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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 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Quality of Life in Schizophrenic Patients: The Relationship with Personal Characteristics
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Objectives: The study aims to identify the quality of life level in schizophrenic patients and to find out the
relationships between the quality of life and some of personal characteristics for those patients with
schizophrenia.
Methodology: A descriptive correlation analytic design was used by using the assessment technique on sample
of 100 schizophrenic outpatients, who were selected purposively (non-probability sample) during the period
10/ 3/2013 - 1/ 12 /2013. The study was conducted on the schizophrenic patients in an out patient psychiatric
clinics at Ibn-Rushd; and Al-Rashad Psychiatric Teaching Hospital; Baghdad Teaching Hospital, and Al-Kadhimya
Teaching Hospital. Self administrative questionnaire was used

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Publication Date
Mon Dec 20 2021
Journal Name
Baghdad Science Journal
Pollution threatens water quality in the Central Marshes of Southern Iraq
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Water pollution is an issue that can be exacerbated by drought as increased concentrations of unwanted substances are a consequence of lower water levels. Polluted water that flows into natural marshlands leads to the deposition of pollutants in the interior of the marsh. Here we present evidence that the interior of the Central Marsh (CM) in southern Iraq suffers from higher levels of pollution than areas closer to the source of water entering the marsh (the Euphrates River). A 1.7m embankment that halts the flow of the Euphrates is only infrequently breached and so the CM is effectively the terminal destination of the waters (and their associated pollutants and agricultural waste) flowing from the West of Iraq.

A range of water

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Publication Date
Fri May 31 2024
Journal Name
Research Journal Of Biotechnology
The Utility of SHBG Assay in Clinical Biochemistry for Iraqi Women
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Polycystic ovarian syndrome, additionally called PCOS is the most widespread endocrine illness amongst women. The aetiology of PCOS is attributed to a multi-factorial interplay among environmental and genetic effects. The overarching goal evaluates the correlation among blood concentrations of total testosterone, sex-hormone-binding globulin (SHBG), estradiol (E2), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in ladies with PCOS and the impact of obesity, age, marital popularity on the obtained results. This study was conducted at the National Center for Educational Laborites /Medical City/ Baghdad. The study comprised of a sample of 83 women, elderly between 17 -45 years, who had been selected in a random manner

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Publication Date
Sun Apr 02 2023
Journal Name
Journal Of Oral Microbiology
Current concepts in the pathogenesis of periodontitis: from symbiosis to dysbiosis
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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
The Indian Ghost in Lynn Riggs' Play The Cherokee Night
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This play is written in 1932 by Lynn Riggs who is half Cherokee. The play is set in Claremore Mound, Oklahoma almost a century after the Trail of Tears. Riggs presents mixed- blood, young Cherokees to portray a post-colonial state of spiritual loss and disruption of traditional community ties. The new generation lives in darkness, and the title of the play tells about the dramatist's view that night comes to his Cherokee Nation. The Indian ghost is one of the play’s characters.  It is an Indian ghost of a warrior. It comes to remind Cherokees of their heritage and traditions. The ghost sees the new generation as nothing as ghosts because they are neither good for themselves nor for their nation. This paper is important as it discu

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Publication Date
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
ADVERTISEMENTS IN THE CINEMA STARTING FROM THE MID 20TH CENTURY
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At the time when many important political events and evolutions took place, the cinema has been pretty active, and witnessed the historical events before and after the two world wars and the cold war. During the first half of the 20th century, the cinema had great interest from the major countries and their politicians, as well as the commercial turnout of large companies to invest in that field for the profits.  In the beginning of the 20th century, the major powers like the Soviet Union, the United States, Germany, Italy, England, and France started to compete in the development of their film industry and the investment of the new medium and the transformation of some famous works of fiction into films that perpetuate their cultur

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Publication Date
Wed Jun 03 2020
Journal Name
Political Sciences Journal
nternational will in the Security Council Towards the Syrian crisis
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Nations witnessed since its existence a state of wills conflict as a result of the intersection and intertwining of interests, through which it sought to achieve its goals and objectives, and this has often led to direct military conflicts and countless wars, and witnessed the entry into global wars in which humanity lost millions of lives and losses .Despite the great changes in the international arena, especially in recent decades, the conflict of wills has not ceased, although some of its features and forms have changed, and it has become more complicated after the withdrawal of this conflict to international organizations and bodies, including the Security Council. It is mandated under the Charter of the United Nations to wor

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Publication Date
Tue Jan 01 2019
Journal Name
Plant Archives
The seasonal effect on the water bodies in Iraqi marshlands
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Publication Date
Tue Mar 22 2022
Journal Name
Journal Of Al-turath University College
The Turkish role in the US-Iran Crisis (2017-2020)
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New developments imposed different patterns of interactions between major international powers and Iran during 2018, ranging to varying degrees between cooperation and tension, the most important of which is the new measures taken by the United States to withdraw from the nuclear agreement and impose new US sanctions on Iran, which in turn insisted on not responding to pressure to which they are exposed to make changes in their policies and to negotiate again about the main contentious files, especially the nuclear program and ballistic missiles, and the roles they play for crisis countries, especially supporting some armed organizations in Syria, Lebanon, Iraq and Yemen. These differences have put the international forces before difficult

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Publication Date
Thu Apr 16 2015
Journal Name
Frontiers In Physiology
Dopaminergic signaling within the primary cilia in the renovascular system
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