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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
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The evolution of demographic variables and their relationship to the demographic opportunity in Iraq and the possibility of investing
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The variables of quantitative and qualitative Population role in the economic development process and it was said the human center of development and population is the goal of development and its tool , and Iraq suffers from problems in the economic growth and the standard of living and development in general, and if I want him evolution and development sectors must pay for these demographic changes especially , to study and that invest Pmaasb in the interest of the man
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Thu Jun 30 2022
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Sports Culture
Analysis of the kinetic path of some physical measurements and kinetic abilities in terms of the direct attack in the foil
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Through the researchers' acquaintance with the previous studies, the problem was identified as that the preparation of training curricula in all its units must be based on accurate scientific foundations. Positively affect the type of attack and its implication in the presence of correlational relations, whether direct or indirect, i.e., precedence in training and in preparing units Therefore, the researcher decided to build a causal model to know the relationships to show the best model of the direct straight attack. The study aimed to build a causal model for the most important physical measurements and kinetic capabilities of the direct straight attack in the research sample. The two researchers used the descriptive approach in t

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Sun Dec 28 2025
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The reality of technological leadership in youth and sports directorates in the southern region from the point of view of employees
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Mon Feb 01 2016
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The Role of Strategic Leadership in the adoption of Talent Management Practices Field research in the Ministry of Science and Technology
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The current research aims at testing test the relationship and the impact of strategic leadership (strategic vision, Core competencies , human capital, organizational culture and Ethical practices) in the talent management (to attract talent, performance management talent, developing talent and retain talent) among managers in the Ministry of Science and Technology Iraq, and figuring out  a number of recommendations to the ministry to help achieve its desired objectives, and to clarify the relationship between the variables to find the main and secondary aim of the research two major hypotheses have been formed which split into ten sub-hypotheses. Collecting data on  a form questionnaire has been relied on as an essenti

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Sun Dec 28 2025
Journal Name
Al-anbar University Journal Of Law And Political Sciences
The reasons for the fall of sanctions in the decisions and customs provisions in Iraqi law
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Sun Dec 31 2023
Journal Name
College Of Islamic Sciences
Variation in general formulas in the strength of its foundation and the reasons for the discrepancy
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Publication Date
Sun Dec 16 2018
Journal Name
Al-academy
The Problem of Designing the User Interface in the Interactive Websites (website of the Faculty of Fine Arts and Ways of Developing it)
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Thu Jan 04 2024
Journal Name
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A proposal to impose a tax on the profits of securities trading to increase tax revenues: Applied research in the General Commission of Taxes
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Abstract:

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
The Role of the Faculty of Education in Serving the Community in the Light of the Vision of the Kingdom 2030 from the Faculty Members’ Point of View at the University of Jeddah
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The study aimed at identifying the role of the Faculty of Education in the community service in light of vision of the Kingdom 2030 from the faculty members’ point of view at the University of Jeddah. The study used a descriptive method through a questionnaire administered to a sample of the faculty members.It concluded that the role of the College in serving the community is the development of the right habits in the family and the importance of establishing bridges of cooperation between the Faculty of Education and the surrounding environment and teaching special education teachers how to apply some methods of measurement to determine the needs of students with disabilities. The results also pointed out that there are no statistical

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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The relationship of empowering workers with organizational performanceField research of the views of the scientific leaders of a number of colleges at the University of Baghdad
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The Strategy of employees' empowerment, organizational performance and total quality management represent three informative which were and still the hub of many studies and researches including the current study. The higher education is considered one of the most important services sectors and the main development as well as the civil progress in the society. It is the main source that provides the organizations with the human resources having scientific or practical professions. So Higher Education has been chosen especially Baghdad University as a sample of the study. The study problem is concentrated to find answers of the following   questions: What the level of the powers mandate in the organization concerning the

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