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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
Sat May 08 2021
Journal Name
Social Science And Humanities Journal
The impact of accounting for material flow costs in reducing costs: Exploratory study
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Rapid and continuous developments and changes in the modern business environment in all areas of economic, environmental, social, technology and communications push economic units to search for modern methods and methodologies to produce products at low cost as well as produce products that meet the wishes of customers in terms of quality and environment to maintain their market position, and accounting for the costs of the flow of materials is one of the most prominent environmental management accounting techniques capable of providing information to help produce

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Publication Date
Wed Dec 31 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The initial stability of dental implant with horizontal plate (An in vitro study)
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Background: The Initial (primary) stability is one of the factors that play an important role in the success of the dental implants. The purpose of this study was to evaluate the initial stability of dental implant with horizontal plate by using five analytical tests: insertion torque, removal torque, resonance frequency analysis, push-in test and pull-out test. Materials and methods: Two different lengths of dental implants (5mm and 10mm) were tested in this study; each dental implant was 4mm in diameter with a square threads shape of 1mm pitch and 0.5mm depth. The crestal area was 4.2mm diameter contained a right angle margin circumferential ring while the apical area was tapered with two self-tapping grooves. In this study, the initial s

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of American Science
Morphohistological study of the tongue in local mice species by using special stain
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Publication Date
Thu Jan 01 2015
Journal Name
Basrah Journal Of Veterinary Research
Prenatal Histological study of the limbs bone onset development in Guinea pig (CaviaCutleri)
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Publication Date
Thu Jun 30 2016
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study the Efficiency of Drilling With Casing Operation in an Iraqi Oil Field
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Drilling with casing (DWC) can be considered as a modern drilling technique in which both of drilling and casing operations done in the same time by using the casing to transfer the hydraulic and mechanical power to the bit instead of traditional drilling string. To overcome oil well control, minimizing the total cost through enhancing drilling efficiency, drilling with casing was proposed as an enabling technology.

   Two surface sections (17 1/2 - and 12 1/4- inch) were drilled successfully in Rumaila oil field with  casing strings which reached 655m and 1524m measured depths respectively.

   By using DWC technique, the total drill/case phase time was reduced up to 20% comparing to conventional

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Publication Date
Tue Jun 14 2016
Journal Name
Al-academy
Technical openness in the formation of postmodernism Pop Art Example (An analytical study)
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Addressed the problem of the research is marked (technical openness in the formation of post-modernism - Pop Art an Example) the nature of the technical expansion of the output artifacts postmodern, and the nature of the raw materials taken as components of its sensual. The search came in four sections: general framework for research and identified the research problem and the need for him. With an indication of the importance of his presence. From then select the search goal (revealed openness to hire technical material in the art of Pop Art), followed by the establishment of the three search limits (objectivity, the temporal and spatial) were then determine the terms related to the title. Then provide the theoretical framework and indi

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Publication Date
Fri Sep 01 2017
Journal Name
Iosr Journal Of Pharmacy And Biological Sciences(iosr-jpbs)
Histopathological study in the spleen of Albino Mice treated with glucosamine sulfate drug
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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Effect of Insurace Company Capital Adequacy in it’s Profitafility: An Empirical Study
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The Purpose of this research is analysis and discussion " The Effect of Insurace Company Capital Adequacy in it’s Profitafility: An Empirical Study compared the two insurance (national, Iraqi), for a period of one year (2005) and the year (2014), as it is framed theoretical side for two topics head adequacy money the insurance company, and the profitability of the insurance company, and I've been using the research methodology and analytical, in the analysis and measurement of the capital of the insurance company adequacy, and profitability of the company, as the capital adequacy ratio was measured by dividing the total capital available on the total capital rate risk, after measured and appreciated in two insurance research, while I u

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Publication Date
Thu Jun 29 2017
Journal Name
College Of Islamic Sciences
Attributes of those whom God Almighty loves in the Holy Qur’an: Objective study
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In The Name of Allah Most Gracious Most Merciful

The characteristics of the doers of good are mentioned in the Holy Book of God, and love for them in five places, and whoever God loves, honors him and gives him victory. As for the love of the righteous, it has to do with loyalty, covenant, and integrity. Committing sins 0 Then after that he mentioned God those who fight in His cause and those who rely on Him and return to Him and turning away from everything else.

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Publication Date
Sun May 18 2025
Journal Name
Iraqi Journal Of Veterinary Sciences
Histomorphological study of the lymphoglandular complex in adult local breed dog (Canis familiaris)
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