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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 Feb 01 2023
Journal Name
Archives Of Razi Institute
The Effect of Active Compounds and Trace Elements Extracted from Artemisia Fruit on Some Liver Enzymes in Humans
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Artemisia is a perennial wild shrub with large branches and compound leaves. Artemisia contains about 400 types, and its medical importance is due to the presence of many active substances and compounds such as volatile oils, alkaloids and flavonoids, glycosides, saponins, tannins, and coumarins. This study was designed to study the effect of the aqueous extract of the fruit of the Artemisia plant on the organs of the body, as well as to know its ability to activate the hepatic enzyme alanine transaminase (ALT/GPT). The fruit of this shrub was extracted using the measurement technique gas chromatography-mass spectrometry (GC/MASS) and organic solvent hexane and ethyl acetate in one to one ratio. It contained 21 compounds, a high percentage

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Using system dynamics model and the statistical indicators for Road Map of "Green government departments" project In Iraq
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Abstract                                                         

The issue of the protection of the environment is a shared responsibility between several destinations and sectors, and constitutes a main subject in which they can achieve sustainable development. In the sectors of government programs can be set up towards the establishment of the government sector to the green environment, so to be the implementati

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Publication Date
Thu Jun 13 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Association of the MDR1 Variants (rs2032582 and rs2032583) with Steroid Response in Iraqi Children with Idiopathic Nephrotic Syndrome
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Background: Several studies linked the development of steroid-resistant nephrotic syndrome (SRNS) to genetic variations in the multidrug resistance 1 (MDR1) gene, though a disparity in findings was underlined among children with different ethnic origins. Objective: This study examined the relationship between MDR1 variants (rs2032582 and rs2032583) and the risk of developing SRNS in Iraqi patients with idiopathic nephrotic syndrome (INS). Methods: This case-control study included children with steroid-sensitive INS (SSNS; n=30) and SRNS (n=30) from the Babylon Hospital for Maternity and Pediatrics. Sanger sequencing was used to determine the participants’ genotypes. Results: The rs2032582 genotypes and alleles were not associated

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Publication Date
Fri Jun 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of Dental Implant Site Dimensions And Alveolar Bone Density in The Mandible Using Cone Beam Computed Tomography
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Background: The quantity and the quality of available bone, influence the clinical success of dental implants surgery. Cone beam Computed tomography is an established method for acquiring bone images before performing dental implant. Cone beam computed tomography is an essential tool for treatment planning and post-surgical procedure monitoring, by providing highly accurate 3-D images of the patient's anatomy from a single, low-radiation scan which yields high resolution images with favorable accuracy. The aim of study is the Measurement of alveolar bone (height and buccolingual width) and density in the mandible among Iraqi adult subject using CBCT for assessment of dental implant site dimensions. Material and method: The study sample in

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Publication Date
Sun May 01 2016
Journal Name
Arabian Journal Of Geosciences
Iron mineralization in the Garagu Formation of Gara Mountain, Duhok Governorate, Kurdistan, NE Iraq: geochemistry, mineralogy and origin
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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Indian Academy Of Oral Medicine And Radiology
The Degenerative Condylar Change in Temporomandibular Joint Disorder of Iraqi Population and their Variability Based on Clinical Diagnosis
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Background: As a multifactorial disorder, temporomandibular joint (TMD) is difficult to diagnose, and multiple factors affect the joint and cause the temporomandibular disorder. Standardization of clinical diagnosis of TMD should be used to reach a definite clinical diagnosis; the condylar bone may degenerate in accordance with these disorders. Aims: Evaluate the correlation between the clinical diagnosis and degenerative condylar change (flattening, sclerosis, erosion, and osteophyte). Materials and Methods: A prospective study with a study group of 97 TMD patients (total of 194 joints) aged 20 to 50. Patients were sent to cone beam computed tomography (CBCT) to assess the degenerative condylar change. Results: No association was found bet

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Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
Transformations of Actor's Performance between the Body and Mask Dualism in Iraqi Child's Theatre Shows: حازم عوده صيوان
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The Child's theatre was and still is the most investing art for masks of all kinds (partial and total) for suspense, aesthetic and artistic purposes that meet the requirements of those performances. Here the actor's performance is associated with two tools, i.e. the body and the mask, where it has become a must to search for the performance transformations required in order to achieve the highest level of the right performance through this dualism. This urged the researcher to address this problem. Thus, the researcher has put forward an objective to identify the transformations of the character's performance between the body and the mask in the child's theatre shows. The research consists of a methodological framework and a theoretical

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Publication Date
Mon Jul 28 2025
Journal Name
Journal Of Physical Education
Designing and Standardizing two Dribbling Tests for the Initial selection of Individuals With Simple Mental Disabilities In Futsal
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The game of football is one of the most popular games in the world because of its beauty in the hearts of its fans. From this position, the game of five football for people with simple mental disability has become as much attention to many other sporting events, so the researchers believe that the tests of basic skills match the level of individuals tested In terms of their age and mental ability, the technical aspects were adopted as a means of selecting those who are qualified to practice this game in the simplest form, so the importance of the research problem in designing and standardizing two dribbling skating tests for members of this category and It depends by training their cadres during the selection process. The research community

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Publication Date
Fri Mar 06 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Building HEC-RAS model to detect the areas of Water Cycle Interruption in river stream and their sections
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The purpose of this paper is to build a simulation model by using HEC-RAS software to simulate the reality of water movement in the main river of Basra City (South of Iraq) which is known as Siraji-Khoura River. The main objective of the simulation is to detect areas where the water cycle is interrupted in some stations of the river stream, as this river has become an outlet for the disposal of sewage, leading to pollution and causing weakness in some sections of the river & obstructing the water cycle that takes place between this river and Shatt al – Arab river. A field survey data of the river and its banks were adopted to derive the grades, longitudinal and cross sections of the river, these data included three-dimensional coordinates

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Publication Date
Wed Apr 02 2025
Journal Name
Retos
The effect of rehabilitation exercises accompanied by ultrasound waves in reducing pain and healing from carpal tunnel compression
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Objective: The current study aimed identifying the impact of rehabilitative exercises combined with ultrasonic waves on reducing pain in people with carpal tunnel compression and determining how these activities affect range of motion of the upper limb for those suffering from carpal tunnel compression. Research methodology: With pre- and post-tests, the researchers employed the experimental method in the form of two equal groups, the experimental and the control. The scientific community and sample are among the priorities that fall on the researcher, so The scientific community is determined by those suffering from carpal tunnel compression, numbering (14) patients. (12) Patients were approved and two were excluded from the resear

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