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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 Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
The House of Illusions A Study in Genet's The Balcony
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The definition of "prostitute" and prostitution is a difficult one and a
question over which the legislators of many lands and nations differed. A
notable feature of prostitution is its epidemic increase at times of war,
revolution and armed commotion, on account of economic, social and
psychological factors generated by such conditions of mortal conflicts. Wars
invariably deprive young wives and lovers of their men folk, resulting in
financial , sexual and emotional frustrations . At no time is the natural
balance between the sexes more seriously disturbed than during wars, when
thousands of men are thrown into one sector of the country and hundreds of
towns and villages are left to women and children only. Lo

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Publication Date
Thu Jun 15 2023
Journal Name
Journal Of Population Therapeutics And Clinical Pharmacology
Detection the Phylogenetic groups of E. coli that isolated from diarrheal in children under five years and study their relationship of common serotypes in Baghdad hospitals.
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Publication Date
Sun Mar 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of Poisoning Cases in the Poisoning Consultation Center and Forensic Medicine Institute within Baghdad area
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Social factors may affect the available sources of toxic substances and causes of poisoning, and these factors may change over time. Additionally, understanding the characteristics of poisoning cases is important for treating such patients. Therefore, the present study investigated the characteristics of poisoning cases in Baghdad Poisoning Consultation Center (PCC) and Forensic Medicine Institute (FMI). Data on all poisoning cases reported in PCC and FMI during 2013 were retrospectively obtained from medical records. Total of 1131 reports of poisoning cases (1082 from PCC and 49 from FMI) were analyzed according to age, sex, geographical distribution and causes of poisoning according to the type and class of poisoning agent. The results

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Publication Date
Sun Jan 01 2017
Journal Name
Pakistan Journal Of Biotechnology
Fragmentation of gallbladder stones using transformer streptococcus salivarius and measuring of RNA expression to cholesterol lowering genes
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Recently, gallbladder stones have been contained bile salt saturated a proximal 70 % cholesterol. This led us to investigate how can use transformer Streptococcus salivarius with plasmid pMG36bsh to fragment cholesterol of gallstones in vitro. Total mRNA of S. salivarius was produced using easy-spinTM, total RNA extraction kit and PCR cDNA-RT to observe the change after percent pMG36bsh vector and prepare S. salivarius have two copies from bsh genes (cgh, bsh) to fragment gallstone in bacterial culture. Our data shows increase bacterial bsh expression help to reduce gallstones concentration in culture when bile salt presented as stimulating agent for the association bsh genes were 77% compare with wild type has the reducing concentration ra

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Publication Date
Tue Dec 29 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Management accounting techniques in product development and achievement customer requirements by adopting the technique of Quality Function Deployment: Applied Research in Baghdad Company for Soft Drinks
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The research aims to apply one of the techniques of management accounting, which is the Quality Function Deployment(QFD) on the Pepsi product in Baghdad Soft Drinks Company and to determine the technical requirements objectively that have been applied in practice in Baghdad Soft Drinks Company / a private shareholding company, as it focuses on meeting the quality requirements and achieving positive quality to provide a product It meets the requirements of current and future customers, hence the importance of research that indicates that the Quality Function Deployment(QFD) is a useful tool to develop the requirements of new products, being a design process driven by customers through their voices, and thus contribute to achieve a competi

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Publication Date
Fri Jun 07 2024
Journal Name
Medicine
Impact of TYMS gene polymorphism on the outcome of methotrexate treatment in a sample of Iraqi rheumatoid arthritis patients – identification of novel single nucleotide polymorphism: Cross-sectional study
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The current work aims to evaluate the association between genetic mutations in thymidylate synthetase (TYMS gene in exon1 and partial regions of promotor and intron 1 [877 bp, 657,220–658,096 bp]) and the therapeutic outcomes for rheumatoid arthritis (RA) Iraqi patients. An observational cross-sectional study involving 95 RA patients with established RA patients based on their methotrexate treatment responsiveness. Genetic sequencing of the TYMS gene was performed for all patients according to the instruction manuals of the sequencing company (Macrogen Inc. Geumchen, South Korea). Four polymorphisms were identified by sequencing 95 randomly selected patients in the noncoding region of TYMS

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Publication Date
Fri Mar 07 2025
Journal Name
Jurnal Keperawatan Soedirman
THE EFFECTS OF MUSIC INTERVENTIONS ON CHILDREN'S PAIN SEVERITY AND ANXIETY DURING DRESSING CHANGES IN IRAQ: A RANDOMIZED CONTROLLED TRIAL
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Abstract Daily dressing changes cause distress and pain for victims of burn injuries. The study aimed to determine the effect of music in reducing the pain and anxiety of thermally burned children during routine dressing changes. This quantitative study employed a randomized controlled trial design. The participants comprised 80 children at the Specialized Burns Hospital, in Baghdad, Iraq who were divided into two groups. The intervention group were exposed to three generic musical pieces (children’s music, nature sounds, and classical music) for 10-15 minutes. The researchers used the Objective Pain Scale, State-Trait Anxiety Inventory, and physiological parameters to measure the children’s responses immediately before the dressing cha

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Scopus
Publication Date
Thu May 15 2025
Journal Name
Magazine Of College Administration&amp;economics For Economic &amp; Administration &amp; Financial Studies
The Design of Optimal Layout Using Computerized Relative Allocation of Facilities Technique (CRAFT) - Applied Research in Al-M&#39;ammon Factory / The General Company for Vegetable Oils Industry
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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the relationship between Government spending compression and the window of the currency and its impact on the exchange rate of the Iraqi dinar
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The exchange rate is the backbone of  any economy in the world, whether  developed or developing, where most countries adopted  many policies, in order to ensure the stability of the exchange rate of the currency, because of its importance as a link between the local economy and the others ,And it contribute in the achievement of internal and external balance and despite the many different factors that affect it, but there is wide consensus on the effectiveness of the role of spending and the currency window in the exchange rate of the Iraqi dinar, especially in the Iraqi economy, effectiveness As the increase in government spending lead to an increase in the supply of money and increase domestic demand and high pr

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Publication Date
Thu Jan 01 2009
Journal Name
Journal Of Global Pharma Technology
Contribution of Equilibrium Variables with the High Spike Accuracy of the Position Diagonal Center (4) in the National Volleyball Team Players
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