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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 Jun 18 2026
Journal Name
University Of Anbar Sport And Physical Education Science Journal
The study of comparing the cognitive teaching method effect ( total and analytic ) in teaching the counter- attack of Epee
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The research's aim is to place two teaching methods ( total and analytical method) and to know which one of them is better than the other in teaching the counter-attack with Epee. The researchers have used the experimental method for being considered suitable to solve the problem of the research. The sample of the research includes third –stage female students of college of physical education and sport sciences / Baghdad University in the subject of fencing, their number amounted 60 female students. It has been used SPSS for processing the results. They have concluded that the two groups of the research and the two methods (( total and analytical) have learnt the counter- attack of the two over mentioned groups. they have recommended to c

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Publication Date
Thu Apr 07 2016
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Isolate and diagnose Mycotoxins associated with some producers of Indomie and Chips that available in local markets: Isolate and diagnose Mycotoxins associated with some producers of Indomie and Chips that available in local markets
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Abstract
This study aimed to survey fungi associated with the product Indomie and Chips being the trades Iargely by a very important segment of society who are the children, beside consumed by adults, but less so, as the survey results to accompany some fungui samples sterile showed proportions presence included various fungi like. Aspergillus flavus, Aspergillus niger, Penicillium Spp., Fusarium graminearum, F.moniliforme, Alternaria alternate and Rhizopus Spp., and other fungi sterile are not diagnosed. The results showed large dominion fungi A. niger by presence sterile samples of both producers, followed by infection in Fusarium Spp., Penicillium Spp., and A. alternata by infection percentage 55, 20 and 17% respectively for the pr

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Publication Date
Wed Jan 01 2020
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees20
Theoretical estimation of the trapping reaction rate for deuteron-deuteron fusion in nickel metal using Bose-Einstein condensates phenomena
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A mathematical model has been introduced to investigate the effect of nuclear reaction constant ( A ), probability of the BEC ground state occupation Ω i, nD is the number density of deuteron (d) and the overall number of nuclei ND on the total nuclear d-d fusion rate (R). Under steady-state of the condensates of Bose-Einstein, the postulate of quantum theory and Bose-Einstein theory were applied to evaluate the total nuclear (d-d) fusion rate trapping in Nickel-metal The total nuclear fusion rate trapping predicts a strong relationship between astrophysical S-factor and masses of Nickel. The reaction rate trapping model was tested on three reaction d(d,p)T, d(d, n)3He and d(d, 4He)Q = 23.8MeV respectively. The reaction rate has described

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Publication Date
Sat May 14 2022
Journal Name
Oral And Maxillofacial Surgery
Evaluation of crestal sinus floor elevations using versah burs with simultaneous implant placement, at residual bone height ≥ 2.0 _ &lt; 6.0 mm. A prospective clinical study
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Publication Date
Mon Nov 10 2014
Journal Name
Advances In Language And Literary Studies
The Functions of Onomatopoeia in Modern English and Arabic Poetry: A Study in Selected Poems by Lawrence and al-Sayyab
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Onomatopoeia has always been a functional poetic device which enjoys a high sound significance in the poetry of many languages. In modern English and Arabic poetry alike, it proves to be vital and useful at different levels: musical, thematic and at the level of meaning. Still, the cultural difference looms large over the ways it is employed by the poets of each. The present paper investigates the employment of onomatopoeia in the poetry of D. H. Lawrence (1885-1930) and Badr Shakir al-Sayyab (1926-1964) who are chosen due to the importance they enjoy in modern English and Arabic poetry and the richness of their poems in onomatopoeias. The conclusions reached at are in a sense related to cultural differences which govern the use of onomato

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of tax techniques on the quality of services provided to income taxpayers: An exploratory study in a sample of the branches of the General Tax Authority / Baghdad Governorate
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The research aims to demonstrate the impact of tax techniques on the quality of services provided to income taxpayers by studying the correlational and influencing relationships between the exploited variable (tax techniques) and the dependent variable (the quality of services provided to income taxpayers), and in line with the research objectives, the main hypothesis of the research was formulated (there is a relationship Significance between tax techniques and the quality of services provided to income taxpayers) a number of sub-hypotheses emerged from this hypothesis that were stated in the research methodology, and a number of conclusions were reached, the most important of which were (through the use of the correlation coeff

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Publication Date
Sun Jan 01 2017
Journal Name
Engineering And Technology Journal
Study of the Diffusion Coefficient and Hardness for a Composite Material when Immersed in Different Solutions Polymer
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Publication Date
Mon Mar 30 2026
Journal Name
Anbar University Journal Of Languages And Literature
Pain Woven into the Body: A Study of Somatics in Emtithal Mahmoud and Jasmin Kaur's Selected Poems
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Publication Date
Tue Dec 31 2019
Journal Name
Revue Académique De La Recherche Juridique
Consent in Reality TV Program Contracts – A Legal Study in Light of the American Experience
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The development of the television industry has led to the emergence of a new type of entertainment program in which producers have abandoned stereotypes in traditional programs, known as (Reality TV show). This type of program has spread rapidly in America, (where there are more than 40 series of these programs), as well as Europe and more than twenty countries around the world, including the Arab countries, where the number of these programs today to about 1000 programs and the number is increasing , Especially with the readiness of the production networks to produce more of these programs for the huge profits they derive from them (because of the high viewing rates and the large number of ads broadcast through them) in return for low prod

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Publication Date
Wed Jan 01 2020
Journal Name
International Journal Of Innovation, Creativity And Change
Sustainable development in islam: A study regarding the possibility of achieving development goals in Iraq
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Sustainable human development means meeting the basic needs of society and striving for continuous improvement in quality, as it seeks to increase economic well-being while providing adequate housing and nutrition, as well as providing electricity, water, health and education services . Ten centuries ago, Islam highlighted the importance of the development effort and the necessity of its sustainability before the West took it in the 1970s. There are a number of challenges that greatly affect the reality of achieving and ensuring Millennium Development Goals. The research recommends the importance of fighting administrative and financial corruption, as this is one of the biggest challenges facing the possibility of advancing the economy and

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