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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 May 01 2020
Journal Name
مجلة بحوث الشرق الأوسط
دراسة مقارنة لمستوى التمکین الإداری بین مشرفی التربیة الریاضیة (الاختصاص والفنی) لمدیریات التربیة فی محافظة بغداد A Comparative Study of the Level of Administrative Empowerment between the Physical Education Supervisors (Specialization and Technical) of Education Directorate in Baghdad Governorate
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Publication Date
Tue Dec 30 2025
Journal Name
Journal Of Physical Education
The impact of a computerized program (cogniplus) to develop the strength to focus and perform kinetic chain on the balance beam
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Publication Date
Mon Jun 30 2003
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study of the Factors Affecting Cells of Sodium Chlorate Production
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Publication Date
Sun Sep 02 2012
Journal Name
Baghdad Science Journal
Study Of Factors Affecting The Thermal Conductivity Of Iraqi Bentonite
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Thermal conductivity of compacted bentonite is one of the most important properties where this type of clay is proposed for use as a buffer material. In this study, Lee's disc method was used to measure the thermal conductivity of compacted bentonite specimens. The experimental results have been analyzed to observe the three major factors affecting the thermal conductivity of bentonite buffer material. While the clay density reaches to a target value, the measurement is taken to evaluate the thermal conductivity. By repeating this procedure, a relationship between clay dry density and thermal conductivity has been established in specimens after adjusting the water contents of the bentonite by placing its specimens in a drying oven for diffe

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Publication Date
Mon Jun 30 2003
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study of the Drying of Ethanol using Zeolite Molecular Sieves
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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi Journal Of Physics
Study of the mechanical properties of Iron-Epoxy composite materials
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Iron-Epoxy composite samples were prepared by added
different weight percentages (0, 5, 10, 15, and 20 wt %) from Iron
particles in the range of (30-40μm) as a particle size. The contents
were mixed carefully, and placed a circular dies with a diameter of
2.5 cm. Different mechanical tests (Shore D Hardness, Tensile
strength, and Impact strength ) were carried out for all samples. The
samples were immersed in water for ten weeks, and after two weeks
the samples were take-out and drying to conducting all mechanical
tests were repeated for all samples. The hardness values increased
when the Iron particle concentration increased while the Impact
strength is not affected by the increasing of Iron particles
c

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Publication Date
Mon Dec 30 2002
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study of the Factors Affecting Cells of Sodium Perchlorate Production
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Publication Date
Tue May 30 2023
Journal Name
Gsc Biological And Pharmaceutical Sciences
Anatomical study of the 3rd metacarpal bone of some mammals
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The current study included the anatomical structure of the metatarsal bone in sheep in terms of the traditional structural description of the bone, as it was found that the metatarsal bone in the fore and hind limbs of adult sheep had no visible differences between it and animals, especially ruminants. The metacarpal \tarsal bone No. 3 was cylindrical in shape, with the presence of the metacarpal \tarsal bones 2 and 4 declines, articulated from the proximal end with the metacarpal and metatarsal bones whereas from the distal part with the fetlock joint and the first phalanx bone. The aim of the study is to determine whether the environment and its changes in Iraq have affected the animals and their bones in terms of length, thicknes

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Publication Date
Sat Dec 31 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
PREPARATION AND STUDY OF THE PHYSICAL PROPERTIES OF SOME COMPLEXES WITH SCHIFF BASE LIGAND FOR CEFDINIR DERIVATIVE : PREPARATION AND STUDY OF THE PHYSICAL PROPERTIES OF SOME COMPLEXES WITH SCHIFF BASE LIGAND FOR CEFDINIR DERIVATIVE
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ABSTRACT

Metal (II) complexes of Co, Ni, Cu and Zn with cefdinir C14H13N5O5S2 derivative (L) were synthesized and identification by elemental analysis CHNS Uv-Vis, FTIR, TGA, metal analysis AA, magnetic susceptibility and conduct metric measurement. by analysis the ligand behaves as a bidentate. For the cobalt complex, Tetrahedral geometry shape was suggested, while other complexes that have nickel, copper and zinc ions were proposed as octahedral geometry shape. The experimental method was studied for prevention of corrosion carbon steel in 3.5% NaCl by using a novel Cefdinir derivations drugs. The results showed that metal complex was a strong corro

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Publication Date
Sun Dec 15 2019
Journal Name
Al-academy
Directorial Vision and its Relation to Scenographic Proposal in the Iraqi Theater Show- The Play of Darkness -A Model: رامي سامح زكي
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The increase of the scenographic designer role on account of the character of the director in the Iraqi theater constituted a clear phenomenon that has been manifested in many shows, which necessitated a stance on the nature of this relation and delimiting the work space for each one of them inside the theater show. The research focuses on determining the work relation between the directorial vision and the scenographic proposal in the Iraq theater show. The research is divided into four chapters, the first one addressed the methodological framework, where the research problem was stated in the following question (has the scenographic designer been able through his scenographic proposal to remove the director from his position being the

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