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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 Jul 01 2017
Journal Name
Journal Of Biological Chemistry
Functional and phylogenetic evidence of a bacterial origin for the first enzyme in sphingolipid biosynthesis in a phylum of eukaryotic protozoan parasites
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Publication Date
Sat Jun 30 2007
Journal Name
Al-kindy College Medical Journal
Lower Ureteral Obstruction and Leakage in the First Month Following Renal Transplantation
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Background: Transplantation has revolutionized
treatment of end- stage renal disease (ESRD) by proving
more cost effective than hemodialysis, with a lower
morbidity and improved quality of life.
Objective: To evaluate the development of these
complications in the first month postoperatively and
correlate their development to the type of donation
whether related or unrelated.
Methods: Fifty (50) patients aged (15-62) years, with a
mean age (34.46 ± 12.4 SD) years with (ESRD), who
underwent renal transplantation from September 2000 to
October 2002, were followed-up for one month
postoperatively clinically and by assessment of renal
function tests, sonographic and Doppler examinations.
Ureteral obs

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Publication Date
Mon Oct 01 2018
Journal Name
Iraqi Journal Of Physics
Preparation single layer of (MgO) as antireflection coating using PLD technique
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In this work preparation of antireflection coating with single layer of MgO using pulsed laser deposition (PLD) method which deposit on glass substrate with different thicknesses (90 and 100) nm annealed at temperature 500 K was done.
The optical and structural properties (X-ray diffraction) have been determined. The optical reflectance was computed with the aid of MATLAB over the visible and near infrared region. Results shows that the best result obtained for optical performance of AR'Cs at 700 shots with thickness 90 nm nanostructure single layer AR'Cs and low reflection at wavelength 550 nm.

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Publication Date
Mon Oct 13 2025
Journal Name
Journal Of Baghdad College Of Dentistry
A Comparative Study between Flapped and Flapless Surgical Techniques in Dental Implant Stability According to Resonance Frequency Analysis
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Background: Recent implant surgical approach aims to cause less trauma, invasiveness and pain as much as possible and to reduce patient and surgeon discomfort, time of surgery and time needed for functional implant loading. Flapless surgical techniques considered recently as one of the most popular techniques that may achieve these aims especially enhancing osseointegration and subsequently implant stability within less time than the traditional flapped surgical technique. So this study aimed to make a comparison between flapped and flapless surgical techniques in resulted implant stability according to resonance frequency analysis RFA and in duration of surgical operation. Materials and methods: A total of 26 patients with 41 implants (o

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Publication Date
Wed Apr 03 2013
Journal Name
The Official Journal Of Iraqi Board For Medical Specialization
Presentation and management outcomes of eclampsia at Al-Elwiyah teaching hospital
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Publication Date
Mon Jul 01 2024
Journal Name
World Neurosurgery
Orbital Rhabdomyosarcoma: Comprehensive Review of Epidemiology, Clinical Staging, and Treatment Outcomes
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Publication Date
Thu Jun 20 2024
Journal Name
Acta Facultatis Medicae Naissensis
Clinical properties and seminal fluid analysis of patients with primary infertility consulting the urology outpatient clinic for the first time: A cross-sectional study
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Introduction/Aim. Seminal fluid analysis (SFA) plays a crucial role in helping infertility clinics diagnose the underlying reason of male infertility. The aim of the study was to investigate seminal fluid patterns of male partners of an infertile couple with apparently fertile female partners. Materials and methods. A cross-sectional study was conducted between January 2019 and December 2022. Patients were attending consultations for delayed conception for more than 12 months with apparently fertile female partner. Results. Four hundred fifty-three patients were included in the study. The distribution of patients according to age groups showed that 277 patients were young, aged 21 - 30 years (61%). Two hundred sixty-two (58%) patien

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Publication Date
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
The evolution of the press image in the Iraqi press (An analytical study of the pictures of the first page of Al-Sabah newspaper for the year)
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This research sheds light on the development that has occurred on the use of press pictures in the Iraqi press by analyzing the form and content of the images used in (Al-Sabaah) newspaper for the 2012 model. The researcher's interest in this topic for what represented by the press picture of a way to highlight and attract the reader's attention to the substance journalist who represents the goals behind the newspaper publishing.

This research is divided into three sections. The first one dealt with the methodological framework of the research, and the second part addressed the aspect of press pictures and its history and technological development, while the third section devoted to the study of the development of the form and co

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Engineering
A Computational Fluid Dynamics Investigation of using Large-Scale Geometric Roughness Elements in Open Channels
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The hydraulic behavior of the flow can be changed by using large-scale geometric roughness elements in open channels. This change can help in controlling erosions and sedimentations along the mainstream of the channel. Roughness elements can be large stone or concrete blocks placed at the channel's bed to impose more resistance in the bed. The geometry of the roughness elements, numbers used, and configuration are parameters that can affect the flow's hydraulic characteristics. In this paper, velocity distribution along the flume was theoretically investigated using a series of tests of T-shape roughness elements, fixed height, arranged in three different configurations, differ in the number of lines of roughness element

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Predictors of poor first trimester outcome in asymptomatic women : the value of embryonic heart rate , mid sac diameter / yolk sac ratio & mid sac diameter / crown rump length
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Background:  Ultrasound provides a powerful tool for assessing early pregnancy and detecting pregnancy failure at first trimester and promoting rapid effective management. Several  criteria have been established  to predict  the pregnancy outcome particularly in symptomatic women .

Aim: To evaluate  asymptomatic women at the first trimester of pregnancy , to assess the efficacy of certain ratios as mid sac diameter (MSD)  / yolk sac ratio & crown rump length (CRL)/mid sac diameter (as indicator  of early first trimester oligohydramnios)  in predicting poor 1st   trimester outcome

Type of the study: A cross-s

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