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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
Thu Jan 13 2022
Journal Name
Journal Of Water And Land Development
A study of the climate and human impact on the future survival of the Al-Sannya marsh in Iraq
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Polish Academy of Sciences

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Mottos Of Opposition Movements In Iraq During The Umayyad Period and Their Religious and Political Indications
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Mottos Of Opposition Movements In iraq during the umayyad period and their religious and political indications - al shia and al khawarij

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Publication Date
Sun Jun 01 2025
Journal Name
Journal Of The College Of Languages
A Stylistic Study of the Concept of Love in Kahlil Gibran’s ’The Prophet’
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In his masterpiece ’The Prophet’, Kahlil Gibran presents his unwavering faith and passionate belief in the healing power of universal love that brings humans to sublime ideas and elevates their souls and behavior. The current study aims to find out the stylistic devices utilized to represent the concept of love based on the hypothesis that Gibran tends to use certain stylistic effects to convey his meaning. The study adopts Leech and Short’s (2007) framework of stylistic analysis to analyze the lexical items and figures of speech in selected extracts from the book. The findings reveal that Gibran prefers concrete nouns, dynamic verbs, and physical adjectives over abstract nouns, stative verbs, and psychological adjectives to s

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Publication Date
Tue Nov 30 2021
Journal Name
Research Journal Of Pharmacy And Technology
Diagnostic approach to Perimenopausal bleeding by Pipelle or Dilatation and Curettage
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Perimenopausal bleeding, is a very common problem, which is an alarming symptom for both; women and their doctors because of the rising fears of cellular changes or tumor of endometrium. In our study we tried to prove that collecting endometrial samples using the outpatient method of Pipelle is as effective as collecting the endometrial samples in the traditional method of Dilation and Curettage (DandC) in operation theatre which necessitates general anesthesia. Ninety four patients more than 40 years old were included in the study, all of them were complaining of abnormal uterine bleeding (pregnant ladies and ladies using hormonal contraception were excluded from the study) and endometrial samples were collected first in outpatient

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Publication Date
Wed Mar 16 2022
Journal Name
International Academic Journal Of Accounting And Financial Management
Analyzing and Measuring the Relationship between Public Spending and the Parallel Exchange Rate in the Iraqi Economy for the Period 2004-2022
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Public spending represents the government’s financial leverage and has a significant impact on real and monetary economic variables, and one of these effects is the effect of public spending on the exchange rate as an important monetary variable for monetary policy, As we know that public spending in Iraq is financed from oil revenues sold in US dollars, and the Ministry of Finance converts the US dollar into Iraqi dinars to finance the government's need to spend within the requirements and obligations of the state's general budget, And converting the US dollar into Iraqi dinars has an impact on the parallel exchange market, even if there is a contractual exchange rate between the Ministry of Finance and the Central Bank of Iraq to

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Publication Date
Sun May 01 2016
Journal Name
Journal Of Engineering
Prediction of Ryznar Index for the treated water from WTPs on Al-Karakh side of Baghdad City using Artificial Neural Network (ANN) technique
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In this research an Artificial Neural Network (ANN) technique was applied for the prediction of Ryznar Index (RI) of the flowing water from WTPs in Al-Karakh side (left side) in Baghdad city for year 2013. Three models (ANN1, ANN2 and ANN3) have been developed and tested using data from Baghdad Mayoralty (Amanat Baghdad) including drinking water quality for the period 2004 to 2013. The results indicate that it is quite possible to use an artificial neural networks in predicting the stability index (RI) with a good degree of accuracy. Where ANN 2 model could be used to predict RI for the effluents from Al-Karakh, Al-Qadisiya and Al-Karama WTPs as the highest correlation coefficient were obtained 92.4, 82.9 and 79.1% respectively. For

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Publication Date
Mon May 09 2022
Journal Name
مجلة علوم ديالى
The expression of PmrA gene in Acinetobacter baumannii bacteria that is responsible for Colistin resistance
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Publication Date
Wed Apr 03 2013
Journal Name
Iraqi Journal Of Medical Sciences
Ligasure versus clamp and tie technique to achieve henostasis in thyroidectomy for benign diseases
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Publication Date
Tue Dec 31 2024
Journal Name
Iraqi Geological Journal
Geomechanical Modeling and Artificial Neural Network Technique for Predicting Breakout Failure in Nasiriyah Oilfield
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Wellbore instability is one of the major issues observed throughout the drilling operation. Various wellbore instability issues may occur during drilling operations, including tight holes, borehole collapse, stuck pipe, and shale caving. Rock failure criteria are important in geomechanical analysis since they predict shear and tensile failures. A suitable failure criterion must match the rock failure, which a caliper log can detect to estimate the optimal mud weight. Lack of data makes certain wells' caliper logs unavailable. This makes it difficult to validate the performance of each failure criterion. This paper proposes an approach for predicting the breakout zones in the Nasiriyah oil field using an artificial neural network. It

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Engineering
Numerical Simulation of Flow in Rectangular Duct with Different Obstruction Heights
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       In this study, a simulation model inside a channel of rectangular section with high of (0.16 m) containing two rectangular obstruction plates were aligned variable heights normal to the direction of flow, use six model of the obstructions height of (0.059, 0.066, 0.073, 0.08 and 0.087 m) were compared with the flow behavior of the same duct without obstructions. To predict the velocity profile, pressure distribution, pressure coefficient and turbulence kinetic energy flow of air, the differential equations which describe the flow were approximated by the finite volumes method for two dimensional, by using commercial software package (FLUENT) with standard of k-ε model two dimensions turbulence flow.

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