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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 Oct 01 2020
Journal Name
Journal Of Engineering
Transient Stability Enhancement and Critical Clearing Time Improvement for Kurdistan Region Network using Fact Configuration
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The Electrical power system has become vast and more complex, so it is subjected to sudden changes in load levels. Stability is an important concept which determines the stable operation of the power system. Transient stability analysis has become one of the significant studies in the power system to ensure the system stability to withstand a considerable disturbance. The effect of temporary occurrence can lead to malfunction of electronic control equipment. The application of flexible AC transmission systems (FACTS) devices in the transmission system have introduced several changes in the power system. These changes have a significant impact on the power system protection, due to differences inline impedance, line curre

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Publication Date
Sun Nov 30 2025
Journal Name
Annals Of Abbasi Shaheed Hospital And Karachi Medical &amp; Dental College
Exploring Coffee Consumption Patterns and their Relationship with Menstrual Symptoms among Iraqi Female Medical Students
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Objectives: This study aimed to assess patterns of coffee consumption among medical students at Al-Kindy College of Medicine, evaluate awareness of its benefits and adverse effects, and explore possible associations between caffeine intake and menstrual characteristics among female students.Methods: A descriptive cross-sectional study was conducted between November 2023 and February 2024 among 297 undergraduate medical students selected by convenience sampling. Data were collected through a validated, self-administered online questionnaire covering sociodemographic characteristics, coffee-drinking habits, perceived effects, and menstrual patterns. Descriptive and inferential analyses were performed using SPSS version 25. Association

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Publication Date
Sat Sep 30 2017
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Permeability Prediction By Classical and Flow Zone Indictor (FZI) Methods for an Iraqi Gas Field
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The permeability is the most important parameter that indicates how efficient the reservoir fluids flow through the rock pores to the wellbore. Well-log evaluation and core measurements techniques are typically used to estimate it. In this paper, the permeability has been predicted by using classical and Flow zone indicator methods. A comparison between the two methods shows the superiority of the FZI method correlations, these correlations can be used to estimate permeability in un-cored wells with a good approximation.

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Publication Date
Thu Oct 26 2017
Journal Name
International Journal Of Pure And Applied Mathematics
ON CONVEX FUNCTIONS, $E$-CONVEX FUNCTIONS AND THEIR GENERALIZATIONS: APPLICATIONS TO NON-LINEAR OPTIMIZATION PROBLEMS
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Contents IJPAM: Volume 116, No. 3 (2017)

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Publication Date
Mon Jul 03 2023
Journal Name
Veterinary Integrative Sciences
Crimean-Congo hemorrhagic fever favouring factors virus transmission: Special focus on Iraq and neighbouring countries
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Arthropod-borne infections, known as vector-borne diseases, are a significant threat to both humans and animals. These diseases are transmitted to humans and animals through the bites of infected arthropods. In the last half century, there have been a number of unexpected viral outbreaks in Middle Eastern countries. Recently, Iraq has witnessed an outbreak of the Crimean-Congo Hemorrhagic Fever virus with high morbidity and mortality rates in humans. However, very little is known about the prevalence and distribution of CCHFV in Iraq, and therefore, it is impossible to quantify the risk of infection. CCHFV is transmitted to humans through the bite of infected ticks. However, transmission can also occur through contact with the blood or ti

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Publication Date
Wed May 01 2019
Journal Name
Research Journal Of Chemistry And Environment
Biodiesel from fresh and waste sunflower oil using calcium oxide catalyst synthesized from local limestone
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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
Moral identity and its relationship to social affiliation among university students Exposed to shock pressure
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The current research aimed to identify the level of moral identity and social affiliation among students exposed to shock pressures, as well as to reveal the relationship between these variables. To achieve these objectives, the researcher adopted the diagnostic tool for the measure of post-traumatic stress disorder (PDS-5) scale (Foa, 2013) translated to Arabic language by (Imran, 2017). The researcher also adopted the moral identity scale built by (Al-Bayati, 2015) and the measure of social affiliation built by (Al-Jashami, 2013), which were applied to a random sample of (200) male and female students chose from al Anbar University. They were exposed to shock pressures. The results of the research showed that the sample has an average

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Publication Date
Sat Oct 01 2022
Journal Name
Journal Of Composites For Construction
Near-Surface-Mounted CFRP for Strengthening Concavely Curved Soffit RC Beams: Experimental and Analytical Investigation
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Publication Date
Wed Sep 17 2025
Journal Name
Molecular Biology Reports
Antibacterial effect and MexA efflux pump Inhibition by green-synthesized copper nanoparticles from Mentha piperita
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Publication Date
Wed May 10 2023
Journal Name
Biomass Conversion And Biorefinery
Lactic acid-based deep eutectic solvents and activated carbon for soap removal from crude biodiesel
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