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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 Oct 17 2025
Journal Name
Ieee Access
Optic Flow-Based Gait Symmetry Assessment of Center and Peak Pressure Trajectories Applied to Foot Deformities
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Analyzing plantar pressure trajectories is crucial for assessing foot behavior in dynamic gait stability. We propose the identification of foot symmetry and the detection of deformities by analyzing the trajectories of the center of pressure (CoP) and peak pressure (PP). First, using a foot pressure mapping system, plantar pressure data are acquired during a normal gait cycle. After the data have been acquired, post processing extracts both the CoP and PP trajectories over the spatiotemporal domain of foot motion for each foot independently. For this purpose, we used the optical flow technique which accurately estimates the direction of foot motion. The extracted trajectories of each foot are then segmented into, the medial and lateral regi

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Publication Date
Mon Feb 13 2023
Journal Name
International Conference Of Computational Methods In Sciences And Engineering Iccmse 2021
Management of the flood disaster and assessment their damaged areas using remote sensing and GIS techniques: A case study of Tigris River – Maysan Governorate, Iraq
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Publication Date
Wed May 01 2024
Journal Name
Diamond And Related Materials
A comparative study on the effects of multi-walled carbon nanotubes and graphene nanoplates incorporated for improved thermal conductivity and dielectric properties of polyvinyl chloride
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Publication Date
Tue Dec 29 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Electronic Payment System and its impact on the efficiency of the performance of banking: An applied research on a sample of banking sector in Iraq
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The electronic payment systems are considered the most important infrastructure for the work of banks, particularly after a steady and remarkable development in information and communication technology, Which created the reality of the work of the infrastructure for these systems and these systems also become one of the most important components of infrastructure for the work of banks, cause it is one of the most important channels through which the transfer of cash, financial instruments between financial institutions in general and banking in particular.

     In order to achieve the objectives of the research, the most important to identify the concept of electronic payment systems, and its divisions, and th

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Publication Date
Fri Dec 26 2025
Journal Name
Al–bahith Al–a'alami
Evaluation of the Iraqi Community for Election Campaigns for Candidates of the House of Representatives and Media Coverage in March 2010: (Cairo as a Model)
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The elections of the Council of Representatives in Iraq are one of the manifestations of political participation, which makes it attracts the attention of researchers. Where Iraq witnessed in 2005 important political events in the Iraqi arena, a pluralist parliamentary elections or elections in Iraq by direct free election on January 30, the first almost half a century ago. On November 15 of the same year, Iraq adopted a permanent constitution for the country through a popular referendum.

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Publication Date
Sat Jul 01 2006
Journal Name
Saudi Medical Journal
Treatment of alopecia areata by topical diclofenac sodium gel in comparison to benzoyl peroxide gel. A novel single blind therapeutic clinical trial
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KE Sharquie, AA Al-Nuaimy, WJ Kadhum, Saudi medical journal, 2006 - Cited by 3

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Publication Date
Sun Jul 01 1990
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
CHALCIDOID (HYMENOPTERA.) PARASITES OF THE BRUCHID BEETLES IN IRAQ WITH A DESCRIPTION OF A NEW SPECIES)
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The present work deals with five species of parasitic Hymenoptera belonging to Pteromalidae, Eupelmidae and Eurytornidae which have been reared from brachid beetles. A new species, Eurytoma irakensis is described and the species, Bruchocida orientalis Crawford is recorded for the first time from Iraq.

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Study of growth curve and morphological change for Trichomonas vaginalis parasite in the tow culture media
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The objective of this study was shed light for cultivation and maintenance of Trichomonas vaginalis parasite growth after isolated it by vaginal swaps from females suffering vaginitis and abnormal vaginal discharges in these media CPLM and TAB media to detect growth curve, morphological changes and viability of parasite in the two culture media, together with effect of sheep and bovine serum on the growth of it. The results of this studies were showed there was abtaine differences between the two types of media , The maximum growth of parasite was in TAB medium after 72 hours incubation with use of bovine serum, while such growth was maximized after 144 hours incubation with the use of sheep serum. In CPLM medium, a maximum gro

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Publication Date
Mon Jan 01 2018
Journal Name
Pakistan Entomologist
Taxonomic and molecular study of the widow spider genus Latrodectus Walckenaer, 1805 (Araneae: Theridiidae) in Iraq
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The genus Latrodectus Walckenaer, 1805 (Araneae: Theridiidae) is a worldwide distribute genus (Graudins et al., 2001), it includes a group of species commonly referred to as widow spiders. It's considered a taxonomically complex genus as the status of several forms had not been properly evaluated and specific boundaries are not well defined or understood (Levi, 1959; 1967; Garb et al., 2001), therefore, in multiple cases, populations has been uncritically referred to as different taxa. Discriminating between Latrodectus species using morphology has always been problematic (Levi, 1983), it is difficult taxonomically and readily separated from members of other Theridiid genera (Mirshamsi, 2005). The Genus Asagena Sundevall, 1833 was revalidat

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Publication Date
Tue Jun 01 2010
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Relevance of Budgeting Estimations for Control and Performance Evaluation in Adopting Kaizen: Hypothetical & Empirical Study
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The kaizen is considered as one of the most important modern techniques which has been adopted by various economics entities especially manufacturing firms and its beginnings return to the middle of the earlier century that has been used by companies like Toshiba, Matsushita Electric, and Toyota. Which realized that these modern techniques would make a total change in the competitive environment and started qualifying and its staff in such away that enables them to go along with this unique environment. The continuous improvement (Kaizen) depends on the small continuous improvements in the product and the production operations during the production stage. Consequently, the research problem is represented in the improperly of the budg

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