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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
Fri Jan 01 2016
Journal Name
Journal Of The College Of Languages (jcl)
Investigating English Composition Writing Problems Encountered by Preparatory School Students and Finding Solutions to These Problems through Schema- Based Approach
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Writing in English is one of the essential factors for successful                      EFL learning .Iraqi students at the preparatory schools encounter problems when using their background knowledge in handling subskills                                  of writing(Burhan,2013:164).Therefore, this study aims to investigate the 4thyear preparatory school students’ problems in English composition writing, and find solutions to these pro

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Publication Date
Mon Sep 04 2017
Journal Name
Journal Of The College Of Education For Women
Adolf Hitler, existence and his political victim until junuary, 1933 Dr.Suaad Rood Sheer Mohammed (PhD) Dr. Qassim Abdul Amir Waseem
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This study aims to track and analysis Hitler's personality by explaining the impact of the social environment in shaping his behavior and addressing the defeat of Germany in the World War 1 and its impact on building his political personality and included his political activism and his policy to get rid of the terms of the Versailles Military Treaty in the light of his plans in his book ( Kifahi) The nature of the study had to be divided into an introduction and two topics followed by the conclusion of the most important results, in addition to a list of references and a summary in English and from God the Good luck.

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Publication Date
Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
Linguistic Errors in second language learning through Error Analysis theory: هه‌ڵه‌ زمانییه‌كان له‌ فێربوونی زمانی دووه‌مدا (له‌ ڕوانگه‌ی تیۆری شیكاری هه‌ڵه‌ییه‌وه‌)
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Second language learner may commit many mistakes in the process of second language learning. Throughout the Error Analysis Theory, the present study discusses the problems faced by second language learners whose Kurdish is their native language. At the very stages of language learning, second language learners will recognize the errors committed, yet they would not identify the type, the stage and error type shift in the process of language learning. Depending on their educational background of English as basic module, English department students at the university stage would make phonological, morphological, syntactic, semantic and lexical as well as speech errors. The main cause behind such errors goes back to the cultural differences

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Publication Date
Sun Jan 19 2025
Journal Name
Al.qadisiya Journal For The Sciences Of Physical Education
Making standards limits for some skill tests in basketball for juniors players age (15-16) year to choosing national team players
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The basic skills (defensive & offensive) in basketball it is a base for completion and decide the level of the team and the rank, in same time considers the axel of the researchers when putting tests and forming new groups so close from real situation games to create real vision and estimate for skill state and a method to recorrect & presenting positive resolutions, the problem of research were indicate to variables may happen in training operation it demand tests matches with these variables and forming new standards, and another way the researchers find a few patterns for measuring basic skills (defensive & offensive) also application these tests on samples it differs from the originals one that the tests designed for it. The sample repr

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Publication Date
Wed Jul 05 2017
Journal Name
Chemical Engineering Communications
Microwave-assisted preparation of mesoporous-activated carbon from coconut (<i>Cocos nucifera</i>) leaf by H<sub>3</sub>PO<sub>4</sub>activation for methylene blue adsorption
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Publication Date
Sun Jan 19 2025
Journal Name
Journal Of Physical Education
Specifying Standard Scores and Levels for Some Physical Variables as Indicators for Selecting Youth Soccer Players Aged (17 – 19) years Old
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Publication Date
Fri Jun 24 2022
Journal Name
Iraqi Journal Of Science
Vehicle Indoor Air pollution with Fungi Generated by Air Conditioning Systems (AC) and Treatment by Using Aqueous Extracts Mushroom (Ganoderma lucidum)
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Vehicle Air Conditioning (AC) systems are used in countries that suffer high temperature degrees during the summer season, one of these countries is Iraq. Most passengers suffer manifestations which may lead to Allergic or Respiratory diseases as they inhale polluted air produced by AC systems.
In this study 10 vehicle were selected randomly on the basis of noxious odors emitted from AC systems. Indoor air samples were collected by using impaction method and using Sabouraud's dextrose agar to grow and isolate dominant fungi species accompanied with AC polluted air. Dust particle diameters aggregated in AC filters were measured because the particles work as transporters to carry fungi then get inhaled by the passengers. After isolating

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Publication Date
Sat Nov 28 2020
Journal Name
Iraqi Journal Of Science
Investigation for some Aminoglycosides Modifying Enzymes- Encoding Genes and Co-Resistance to Fluoroquinolones among Klebsiella pneumoniae Isolates from Different Clinical Cases
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In this study, we investigated the prevalence of aminoglycosides modifying enzymes (AMEs)-encoding genes, including aac(3′)-ΙΙ, ant(3′′)-Ι, aph(3′)-VΙ, and aac(6′)-Ιb-cr and their potential effect on the development of resistance to aminoglycosides and fluoroquinolones in clinical isolates of Klebsiella pneumoniae. According to the phenotypic and biochemical characteristics of 150 clinical samples, 50 (33%) isolates were identified as K. pneumoniae. These isolates were collected from different clinical sources, including urine (15, 30%), blood (12, 24%), sputum (9, 18%), wounds (9, 18%), and burns (5, 10%). The minimum inhibitory conce

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Publication Date
Tue Dec 05 2023
Journal Name
Baghdad Science Journal
Red Ginger's Anti-Anxiety Effect on BALB/c Strain Mice (Mus musculus) Pro-Inflammatory and Anti-Inflammatory Measurements as Anxiety Model
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There is a correlation between the occurrence of anxiety and the production of inflammatory mediators, and red ginger rhizome is a well-known herbal product with a high content of phenolic and flavonoid compounds that can be used as anti-inflammatories and antioxidants. The aim of study to evaluate the effect of red ginger as antianxiety in mice (Mus musculus) BALB/c strain by measuring levels of TNF-α, IL-6 and IL-10.  Anxiety model mice were carried out by giving treatment with the Forced Swimming Test (FST) for 7 days then assessed by carrying out the Elevated Plus Maze for Mice (EPM) test for one day. After the treatment, the anxiety mice model was made, followed by administration of red ginger ethanol extract therapy for 14 days.

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Publication Date
Sun Dec 05 2010
Journal Name
Baghdad Science Journal
On Semi-p-Compact Space1
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The purpose of this paper is to introduce a new type of compact spaces, namely semi-p-compact spaces which are stronger than compact spaces; we give properties and characterizations of semi-p-compact spaces.

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