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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 Feb 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Insights of Experienced Pharmacists Regarding the Iraqi health Insurance Program: A Qualitative Study(Conference Paper )#
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The aim of study was to explore pharmacist insights toward the impact of prospective implementation of the national health insurance program on patients, providers and Iraqi health system.

This was a qualitative study including semi-structured face-to-face (mostly) interviews with experienced pharmacists. The interview guide included open-ended questions about the impact of the national health insurance program on patients and healthcare providers at three levels: quality of services, costs, and frequency of visits. Potential challenges were also discussed. Interviews were conducted in four provinces from March to May 2022. Thematic analysis was used to analyze the interview findings and generate themes and subthemes.

The

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Publication Date
Wed Jan 01 2020
Journal Name
International Conference Of Numerical Analysis And Applied Mathematics Icnaam 2019
Prevalence of gastrointestinal parasites in Iraq during 2015
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Publication Date
Thu Mar 18 2021
Journal Name
Review Of International Geographical Education Online
Chomsky&#39;s Political Views as a Case Study in a Critical Discourse Analysis of Ideology in the Iraqi Wars
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APDBN Rashid, Review of International Geographical Education Online (RIGEO), 2021

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Publication Date
Sat Dec 20 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Soft Tissue Changes Following Orthodontic Treatment of Bimaxillary Protrusion (A Clinical and Photographical Study)
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Background: Bimaxillary protrusion is considered as one of the most important causes to seek the orthodontic treatment to get better esthetics. This study aimed to test the effect of orthodontic treatment in improvement the facial esthetics. Materials and Methods: Ten Iraqi Arab females having bimaxillary protrusion based on Class I malocclusions treated with fixed orthodontic appliance and extraction of the maxillary and mandibular 1st permanent premolars. Pre and post-treatment facial profile photographs were taken for each patients and the effect of treatment was tested in comparison with the pre-treatment photographs by using seven angular measurements. Results: After treatment, the upper and lower lip projections were decreased signifi

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
A Contrastive Study on the Syntactic Structure of Standard English and Standard Arabic Determiner Phrase
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The determiner phrase is a syntactic category that appears inside the noun phrase and makes it definite or indefinite or quantifies it. The present study has found wide parametric differences between the English and Arabic determiner phrases in terms of the inflectional features, the syntactic distribution of determiners and the word order of the determiner phrase itself. In English, the determiner phrase generally precedes the head noun or its premodifying adjectival phrase, with very few exceptions where some determiners may appear after the head noun. In Arabic, parts of the determiner phrase precede the head noun and parts of it must appear after the head noun or after its postmodifying adjectival phrase creating a discontinu

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Development of human resources and their role in achieving artificial intelligence A survey of the views of a sample of workers in the cement plant
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The research topic was chosen as a result of the importance of human resource in business organizations in general and the industrial process in particular. Without the human resource, business organizations cannot continue and achieve success and excellence, and the research problem has been diagnosed in the lack of sales of General Cement Company’s northern products, despite their distinctiveness, standing, and reputation in The market and its products with standard specifications, and through this problem, the following questions were raised:                                                    &nbs

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Publication Date
Sat Dec 20 2025
Journal Name
Iraqi Journal Of Applied Physics
Effect of Gas Mixing Ratio on Energy Band Gap of Mixed-Phase Titanium Dioxide Nanostructures Prepared by Reactive Magnetron Sputtering Technique
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Publication Date
Mon Mar 01 2010
Journal Name
Journal Of Economics And Administrative Sciences
A study to determine the most important factors affecting student performance In the secondary school in Diwaniya
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Student performance may influence by several factors in all his study levels such as primary school, intermediate school and even in his college; some of these factors are psychological factors, social factors, and the factors which correlate with student environment.

In this paper we study some of these factors to discover their influence by using canonical correlation analysis to analyze the data. Many conclusions are discovered to help who focuses student performance or to make it pest in future.

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Media in Developing the Tax Awareness of the Iraqi Citizen: Applied Study in the General Commission for Taxes
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 Interested in many scholars and reseachers  the subject of the media and means varied his roleinfluential in the definition of the public of issues and political, cultural, social and because of its spread wide and ability to address the people of all levels effect them  in the formation consciousness of those issues and types of this awareness is an awareness of the tax, contribute to media formation consciousness tax through the definition of people what tax and importance of the role of its revenues to supplement the state budget by posting tax laws and regulations of applied and all what respect process account tax, to be in charge of the tax familiar enough about this, which avoid being cheated taxmisleading when rev

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Publication Date
Fri Jun 30 2006
Journal Name
Al-kindy College Medical Journal
Oral Carriage Rate of Candida Species in Diabetic Patients
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Background: It is well known that oral carriage
of Candida species increase in many situations, like
obesity, debility, leukemia, viral infection, use of
certain drugs in addition to diabetes mellitus.
Objective: find the relation between diabetes and
its control on oral carriage of Candida.
Methods: Thirty four hundred oral swabs from
diabetic patients 67% are females and 33% are
males, 41.7% are type 1 diabetes and 58.3% are type
2.different culture media are used.
Results: we found that 37.9% of diabetics had oral
carriage, older age group had more but the
difference is not significant statistically P>0.05, in
addition females carry more Candida than males
P<0.05, while type of diabetes

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