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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
Sun Jan 01 2017
Journal Name
Research Journal Of Pharmacy And Technology
The Lived Experience of Iraqi Nurses who Live and Work in Communities Impacted by War or Terrorist Threat
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Publication Date
Sun Aug 23 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Development Accounting Rule disclosure by accounting policies in the light of Islamic and electronic banking Activities: Proposal pattern
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the bank sect for any country  is very important  because  its represent a major  nerve   to feed a verity economic and finance activities .development any state measure by development  banking  sets and its represent  important  factor to investors attract . and because  important  of this subject ,teen accounting rule is a specialized for it .its related by  Disclosures in the Financial Statements Of Banks and The Similar Institutions, its accredit  by auditing and accounting standard  consul in republic of Iraq.in date 10/28/1998.                      &

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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
Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
The use of Arabic-Islamic Theme in The Stories of Western writers: El empleo del material árabe-islámico en las historias de los escritores occidentales
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This article presents and  explores the theoretical aspect in the use of Arab Islamic theme by the western writers to obtain and achieve individual motives. In this study the model for the theory of Arab presence in Andalusia  , through the book entitled “ Alhamra” by the English writer Washington Erving ,was  analyzed.

The most important results in this research: the success of  the author in the employment of the Islamic history in the formation of the first American legend, Columbus legend, through the selection of the right thoughts to establish his American National theory.  The author compared between the Andalusia experience and the Arab occupation to Spain and the American conquest of the new

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Publication Date
Fri Mar 30 2001
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study of Performance of Air Filters in Public Shelters
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Publication Date
Mon Nov 17 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The frontal sinus dimensions in mouth and nasal breathers in Iraqi adult subjects
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Background: The frontal sinus area can be used as a diagnostic aid to recognize mouth breather subjects. The aims of this study were to determine the gender difference in each group, to compare the frontal sinus area between mouth breather and nasal breather group, and to verify the presence of correlation between the frontal sinus area and the cephalometric skeletal measurements used in this study. Materials and Methods: Cephalometric radiographs were taken for 60 adults (30 mouth breathers and 30 nasal breathers) age range (18-25), for each group 15 males and 15 females, in the orthodontic clinic in the college of Dentistry at Baghdad University. The control group (nasal breather) with skeletal class I and ANB angle ranged between 2-4º,

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Publication Date
Sat Jan 01 2022
Journal Name
Geminivirus : Detection, Diagnosis And Management
Geminiviruses occurrence in the middle east and their impact on agriculture in Iraq
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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Strategic Planning and its Importance in Building Institutional Work in the National Insurance
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The aim of the research is to identify the reality of strategic planning in the National Insurance Company and its importance in building institutional work and to identify the requirements that enable this company to successfully implement strategic planning and the obstacles that limit its application and then achieve the marketing objectives of this company. This study started from the fact that there is a problem represented by the main question that was stated.                                            &nbsp

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Publication Date
Thu Sep 19 2024
Journal Name
Irish Journal Of Medical Science (1971 -)
Correlation between clinical and MRI findings in disc herniation in the lumbosacral region
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Publication Date
Wed Feb 15 2023
Journal Name
International Journal Of Emerging Technologies In Learning (ijet)
Instructional Design According to the Repulsive Learning Model and its Impact on the Achievement of Chemistry and Lateral Thinking for Third-Grade Intermediate Students
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Identify the effect of an educational design according to the repulsive (allosteric) learning model on the achievement of chemistry and lateral thinking. The sample consisted of (59) students from third-grade intermediate students. They were randomly distributed into two groups (experimental and control), and the equivalence was done in (chronological age, previous achievement in chemistry, intelligence, lateral thinking). The (30) students from experimental group were taught according to the instructional design, other 29 students from the (control) group were taught according to the usual method. Two tests done, one of them is an achievement test consisted of (30) items of the type of multiple choice, the other was a lateral think

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