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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 Jul 23 2025
Journal Name
Accounting And Financial Sciences Journal
The Analyze of the Available Strategic Choices for External Borrowing (Futuristic Vision)
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يهدف البحث الى تحليل الخيارات الاستراتيجية للاقتراض الخارجي في العراق لاستشراف افضل الخيارات الاستراتيجية المستقبلية في مجال الاقتراض الخارجي في دائرة الدين العام في وزارة المالية ، وقد استخدم الباحث منهج دراسة الحالة وباستعمال اسلوب تحليل خوارزمية ال K-Means لتشخيص كفاءة الاقتراض الخارجي لعينة البحث البالغة (81) قرضا التي اقترضتها وزارة المالية للفترة 2007-2020 . ولقد كان الغرض الرئيسي للبحث المساهمة في تمكين وزا

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Publication Date
Mon Oct 01 2018
Journal Name
Iraqi Journal Of Physics
SiO2 particles effect on the mechanical properties of the starch/PVA blends
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The present work studies the mechanical properties of SiO2 μPs, and NPs in St/PVA blends. The samples were prepared by casting method as PVA, St/PVA blends at different concentrations (30, 40, 50, and 60 %). DSC and TGA tests were carried out to the samples evolved. The result showed a single glass transition temperature (Tg) for all St /PVA blends that was attributed to the good miscibility of the blends involved. It was found that (Tg) decrease with starch ratio increase. It was seen that (PVA) of (Tg=105 oC); The glass transition temperature which was decrease with starch ratio that was attributed to glass transition relaxation process due to micro-Brownian motion of the main chain back bond. The endothermic peak at 200 oC was attrib

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
The chronic effects of salinity on the Crustacean Moina affinis Birge (1893)
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Thi s study included the effect of chronic exposure of di fferent concentrations of Nan on the biology of fresh water zroDplonk ton species Moina 41.112' ( Cladcxe'ra The concentrations used for chronic exposure were 03, 0.75. 1 960 to investigate iI effects on the life cycle and la lables of this species after exposure period and the range of this exposure effects on the rate of expectation for further life, also the effect of salinity on reproduotive parameters was studied which included average of total number of eggs and young produced, volume clutch's (6.95. indiclutch for control group , 14.516 indi clutch for 0.596a ,3_65 ind./ clutch for (175 5(.. and 03 Ind} cruel] for 1960) and number of Clutch's (5.5 clutch/ female for control gr

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Publication Date
Wed Dec 29 2021
Journal Name
Al-khwarizmi Engineering Journal
Comparison of Prediction Programs for Short Wave Circuit Link from Iraq to Test points on Both Earth Hemispheres during Solar Minimum
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This paper compare  the accurecy of HF propagation  prediction programs for  HF circuits links between Iraq and  different points world wide  during August 2018 when  solar cycle 24 (start 2009 end 2020) is at minimun activity and also find out the best communication mode  used. The prediction   programs like Voice of America Coverage Analysis Program (VOACAP) and ITU Recommendation RS 533 (REC533 )  had been used to generat HF circuit link  parameters like Maximum Usable Frequency ( MUF) and Frequency of Transsmision (FOT) .Depending  on the predicted parameters (data)  , real radio contacts had been done using a radio transceiver from Icom  model IC 7100 with 100W RF

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Publication Date
Sat Jan 01 2022
Journal Name
Geotechnical Engineering And Sustainable Construction
Determine the Most Common Geotechnical Risks and Their Impacts on the Cost and Time Schedule for Implementing Water Treatment Plants in Iraq
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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Coordination between real estate and income tax and its impact on the tax outcome: Applied research in the General Authority for Taxes
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The research aimed to demonstrate the possibility of benefiting from the coordination between real estate and income tax as the independent variable on the tax outcome as the dependent variable as the dependent variable. Which were practiced within rented buildings, as information was obtained from real estate owners, and the annual controls for the year 2021 were relied upon in the process of calculating the tax amounts expected to be obtained. used in the tax inventory process lacks seriousness and continuous updating

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Publication Date
Sun Jun 02 2013
Journal Name
Baghdad Science Journal
Comparison of The Effect of Aqueous Extracts of two Plants, Origanum Vulgare L. and Fenugreek Seeds with Anticancer Drug Cis-Platin on the Growth of Cancer Cell Lines
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This study involved the effect of the aqueous extracts of two plants, Origanum vulgare L.(1), Trigonella Foenum Graecum L. (Fenugreek) seeds(2) on the growth of cancer cell lines. Rhabdomyo sarcomas (RD) of human cell line and female intestine cells of Albino mice (L20B) in vitro System. These extracts were compared with the known anticancer drug Cis-platinum(Cis-Pt) as a positive control. The phytochemical tests were used for screening the active compounds in plants. The inhibition activity assay was used as a parameter of the cytotoxic effect of these extracts. Cancer cell lines were treated with four concentrations of Cis-platin, 31.25, 62.5, 125 and 250 ?g/ml for 72 hour exposure time. The same concentrations were used for the other ext

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Evaluating the quality of municipal services according to the financial budgets for years 2006-2016 Analytical research in Diwaniyah Governorate
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The research aims at determining the main reason for the deterioration of the services and determining the correct method of distributing the funds to the administrative and administrative units. The discrepancy between the size of the financial allocations and the municipal services was the main research problem. Therefore, the researcher identified the gaps in municipal services by the concerned departments and compared them with The percentage of funds obtained through the work of a checklist for each of the directorates concerned. The researcher studied the specific criteria for these services, which were approved by the Ministry of Construction, Housing, Municipalities, and Public Works, and compared them wi

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Publication Date
Sun Sep 07 2008
Journal Name
Baghdad Science Journal
The antiviral activity of the compound chalcone (4-ethoxy-2-hydroxy-4, 6-dimethoxy-chalcone) against rubella virus in vitro
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The studies on the antiviral compound chalcone in vitro in both tissue and organ culture systems against rubella virus glass that this compound relatively non toxic to the cell culture and organ culture of the concentration of 8 ug/ml or less, chalcone have significantly antiviral activity against rubella virus in tissue culture and organ culture. We find that a concentration of 0.03ug/ml or more inhibit the IOOTCID50 of rubella virus. The therapeutic index (TI) used in this study to evaluate the drug, the (TI) which is the ratio of the dose of drug which is just toxic (Maximum tolerated dose) to the dose which is just effective (Minimum effective dose). If this index is one or less it not possible to use the drug under the conditions outli

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Publication Date
Mon Mar 15 2021
Journal Name
Al-academy
Variables related to the performance styles of batik art to achieve linear tactile effects in the printmaking: نجلاء المرضوف السعدي
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The art of batik is one of the ancient arts that has a long history in East Asian countries, especially in Indonesia, where it was considered a traditional craft with which many Indonesian tribes lived. This art began to move to other continents and develops and progresses due to the artist’s connection to the surrounding technological and intellectual development, as art became more outgoing and liberated, it helped the artist to create and innovate in his designs. In this research, he focuses on modern performance methods through which print paintings can be produced through design elements, especially calligraphy, to create aesthetic and creative effects in the productive work. The current research aims to identify the various perfo

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