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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
Wed Jan 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
The problems faced by First-grade intermediate students in studying the Arabic language
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This study investigates the challenges encountered by first-grade intermediate students in learning the Arabic language. It aims to identify specific obstacles that hinder language acquisition and proficiency among this demographic. Through qualitative and quantitative methods, including surveys and interviews with students, teachers, and parents, the research highlights key issues such as limited vocabulary, difficulties in grammar, lack of engagement with the material, and inadequate teaching resources. The findings reveal a complex interplay between cognitive, social, and educational factors that contribute to these challenges. The study underscores the need for targeted interventions, such as enhanced pedagogical strategies and improved

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
Matrix Form of Deriving High Order Schemes for the First Derivative
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For many problems in Physics and Computational Fluid Dynamics (CFD), providing an accurate approximation of derivatives is a challenging task. This paper presents a class of high order numerical schemes for approximating the first derivative. These approximations are derived based on solving a special system of equations with some unknown coefficients. The construction method provides numerous types of schemes with different orders of accuracy. The accuracy of each scheme is analyzed by using Fourier analysis, which illustrates the dispersion and dissipation of the scheme. The polynomial technique is used to verify the order of accuracy of the proposed schemes by obtaining the error terms. Dispersion and dissipation errors are calculated

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Publication Date
Sun Jan 01 2017
Journal Name
Journal Of Clinical And Diagnostic Research
Treatment of Fistula-In-Ano with Tight (Cutting) Seton: Analysis of Outcomes and Efficacy Assessment
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Publication Date
Fri Jul 18 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The relation between the mesio-distal crown widths of the deciduous second molars and the permanent first molars
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Background: This study aimed to find whether there is a relation between the mesio-distal crown diameters of the deciduous second molars and the permanent first molars in an Iraqi sample from Baghdad city. Material and methods: The sample consisted of 54 Iraqi children aged 8-9 years at the mixed dentition stage. The measurements included the mesio-distal crown width of the deciduous second molars and the permanent first molars on the study casts using digital sliding vernier. Results: The results revealed absence of the side difference of the widths of teeth measured. High significant gender difference was detected for the permanent first molars and the deciduous second molars except mandibular permanent first molar. On the other hand, hig

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of nurses' practices toward postoperative wound dressing in surgical wards
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Objective(s): The study aimed to assess the level of nursing performance and practices in terms of approaching or
distancing itself from the optimal performance criteria universally adopted within the variable dressing surgical
wounds of patients admitted to the surgical wards, and determine the relationship between the level of nurse's
performance and socio-demographic characteristics of them in those wards.
Methodology: A descriptive assessing design was adopted from November the 10th, 2010 until June the 1st, 2011 to
assess the nursing care provided practices for the postoperative period within the variable dressing surgical wounds in
the complex of Medical City. Whereas the study was conducted in three hospitals; Ba

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Publication Date
Thu Mar 04 2021
Journal Name
Journal Of Craniofacial Surgery
Outcome Assessment for Surgical Reconstruction of Mandibular Continuity Defects
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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
Non-Metastatic Breast Cancer : Clinical Presentation and Patterns of Surgical Treatment
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Background : Breast cancer is the most common cancer of
women. When breast cancer is detected and treated early,
the chances for survival are better. Surgery is the most
important treatment for non-metastatic breast cancer.
Al-Kindy Col Med J 2008 Vol.5(1) 40 Original Article
Objectives : The aim of this study is to review different
clinical presentation and to evaluate types of surgical
procedures and complications in treatment of nonmetastatic breast cancer.
Method : During the period from Jun 1998 to May 2005,
93 patients with non-metastatic breast cancer were
diagnosed and treated surgically in 2 hospitals in Baghdad (
Hammad Shihab military hospital and Al-Kindy teaching
hospital).
Results : Wo

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Publication Date
Sun Jul 17 2022
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Clinical Characteristics and Antibiotics Sensitivity of Culture Positive Typhoid Fever Patients in Baghdad Teaching Hospital - A Single Center Study
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BACKGROUND: Enteric fever caused by Salmonella Typhi is an endemic disease in Iraq. Variations in presentations make it a diagnostic challenge. If untreated or treated inappropriately then it is a serious disease with potentially life-threatening complications. The recent emergence of drug resistant strains of S. Typhi is a rising public health problem and a clinical concern to the physician. AIM: The objectives of the study were to assess and describe the patterns of antimicrobial resistance, clinical characteristics, epidemiological distribution, and complications of typhoid fever. PATIENTS AND METHODS: Fifty cases of typhoid fever (culture proven) were collected during the period from February 2019 to November 2019 in the me

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Publication Date
Tue May 05 2015
Journal Name
Scientific Education
The effect of the KWLH strategy on the reading comprehension of first-year intermediate female students
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Publication Date
Wed Jan 01 2014
Journal Name
مجلة العلوم التربوية والنفسية
The effect of the self-scheduling strategy on the chemistry achievement of first intermediate female students
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