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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 Jul 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of thinking Skills in Developing Life Skills among First Year Students at Al- Bisha University: The effectiveness of thinking Skills in Developing Life Skills among First Year Students at Al- Bisha University
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Abstract

     The aim of this research is to identify the effectiveness of thinking skills in developing the life skills of the students of the first Academic year, particularly the differences in life skills according to the variable of study specialization (human-scientific). To achieve the research objectives, the life skills scale was constructed on the classification of (WHO). The psychometric properties of the scale were examined. The validity of the scale, which is the final form of (60) items, was valid for measuring the life skills. The scale was then applied to the research sample of (112) students of the first year of the University of Bisha.  The SPSS program processed

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Publication Date
Thu Nov 02 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Role of Human β-Defensin-3 in Rheumatoid Arthritis: An Observational Single-Center Study
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Background: It's believed that HBD-3 is involved in the tissue remodeling process of articular cartilage. Also, HBD-3 has anti-inflammatory properties. Objectives: The purpose of this study is to assay human beta-defensine-3 (HBD-3) in serum from rheumatoid arthritis (RA) patients and investigate its correlation with proinflammatory cytokines. Methods: In this case-control study, fifty-eight RA patients were aged 20–65 years, and 29 age-matched healthy subjects (HS) had no inflammatory rheumatic diseases. The disease activity score-28 joint erythrocyte sedimentation rate (DAS28-ESR) was used to measure RA activity. CRP, ACPA, HBD-3, TNF-α, and IL-1β were assessed using the enzyme-linked immunosorbent assay technique (ELISA). Res

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The Effect of PDEODE Strategy on the Acquisition of Historical Concepts of First Class of Intermediate Students
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The research aims to find out the effect of PEDODE Strategy on the acquisition of historical concepts of First Intermediate Grade. To achieve this goal, the researcher has put forward this zero hypothesis: There is no statistically significant difference at the level of (05,0) between the mean of the students' marks in the experimental group who study the history subject using PEDODE strategy and that of the students' marks in the control group who study the subject according to the traditional method in the post-testing on the acquisition of historical concepts. The sample of the study consists of (62 female-students) of First Intermediate Grade in the Directorate of Baghdad Education/ Karkh2nd for the academic year 2016-2017. The sampl

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Publication Date
Sun Jun 04 2017
Journal Name
Baghdad Science Journal
Improvement of the technique for the solution method of Gauss Seidel
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In this paper, a new approach was suggested to the method of Gauss Seidel through the controlling of equations installation before the beginning of the method in the traditional way. New structure of equations occur after the diagnosis of the variable that causes the fluctuation and the slow extract of the results, then eradicating this variable. This procedure leads to a higher accuracy and less number of steps than the old method. By using the this proposed method, there will be a possibility of solving many of divergent values equations which cannot be solved by the old style.

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Publication Date
Tue Jun 24 2025
Journal Name
Medicina Moderna - Modern Medicine
Prevalence of Prematurity Outcomes of Overweight Adolescent Pregnancy in One Thousand Premature Neonates in Baghdad
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Background: With the increasing trends of global culinary boom and food revolution, and since adolescents are one of the most important age groups that intereact actively with new emerging waves, the health impacts of overweight adolescent pregnancy could be an evolving issue. Additionally, prematurity has different risks of disease and fatality in different areas and nations. Objectives: We aimed to measure the prevalence of complications of prematurity in 1000 neonates in Baghdad city born to overweight adolescent mothers and general maternal characteristics. Methods: Data of 1000 premature (case) and full-term (control) neonates were collected from hospital records in Baghdad over 12 years. The mothers of our samples were overwei

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Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
The Effect of a Training Program on the Diabetic Patients Utilizing Skills of Insulin Injection Technique
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Objectives: The study aims to evaluate patients’ performance toward insulin injection after training program to
identify the variation in skill of patients in insulin injection technique with regard to some variable (i.e.
educational level and duration of insulin injection.
Methodology: A quasi experimental study has been conducted on diabetic patients.
An observational checklist had been prepared which consisted of 4 main areas with 37 sub-items, which are
syringe preparation for injection, insulin drawing; skin preparation for injection and insulin injection. Each of the
sub-items has 2 options yes or no. One score for positive answer and zero for no.
The sample of the study consisted of (n =30) males and females

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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
Sun Feb 18 2024
Journal Name
Migration Letters
Knee Injuries And Rehabilitation: A Comprehensive Review Of The Psychological Landscape
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MT Suhail, SA Hussein, MN Abdulhussein, WQ Abdaullateef, M khairallah Aid…, Migration Letters, 2024

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Publication Date
Mon Oct 01 2018
Journal Name
Iraqi Journal Of Science
Theoretical Study of The Electromagnetic Structure of Boron Isotopes Using Local Scale Transformation Technique
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