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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
Mon Mar 09 2015
Journal Name
Monthly Notices Of The Royal Astronomical Society
A reliable iterative method for solving Volterra integro-differential equations and some applications for the Lane–Emden equations of the first kind
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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Using the Generative Learning Model on the Achievement of First-Grade Intermediate Students of Chemical Concepts in Science
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Abstract

The current research aims to identify the effect of using a model of generative learning in the achievement of first-middle students of chemical concepts in science. The researcher adopted the null hypothesis, which is there is no statistically significant difference at the level (0.05) between the mean scores of the experimental group who study using the generative learning model and the average scores of the control group who study using the traditional method in the chemical concepts achievement test. The research consisted of (200) students of the first intermediate at Al-Farqadin Intermediate School for Boys affiliated with the Directorate of General Education in Baghdad Governorate / Al-Karkh 3 wit

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Publication Date
Mon Jan 02 2017
Journal Name
Al-nahrain Journal For Engineering Sciences (njes)
Experimental Investigation of Forced Convection Heat Transfer and Pressure Drop in Open Cell Aluminum Fins
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Publication Date
Mon Jun 08 2020
Journal Name
Medical Sciens
COVID-19 clinical characteristics and outcomes in 60 hospitalized Iraqi patients -Case series
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Background: since December 2019, China and in particularly Wuhan, faced an unprecedented an outbreak challenge of coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus 2. Clinical characteristics of Iraqi patients with COVID-19 and risk factors for mortality needed to be shared with the health care providers to improve the overall disease experience. Methods: prospective, single-center study recruited patients with confirmed SARS-CoV-2 infection who were admitted to Al-Shifaa Isolation Center / Baghdad Medical City between the mid of March and the end of April 2020 until had been discharged or had died. Demographic data, information on clinical signs, symptoms, at presentation, treatment, have been collected

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Publication Date
Fri Oct 17 2025
Journal Name
Journal Of Physical Education
The Effect Of Psychological Counselling On The Development Of Psychological Skills and the Level Of First Class Soccer Referees (Baghdad governorate)
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Publication Date
Sat Oct 09 2021
Journal Name
Turkish Journal Of Computer And Mathematics Education
An Analysis of the Mathematics Book for the First Intermediate Grade According to the Dimensions of Mathematical Power
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The current research aims to analyze the mathematics book for the first intermediate grade according to the dimensions of mathematical power by answering the following question: What is the percentage of the availability of the dimensions of mathematical power included in the content of the mathematics textbook for first-grade students, average, in its first, and second parts for the academic year 2020-2021, approved by the Iraqi Ministry of Education / General Directorate of Curricula? The research community was determined by middle school mathematics books, and middle school students for middle ,and high school day schools affiliated to the Directorate of Education in Dhi Qar, and by the intentional test, the research sample was s

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Publication Date
Wed Dec 25 2019
Journal Name
Journal Of Engineering
Comparison of Different DEM Generation Methods based on Open Source Datasets
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Digital Elevation Model (DEM) is one of the developed techniques for relief representation.  The definition of a DEM construction is the modeling technique of earth surface from existing data. DEM plays a role as one of the fundamental information requirement that has been generally utilized in GIS data structures. The main aim of this research is to present a methodology for assessing DEMs generation methods. The DEMs data will be extracted from open source data e.g. Google Earth. The tested data will be compared with data produced from formal institutions such as General Directorate of Surveying. The study area has been chosen in south of Iraq (Al-Gharraf / Dhi Qar governorate. The methods of DEMs creation are kri

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Publication Date
Wed Dec 25 2019
Journal Name
Journal Of Engineering
Comparison of Different DEM Generation Methods based on Open Source Datasets
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Digital Elevation Model (DEM) is one of the developed techniques for relief representation.  The definition of a DEM construction is the modeling technique of earth surface from existing data. DEM plays a role as one of the fundamental information requirement that has been generally utilized in GIS data structures. The main aim of this research is to present a methodology for assessing DEMs generation methods. The DEMs data will be extracted from open source data e.g. Google Earth. The tested data will be compared with data produced from formal institutions such as General Directorate of Surveying. The study area has been chosen in south of Iraq (Al-Gharraf / Dhi Qar governorate. The methods of DEMs creation are kriging, IDW (inver

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Publication Date
Mon Jul 03 2017
Journal Name
Iraqi New Medical Journal
Coarctation of aorta in pediatric age group: mode of presentation, early and intermediate outcomes of interventional treatment
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Although rare, coarctation of aorta is a treatable cause of hypertension, transcatheter dilatation by balloon with or without stent are a well-known treatment strategy

Publication Date
Mon Oct 01 2018
Journal Name
International Journal Of Medical Research & Health Sciences
Non-Surgical Treatment of Gingival Recession by Platelet-Rich Plasma
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