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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 Nov 01 2012
Journal Name
Iraqi Postgraduate Medical Journal
Lactic Acid 5% Mouthwash is an Effective Therapeutic and Prophylactic Agent in Treatment of Recurrent Aphthous Ulcer (Single blind placebo controlled therapeutic study)
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KE Sharquie, SA Al Mashhadani, AA Noaimi, RK Al-Hayani, SA Shubber, Iraqi Postgraduate Medical Journal, 2012 - Cited by 1

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The role of corporate merger in achieving synergy (Analytical research in a sample of companies of the Iraqi Ministry of Industry and Minerals)
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The research aims to shed light on the recent experience in the Iraqi business environment, which is the experience of the merger. To evaluate a recent experience in an important sector of the Iraqi business sectors, namely the industrial sector to enable decision-makers to review that experience to judge the extent of its success and address some of the lapses that experience that by measuring synergies can be judged on the success of the merger experience or not. The research community is the governmental industrial sector. The research sample included six cases of merger (14) companies before the merger. The Holt method was used to predict the net sales and total cost values ​​before the merger as if it were not merged. Th

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Publication Date
Sat Dec 20 2025
Journal Name
Modern Sport
An analytical study of some of the deterministic variables of the stage of advancement and its relation to the accuracy of the performance of the skill of high jump correction
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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
African landlocked countries problems and outlets in the study and classification of geo-political
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Landlocked countries are displayed geopolitical new geo-political and intended to
countries that do not have sea views, a phenomenon present in four continents of the world
are: Africa, Europe, and Asia, and South America and the number arrived at the present time
to the (44) state the largest number of them in the continent it arrived in Africa (16) countries
in Asia (13) countries and Europe (13) In the State of South America two. This phenomenon
emerged due to the division of federations and empires and colonial treaties and others. But
the negative effects suffered by these countries may vary from one country to another, since
these countries in the continent of Europe, for example, is different from the same cou

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The role of the Organizational Service Orientation practices and its Impact in inhancing the employees performance (A Fiald Research in Baghdad Municipality)
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Abstract:

Recently, there is a widespread attention about the service at the level of each of the research and academic studies, and at the organizational level as well. The subject of orientation towards the service aspect is starting to be of this attention being of the modern subjects, relatively, which appeared at the end of the last century, as well as the link of this subject with the relationship between the organization and its customers, and how to provide high quality services to get their satisfaction. Thus, the specialists from researchers were interested in this field to develop an appropriate scale to measure the organizational orientation toward service, and it was the most prominen

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Publication Date
Wed May 01 2019
Journal Name
Sensors And Actuators B: Chemical
Fabrication and Characterizations of a Novel Etched-tapered Single Mode Optical Fiber Ammonia Sensors Integrating PANI/GNF Nanocomposite
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Publication Date
Wed Jun 24 2020
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
A STUDY OF PHYSICAL AND ANATOMICAL CHARACTERISTICS OF THE HEAVY METAL ACCUMULATION OF JUNCUS RIGIDUS DESFONTAINES, 1798 (FAMILY, JUNCACEAE) IN BASRAH PROVINCE, SOUTHEREN OF IRAQ
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This study was carried out to determine the heavy metal accumulation of Juncus rigidus Desfontaines, 1798 from three different regions of the Basrah Province in Southern of Iraq. Specifically, the concentrations of lead, nickel, and cadmium were determined in the roots, culms and leaves of the plant. The results indicated that the highest accumulation of the heavy metal was recorded in lead (Pb) 12.50± 3.58 mg kg-1and then in nickel (< 0.30). The lowest value was recorded for cadmium (< 0.05). As well, lead concentrations in J. rigidus varied in different locations and parts of the plant from undetectable in control to 12.66, 19.33, and 9.80 mg kg-1 in leaves, culm, and roots respective

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a strategy (fahs) in the development of grammar skills of a sample of secondary school Female Students in Saudi Arabia
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The aim of the present research is to measure the degree of strategic effectiveness (fahs) in the development of grammar skills of high school students in the Kingdom of Saudi Arabia and to achieve the goal of the researcher the researcher used the semi-experimental approach; On ten arbitrators specializing in grammar, morphology, curricula and methods of teaching the Arabic language. After confirming the validity of the guideline, the researcher prepared an achievement test consisting of (22) paragraphs of the type of short answer and multiple choice. The researcher trained a teacher to apply the strategy to the experimental research sample using the (screening) component of (30) students, and the same parameter taught the control sampl

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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Mechanical Engineering
Process Parameters Optimization in Single Point Incremental Forming Of Al1050
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This work aims to optimize surface roughness, wall angle deviation, and average wall thickness as output responses of ALuminium-1050 alloy cone formed by the single point incremental sheet metal forming process. The experiments are accomplished based on the use of a mixed level Taguchi experimental design with an L18 orthogonal array. Six levels of step depth, three levels of tool diameter, feed rate, and tool rotational speed have been considered as input process parameters. The analyses of variance (ANOVA) have been used to investigate the significance of parameters and the effect of their levels for minimum surface roughness, minimum wall angle deviation, and maximum average wall thickness. The results indicate that step depth and tool r

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Publication Date
Tue Aug 01 2023
Journal Name
Small Ruminant Research
One intron variant in the oocyte expressed protein (OOEP) gene is associated with twinning rate, prolificacy, and several body measurement traits in Awassi ewes
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