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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
Tue Feb 20 2024
Journal Name
Arab Gulf Journal Of Scientific Research
Investigation of Pseudomonas aeruginosa bacteria in a number of Baghdad schools and extent of their resistance to disinfectants and sterilizers
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Purpose This study was design to investigate of Purpose This study was design to investigate of P. aeruginosa, an example of Gram-negative bacteria, in seven primary and secondary schools of Baghdad city, and the effects of Ethanol and Dettol of P. aeruginosa biofilm. Design/methodology/approach Seventy swabs were collected from seven primary and secondary schools of Baghdad city, Iraq, during November -December 2022. Swabs were collected from classes desk, doors handles, students hands and water taps. Standard microbiological testing methods were used on the samples for isolation and identification. The ability of bacteria to form biofilm and the effects of Ethanol and Dettol on “preformed” biofilms was examined by microtiter plate wi

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The contribution of information systems to increase tax revenues: An applied research at the General Commission of Taxes
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The research aims to study the contribution of tax information systems to increase tax revenues, and to identify how efficiently used information systems currently by the tax authority and their effectiveness in the detection of irregularities by the tax payers such as the cleclaration of incorrect statements that do not show real results of their business activities or hide information from sources related to their income subject to tax, which would negatively affect the outcome of tax revenues and thus damage important sourse of the public treasury of the states resources. The data of research was collected by studying and analysing the tax information systems used by the General Commission of taxs and its branches and a number of prac

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Learning for Scientific Culture by Using Interactive Whiteboard According to the Faculty of the University of Baghdad Viewpoint
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The progress of science in all its branches and levels made great civilized changes of
our societies in the present day, it's a result of the huge amount of knowledge, the increase of
number of students, and the increase of community awareness proportion of the importance of
education in schools and universities, it became necessary for us as educators to look at
science from another point of view based on the idea of scientific development of curricula
and teaching methods and means of education, and for the studying class environment as a
whole, by computer and internet use in education to the emergence of the term education
technology, which relies on the use of modern technology to provide educational content to<

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Publication Date
Wed Nov 04 2015
Journal Name
Journal Of Chemical, Biological And Physical Sciences
The Effect of Alkaloid Extracted from Cordia myxa Leaves on the Survival of Mustard Aphid Lipaphis erysimi (Kalt.)
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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Government Controlling Standards GAO to limit Some of Negative Phenomena According to the Anti-corruption
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Abstract :

       The research aims to diagnose some of the negative phenomena
 ( Counterfiting , Pettifogging , Embezzlement ) that have been detected over the past ( 2010 – 2014 ), a fixed-term part of the national strategy for the fight against corruption launched by the Joint Council for the fight against corruption in Iraq and measuring the application of government control according to the American standard GAO standards and identifying the potential for the application of those standards gap. It has been collecting data and information of special issues of corruption reports and meeting with (42) employees and the use of a checklist has been prepared for thi

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Publication Date
Sat Jan 01 2022
Journal Name
Communications In Mathematical Biology And Neuroscience
The effect of fear on the dynamics of two competing prey-one predator system involving intra-specific competition
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Publication Date
Sun Mar 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Measurement of the distance to the central stars of Nebulae by using Expansion methods with Alladin Sky Atlas
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Abstract<p>The usual methods of distance determination in Astronomy parallax and Spectroscopic with Expansion Methods are seldom applicable to Nebulae. In this work determination of the distances to individual Nebulae are calculated and discussed. The distances of Nebulae to the Earth are calculated. The accuracy of the distance is tested by using Aladin sky Atlas, and comparing Nebulae properties were derived from these distance made with statistical distance determination. The results showed that angular Expansions may occur in a part of the nebulae that is moving at a velocity different than the observed velocity. Also the results of the comparison of our spectroscopic distances with the trig</p> ... Show More
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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
effect of doping with nitrogen on the optical constant of the sic films prepared by TEA-Co2 Laser
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In this research prepare membranes pure silicon carbide (SiC) as well as gas Alloy (ammonia) and using a laser was leaked membrane of glass flooring. To Drasesh optical properties of membranes prepared depending on the technique (Swanepoel) and Adhrt results obtained in general increased permeability pure silicon membranes

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Publication Date
Sat Dec 05 2020
Journal Name
Iop Conference Series: Materials Science And Engineering, Volume 1067
The effect of cyclic loading on the nonlinear response of structural concrete members with arbitrary cross-sectional shapes
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Publication Date
Wed Dec 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of voluntary corporate disclosure on tax planning: The impact of voluntary corporate disclosure on tax planning
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The attention of civil society organizations, governments and international non-governmental organizations in recent years has focused on the acute practices adopted by companies with the aim of reducing the tax burden, and the results of these practices have a negative impact on the tax revenues that the state uses to finance public needsThe aim of the research is to measure the impact of the voluntary disclosure of companies on tax planning for the period from 2011 to 2015 and the research community is in the General Tax Authority. The research sample is 6 companies within the private sector in the financial, banking, insurance and industrial fields. The research was based on a special model to measure the optional disclosure,

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