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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 Aug 17 2025
Journal Name
Karbala Journal Of Physical Education Sciences
Training of different ranges using the (HC-SR04 ultrasonic sensor ) and its effect in developing some of special abilities for young boxers
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Publication Date
Mon May 01 2023
Journal Name
Journal Of Engineering
Assessment of Climate Change Impact on Water Productivity and Yield of Wheat Cultivated Using Developed Seasonal Schedule Irrigation in the Nineveh Province
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The agricultural lands that depend on supplementary irrigation methods for winter wheat cultivating in wide areas of the Nineveh province are most vulnerable to climate change concerns. Due to frequent rainfall shortages and the temperature increase recently noticed and predicted by the climate scenarios. Hence important to assess the climate effect on the crop response in terms of water consumption during the periods (2021-2040) and (2041-2060) by using high-resolution data extracted from 6 global climate data GCMs under SSP5-8.5 fossil fuel emission scenarios in changing and fixed CO2 concentration. And validate the Aqua-Crop model to estimate the yield and water productivity. And gives the RRSME of 7.1- 4.1

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Publication Date
Tue Mar 01 2022
Journal Name
Experimental Parasitology
The association of IL-3, IL-17A, and IL 27 serum levels with susceptibility to toxoplasmosis in recurrent abortion of Iraqi women
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Cytokines are a group of immunomodulatory proteins leading to a variety of immune reactions in the human; these cytokines play a significant role in the development of appropriate immune responses against T. gondii. This study aims to reveal the association of toxoplasmosis with serum levels of IL-3, IL-17A, and IL-27 in aborted women. The blood samples of patients and controls were collected from Al-Alawiya Maternity Teaching Hospital/Baghdad/Iraq from 2019 to 2020 for detecting anti-T. gondii antibodies (IgG and IgM) and the level of interleukins by ELISA. The results of TORCH by rapid test for recurrent abortion recorded 25.3% seropositive for anti-Toxoplasma antibodies, and 31.5% seropositive for one or more cases of TORCH test (Cytomeg

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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of Controlled Release
The efficacy of aerosol treatment with non-ionic surfactant vesicles containing amphotericin B in rodent models of leishmaniasis and pulmonary aspergillosis infection
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Publication Date
Sun Jun 03 2012
Journal Name
Baghdad Science Journal
Study of Some Epidemiological Aspects of Giardiasis in North of Baghdad
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Different factors have been examined to be related with the prevalence of Girdiasis in the north of Baghdad in human beings which were (gender, age , occupation ,family size,faecal status and presence of domestic animals) during the period from the beginning of April 2009 till the end of March 2010. This study revealed that the total rate of infection in human being was 11.66% , and no significant differences (p?0.05) were noticed between male and female as their rates of infection were 52.32% and 47.68% respectively , as well as no significant relation was observed between faecal status and the rate of infection, the percentage of positive cases in diarrheal patients was higher than the non diarrheal patients who were 74.41 and 25.59 respe

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Publication Date
Fri Apr 01 2016
Journal Name
Communications In Nonlinear Science And Numerical Simulation
Simultaneous determination of time and space-dependent coefficients in a parabolic equation
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Publication Date
Wed Dec 15 2021
Journal Name
Al-adab Journal
A Feminist Rhetorical Analysis of Anti-feminist Poetry in English and Arabic
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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
A Feminist Stylistic Analysis of Anti-feminist Poetry in English and Arabic
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Language plays a major role in all aspects of life. Communication is regarded as the most important of these aspects, as language is used on a daily basis by humanity either in written or spoken forms. Language is also regarded as the main factor of exchanging peoples’ cultures and traditions and in handing down these attributes from generation to generation. Thus, language is a fundamental element in identifying peoples’ ideologies and traditions in the past and the present. Despite these facts, the feminist linguists have objections to some of the language structures, demonstrating that language is gender biased to men. That is, language promotes patriarchal values. This pushed towards developing extensive studies to substantiate s

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Publication Date
Tue Nov 17 2020
Journal Name
Journal Of Physics: Conference Series
A trial treatment of Hydatidosis in white mice by Immunization and Chemicals
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The present study was conducted as atrial to treat secondary hydatidosis in white mice of species Mus musculus. (Balb/c strain), experimentally infected with secondary hydatid cysts of sheep origin. The immunization process was carried by using CF/PS antigen which consist hydatid cyst fluid (CF) antigen, and protoscolices (PS) antigen mixed together and by using two concentrations 7.5, 15 mg/ml. Then derivatives of Benzimidazole, Mebendazole (M) and drugs Albendazole (A) were used 10 and 40 μm/gm body weight respectively. The mixture of drugs was used one week after challenged dose. Criteria taken into consideration to define the activity of the immunization and chemotherapy in this study were reduction in the numeral of cysts, the coeffic

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Pharmacy Research
Design and in vitro characterization of bisacodyl as a hollow-type suppositories
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