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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 Sep 01 2013
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The contractual budget: the ideal technique in planning and implementing capital budgeting projects: a strategy of preparing the contractual budget for Baghdad local government
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Public budget is the government's tool in achieving the objectives of economic and social development is the accounting curriculum to estimate state revenues and expenditures for years to come, as well as to have legal status as it is after the adoption of an official statement of government units to spend funds on items planned at the same time is a statement collect resources to finance these appropriations, if the primary objective of the budget initially limited to the achievement of financial and legislative control have evolved this function in the area of public administration turned attention from mere imposition of control over the money, which provides information to assist the Department to utilize available resources and prog

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Publication Date
Tue Dec 01 2009
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
RECORD OF TWO SPECIES OF THE MONOGENETIC TREMATODES GENUS DACTYLOGYRUS FOR THE FIRST TIME IN IRAQ ON GILLS OF THE CYPRINID FISH ALBURNUS CAERULEUS
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For the first time in Iraq, two species of monogenetic tretamtodes of the genus Dactylogyrus were recorded from gills of Alburnus caeruleus from Tigris river at Al-Zaafaraniya, south of Baghdad during June 1995. The first species, Dactylogyrus sphyrna is characterized by having the seventh pair of marginal hooklets almost twice as large as other marginal hooklets, powerful inner and outer processes of median hooks especially the inner one which is expanded terminally, one connecting bar and long spirally twisted copulatory organ. The second species, Daclytogyrus phoxini differs from the first one by having marginal hooklets of the same size, inner and outer processes of median hooks are not powerful, two connecting bars

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Publication Date
Fri Jun 18 2021
Journal Name
International Journal Of Emerging Technologies In Learning (ijet)
The Effectiveness of Educational Pillars Based on Vygotsky's Theory in Achievement and Information Processing Among First Intermediate Class Students
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The aim of the research is to identify the effectiveness of the educational pillars strategy based on Vygotsky's theory in mathematical achievement and information processing of first-grade intermediate students. In pursuit of the research objectives, the experimental method was used, and the quasi-experimental design was used for two equivalent groups, one control group taught traditionally and the other experi-mental taught according to the educational pillars strategy. The research sample consisted of (66) female students from the first intermediate grade, who were inten-tionally chosen after ensuring their equivalence, taking into account several factors, most notably chronological age and their level of mathematics, and they we

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Publication Date
Sun Oct 02 2016
Journal Name
Journal Of Educational And Psychological Researches
The Effect Of Flexible Grouping Strategy And Three Step Interview Strategy On Achievement Of The History Material Among Student Of The First Intermediate Class
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  The research aims to know The Effect Of Flexible Grouping Strategy  and Three Step Interview strategy on achievement of the history material among student of the first literary class, The Researcher used the experimental design of the two experimental groups and the control group and with post test, researcher group (a) represent the experimental group taught according the Flexible Grouping Strategy  , and Division (c) to represent the second experimental group which studied according Three Step Interview strategy and Division (b ) to represent the control group taught in the traditional method, the number of students (99) students of (33) female students in each division. T

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Publication Date
Fri Jan 01 2021
Journal Name
Bulgarian Journal Of Veterinary Medicine
First isolation and molecular phylogenetic analysis of Coxiella burnetii in lactating cows
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Q fever is an infectious disease of animals and humans, caused by globally distributed C. burnetii. In Iraq, there are no previous studies associated with the detection of the organism in cattle. An overall of 130 lactating cows were submitted to direct collection of milk samples. Initially, the samples of milk were tested using the molecular polymerase chain reaction (PCR) assay targeting three genes (16S rRNA, IS1111a transposase, and htpB). However, positive results (18.46%; 24/130) were detected only with the 16s rRNA gene. Concerning risk factors, the highest prevalence of C. burnetii was showed in the district of Badra (42.86%), whereas the lowest - in Al-Numaniyah and Al-Suwaira districts (P=0.025). There was no significant v

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Publication Date
Sat Dec 28 2024
Journal Name
Journal Of College Of Physical Education
Design and standardization of a progressively difficult educational test for football passing skills for first-year students in the College of Physical Education and Sports Sciences
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Standards play a vital role in documenting the values ​​of new test results in the form of tables. They are one of the basic requirements that the standardization process aims for as a complement to standardizing test procedures, and contribute to knowing the current reality of the student. The degree of readiness and level as a result of practicing different exercises for sports activities, in addition to the possibility of adopting it for comparison with his group or similar groups, classification, prediction and selection. Developing the skill of handling the football in the educational field is an important matter for achieving distinguished performance among students. This skill requires a level of accuracy, speed and control, and

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Publication Date
Wed Apr 30 2025
Journal Name
Open Veterinary Journal
Anatomical differences in the biliary duct system between canines and felines: A review article
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The liver is one of the largest glands in the digestive system and performs 13 various functions, including the secretion of hormones and enzymes. The gallbladder serves as a storage reservoir for secretions before they are released into the digestive system through the duodenum. The bile ducts branch from the liver’s lobes and ultimately connect to the digestive system, making this structure significant and distinct among different animal species. This review focuses on the differences between dogs and cats, highlighting the importance of these differences from both health and pathological perspectives. After conducting a detailed scientific review of the biliary tree in dogs and cats, we concluded that cats are more susceptible to the d

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Publication Date
Wed Jan 01 2025
Journal Name
Open Veterinary Journal
Anatomical differences in the biliary duct system between canines and felines: A review article
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The liver is one of the largest glands in the digestive system and performs 13 various functions, including the secretion of hormones and enzymes. The gallbladder serves as a storage reservoir for secretions before they are released into the digestive system through the duodenum. The bile ducts branch from the liver’s lobes and ultimately connect to the digestive system, making this structure significant and distinct among different animal species. This review focuses on the differences between dogs and cats, highlighting the importance of these differences from both health and pathological perspectives. After conducting a detailed scientific review of the biliary tree in dogs and cats, we concluded that cats are more susceptible

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Publication Date
Sun Jun 30 2002
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
A study of the Rate of Sedimentation of Magnesium Hydroxide Obtained from Bittern
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Publication Date
Fri Feb 08 2013
Journal Name
Advances In Life Science And Technology
An Analytical and Clinical Study for Measure the Bioavailabilityof Zinc in Serum Using Flame Atomic Absorption Technique
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An analytical and clinical study has been applied for measure the bioavailability of Zinc in serum of twenty adults healthy volunteers, using flame atomic absorption spectrophotometer (FAAS) at 213.9 nm. The calibration graph is linear in the ranges of 0.25-1.5 μg.mL-1 with correlation coefficient (R) 0.09996)μg.mL1-and molar absorpitivites 22957.76(L.mol1-cm-1.The concentration of Zinc determined in serum of all volunteers before and after administered orally a tablet of 50 mg zinc sulphate, produced by Samara drugs company (SDI). All data were subjected to statistical analysis by calculating accuracy, precision in addition to other parameters. The results indicate that the average maximum concentration (C-max ± SD) of blood zinc was 0.

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