama, as big violation to Aristotle’s rules of tragedy that is forbidden to insert comedian scene in tragedy. Chapter one deals with the research problem, and its significance, purpose,Boarders and the definition of Comic Relieve. Chapter two comprises the theoretical framework which has displayed Arist-Otle’s conception about the imitation way of heroes characters between tragedy and comedy, the different function of catharsis in each one. Then the research has exposed the economical and theatrical activities in London during Elizabethan age which was looke

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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Engineering
Assessment of Pedestrian Walking Speed Through the Religious Occasions in Iraq
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The design of safe pedestrian facilities usually depends on the assessment of pedestrian characteristics and behavior. In this investigation, pedestrian walking speed through the religious occasion have been monitored at three locations, Al- Kadhimiya (Imam AL-Kadim), Najaf and Karbala (Imam AL-Husain) holy shrines. Video captures of the pedestrian through their walking to the two holy shrines have been prepared and analyzed for walking speed, gender, age groups, and clothing tradition. The pedestrian sample size is 468, 501, and 447 for Al- Kadhimiya, Karbala, and Najaf respectively. When the gender is taken into consideration, it can be noted that the walking speed of male and female pedestrian is (0.97, 1.68, and 1.63

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Publication Date
Sat Jul 06 2013
Journal Name
Creative Construction Conference 2013
The challenges of governing public private partnership in Iraq infrastructure projects
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Public-private partnership (PPP) has been used over the past 20-30 years by governments in developed countries to meet the public demand for infrastructural services. In Iraq, the PPP concept is comparatively new to the Government of Iraq (GoI), where the government has historically taken most of the responsibility for providing public services. There are few PPP projects in Iraq. However, the number is increasing. Recently the Iraqi market has experienced a number of attempts of PPP in different sectors, especially after the new investment law in 2006. The aim of this paper is to evaluate the investment environment in Iraq and to indicate the main factors affecting PPP in particular for infrastructure projects. Some literature review and

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Publication Date
Tue Apr 22 2025
Journal Name
Journal Of Physical Education
Studying the Reality of Racket Sports&#39; Administrative Problems In Iraq
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Publication Date
Thu Oct 25 2018
Journal Name
Journal Of Economics And Administrative Sciences
Reflection of the change process in enhancing organizational performance (Analytical research)
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  This research aims to test the relation and effect of the process of organizational change as an independent variable (change in human resources, technological change, change in tasks, change in organizational structure) in organizational performance as a variable of success (financial performance, operational performance, customer satisfaction, growth). And learning) in the Office of the province of Baghdad, as well as determine the existence of differences of statistical significance between the variables of research, and then try to come out with a set of recommendations to contribute to the strengthening of organizational performance, and carried out this research on the eye of the vertical number (75) individuals, The

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Publication Date
Mon Mar 07 2022
Journal Name
Construction Research Congress 2022
Impact of Green Construction on Safety Performance in the Built Environment
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