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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
Sat Apr 01 2023
Journal Name
Full Text Book Of Minar Congress8
REGULARITY VIA PRE- GENERALIZED OPEN SETS
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By use the notions pre-g-closedness and pre-g-openness we have generalized a class of separation axioms in topological spaces. In particular, we presented in this paper new types of regulαrities, which we named ρg­regulαrity and Sρg­regulαrity. Many results and properties of both types have been investigated and have illustrated by examples.

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Publication Date
Sat Apr 04 2020
Journal Name
Journal Of Xi'an University Of Architecture & Technology
Regularity via semi-generalized open set
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In this work the concept of semi-generalized regular topological space was introduced and studied via semi generalized open sets. Many properties and results was investigated and studied, also it was shown that the quotient space of semi-generalized regular topological space is not, in general semi-generalizedspace.

Publication Date
Mon Jun 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Use of lower squares and restricted boxes In the estimation of the first-order self-regression parameter AR (1) (simulation study)
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Use of lower squares and restricted boxes
In the estimation of the first-order self-regression parameter
AR (1) (simulation study)

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Publication Date
Sat Oct 01 2022
Journal Name
The Egyptian Journal Of Hospital Medicine
The Impact of rs767455 and rs1061622 Polymorphisms ‎on ‎Treatment Outcomes in Iraqi Ankylosing Spondylitis ‎Patients Taking ‎Etanercept
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Background: Ankylosing spondylitis (AS) is inflammation of the sacroiliac joints and spine, associated with clinical symptoms such as pain and stiffness in the vertebral column, after which, in a considerable number of individuals, new bone growth occurs. Objective: The current research study attempted to find out whether the presence of SNPs in TNF receptor [TNFRSF1A (rs767455), TNFRSF1B (rs1061622)] encoding genes could influence patients' outcomes to etanercept in a specimen of Iraqi AS patients. Patients and methods: Sixty patients with established AS receiving only etanercept were selected to be enrolled in this research with a mean age of 40.75 ± 8.67 years, 51 patients of them were males and only 9 patients were females. Patients we

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Publication Date
Fri Aug 01 2025
Journal Name
Journal Of Structural Design And Construction Practice
Value of Safety Incentives and Rewards on Construction Outcomes
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Publication Date
Fri Oct 09 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The value of ultrasound and color Doppler ultrasonography in the evaluation of periapical lesions in comparison to histopathological and/or surgical findings
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Background: Imaging techniques play a very important role in the specialty of endodontic. The ultrasonographic technique is non-expensive procedure, safe, and reproducible. The aim of the study was to determine the sensitivity, specificity, and accuracy of ultrasound and color Doppler ultrasonography in evaluation of periapical lesions (cyst, granuloma, mixed lesion “cyst within graulomas mass”, and abscess. Subject, Material and method: The sample consists of prospective study for 64 Iraqi participants who attended Karbalaa Specialized Center for Dentistry (males & females). Those patients were diagnosed clinically and radiographically as having periapical lesions of dental origin. They were examined by real time ultrasound and color

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Cranio-maxillofacial Surgery
Assessment of regional asymmetry of the face before and after surgical correction of unilateral cleft lip
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Publication Date
Sat Jan 31 2015
Journal Name
International Journal Of Advanced Research
BK polyomavirus and Cytomegalovirus Co-infections in renal transplant recipients: a single center study
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Background: Opportunistic viral infections make an important threat to renal transplantation recipients (RTRs), and with the use of more intense newly-developed immunosuppressive drugs; the risk of renal allograft loss due to reactivation of these viruses has increased considerably. At the top priority of these viruses lie BK polyomavirus (BKV) and human cytomegalovirus (CMV). Reactivation of these viruses in these chronically immunosuppressed RTRs can lead to renal impairment and subsequently allograft loss, unless early detected and properly treated. Objectives: The study aimed to detect and quantify plasma viral load of BKV and CMV in RTRs using quantitative real time PCR (qRT-PCR), in order to study the prevalence of these two viruses i

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Publication Date
Sun Jul 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Lead Time Strategy on the First Intermediate Class Pupils' Achievement in Geography
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The study aims at finding out the effect of the lead time strategy on the first intermediate class pupils' achievement in geography The partial experimental design of two groups, experimental and control, with pre-post tests is used. The sample is represented in (73) female pupils. The sample is divided into two groups (37) experimental group and (36) control one. The sam ple is selected from first intermediate class pupils ( Al Batol intermediate school for girls) Baghdad Al-karkh-3, for academic year 2015-2016 The researcher has equalized the two groups in several variables: the previous achievement tests, intelligence, age in months, the scores of geography test of first course

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
A Study of the Structural and Optical Properties of SnS:F prepared by chemical spray pyrolysis technique
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Thin films of pure tin mono-sulfide SnS and tin mono-sulfide for (1,2,3,4)% fluorine SnS:F with Thicknesses of (0.85 ±0.05) ?m and (0.45±0.05) ?m respectively were prepared by chemical spray pyrolysis technique. the effect of doping of F on structural and optical properties has been studied. X-Ray diffraction analysis showed that the prepared films were polycrystalline with orthorhombic structure. It was found that doping increased the intensity of diffraction peaks. Optical properties of all samples were studied by recording the absorption and transmission spectrum in range of wave lengths (300-900) nm. The optical energy gap for direct forbidden transi

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