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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 Jul 01 2012
Journal Name
International Journal Of Computer Mathematics
Numerical solution of the two-dimensional Helmholtz equation with variable coefficients by the radial integration boundary integral and integro-differential equation methods
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Publication Date
Wed Sep 01 2021
Journal Name
Iraqi Journal Of Physics
Theoretical Calculations of the Cross-sections for (n,α) and (n,xα) reactions on the Structural Material for Fusion Reactor 46-50Ti
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The biggest problem of structural materials for fusion reactor is the damage caused by the fusion product neutrons to the structural material. If this problem is overcomed, an important milestone will be left behind in fusion energy. One of the important problems of the structural material is that nuclei forming the structural material interacting with fusion neutrons are transmuted to stable or radioactive nuclei via (n, x) (x; alpha, proton, gamma etc.) reactions. In particular, the concentration of helium gas in the structural material increases through deuteron- tritium (D-T) and (n, α) reactions, and this increase significantly changes the microstructure and the properties of the structural materials. T

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Comparing the Sequential Nonlinear least squared Method and Sequential robust M method to estimate the parameters of Two Dimensional sinusoidal signal model:
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Estimation of the unknown parameters in 2-D sinusoidal signal model can be considered as important and difficult problem. Due to the difficulty to find estimate of all the parameters of this type of models at the same time, we propose sequential non-liner least squares method and sequential robust  M method after their development through the use of sequential  approach in the estimate suggested by Prasad et al to estimate unknown frequencies and amplitudes for the 2-D sinusoidal compounds but depending on Downhill Simplex Algorithm in solving non-linear equations for the purpose of obtaining non-linear parameters estimation which represents frequencies and then use of least squares formula to estimate

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Publication Date
Fri Apr 30 2021
Journal Name
Al-kindy College Medical Journal
Immunological aspects of Alpha 1 Antitrypsin in COVID-19 infection among the Populace and Pregnant Women: Alpha 1 Antitrypsin and COVID-19
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Since the COVID-19 pandemic alarm was made by the severe acute respiratory syndrome (SARS)-coronavirus (CoV) 2, several institutions and agencies have pursued to clarify the viral virulence and infectivity. The fast propagation of this virus leads to an unprecedented rise in the number of cases worldwide. COVID-19 virus is exceptionally contagious that spreads through droplets, respiratory secretions, and direct contact. The enveloped, single-stranded RNA virus has a specific envelop region called (S) region encoding (S protein) that specifically binds to the host cell receptor. Viral infection requires receptors' participation on the host cell membrane's surface, a  key- step for the viral invasion of susceptible cells.

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Publication Date
Fri Jan 01 2021
Journal Name
Special Exercises For Offensive Tactical Skills And Their Impact On Developing The Speed And Accuracy Of Some Basic Skills In Youth Football
SPECIAL EXERCISES FOR OFFENSIVE TACTICAL SKILLS AND THEIR IMPACT ON DEVELOPING THE SPEED AND ACCURACY OF SOME BASIC SKILLS IN YOUTH FOOTBALL
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Publication Date
Sat Feb 27 2021
Journal Name
Journal Of Engineering
Using Geographic Information Systems (GIS) Program and Water Quality Index (WQI) to Assess and Manage Groundwater Quality in the City of Baghdad
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Groundwater is an essential source because of its high quality and continuous availability characterize this water resource. Therefore, the study of groundwater has required more attention. The present study aims to assess and manage groundwater quality's suitability for various purposes through the Geographical Information System GIS and the Water Quality Index WQI. The study area is located in the city of Baghdad in central Iraq, with an approximate area of ​​900 , data were collected from the relevant official departments representing the locations of 97 wells of groundwater in the study area for the year 2019, as it included physicochemical parameters such as  pH, EC, TDS, Na, K, Mg, Ca, Cl,  , and &nbs

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Publication Date
Tue Mar 01 2016
Journal Name
Al-academy
THE METHOD OF EXPRESSION IN INNATE AND POPULAR IRAQI SCULPTURAL CONTEMPORARY STUDYING BETWEEN (Hadi KadhimNassif) and (Ibrahim al nakash): كفاح عبد المجيد
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The innate art,is a major tributary in the art world, It is a bold achievement, has a special flavor, With self-identity, linked to the origins and roots of human ,That goes back to the past and the history and culture of peoples. This business is not limited to only aesthetic side, but is loaded with religious and magical experience, and have social functions, This creations stayed live, breathe, grow, and change with the transformation of society, these processors emerged, from local people have not been trained academically.Their Elvis came from community culture,Which are, Mesopotamian thoroughbreds.This culture that we desperately need today, in order to increase ourselves Iraqi force, In the face of the modern world, which is locke

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Publication Date
Thu Jul 02 2020
Journal Name
International Journal Of Pharmaceutical Research
The Correlation of TGF-ß Level and GARP Gene Expression in Iraqi Patients with Rheumatoid Arthritis Treated By Biological and Chemo-Therapy
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Publication Date
Tue Aug 19 2025
Journal Name
Journal Of Physical Education
Proposed Exercises Using Flexible Resisters And Their Effect On Developing Strength Endurance And The Performance of Some Offensive Skills In Youth Basketball
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Publication Date
Wed Nov 01 2023
Journal Name
International Society For The Study Of Vernacular Settlements
Using Modern Techniques in the Formation of Flexible Interior Spaces: Insights from Iraq
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