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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
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
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
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
Sat Dec 31 2016
Journal Name
Al-kindy College Medical Journal
Comparison between Open Mini-incision Thyroidectomy and Conventional Thyroidectomy: Clinical Experience and Literatures Review
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Background: Thyroid surgery is most common endocrine surgery in general surgical practice. Objectives: the aim of this work is to evaluate the feasibility, benefits and outcomes of open mini-incision thyroidectomy and compared the results with that of conventional thyroidectomy. The comparison between the two groups was in term of incision length, amount of blood loss, time of operation, postoperative pain, hospital stay and the cosmetic outcomes.Type of the study: this is a single-blinded randomized controlled studyMethods: This study compared the advantages and outcomes of 22 patients subjected to mini-incision thyroidectomy (Group A) with the equal numbers of patients subjected to conventional thyroidectomy (Group B).Results: the oper

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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
Mon May 22 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
The First Record of Two Species of Dactylogyrus (Monogenetic Trematodes) in Iraq From Diyala River Fishes, Diyala Province
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  Two species of monogenetic trematodes of the genus Dactylogyrus were recorded in the present paper for the first time in Iraq from two freshwater fishes from Diyala river, Diyala province. The first species,  D. bocageii Alvarez Pellitero, Vicente et Gonzalez Lanza, 1981 was recorded from gills of Aspius vorax, the second species, D. lenkorani Mikailov, 1967 was recorded from gills of Barbus sharpeyi. The descriptions and measurements of these parasites as well as their illustrations were given.

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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
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
Surgical –Audit on breast cancer risk factors in AL-Russafa district in Baghdad
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Background: Breast cancer remains a substantial cause of morbidity and mortality, there is a need for continued efforts to understand the etiology of the disease, maintain screening effort, implement prevention strategies, and develop better treatments.Objective: To analyze the risk factors, improve early detection and prevention of breast cancer in Al-Russafa district- Baghdad, aiming to increase survival rate and improve the quality of life.Methods: A cross sectional audit of 258 breast cancer cases seen at Al-Elwiya maternity teaching hospital from January2009 to December 2011,data collected from patients files were: age, gender , residency, marital status, parity, age at menarche and menopause age at first live birth, hormonal therap

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Publication Date
Wed Mar 08 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
First Occurrence of Plagioporus skrjabini Kowal, 1951 (Trematoda: Opecoelidae) in Iraq from the Sisorid Catfish Mystus pelusius
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The trematode Plagioporus skrjabin iKowal, 1951 was recorded in this study for the first time in Iraq from intestine of Mystus pelusius
(Solander, 1794) which were collected from different locations along Tigris River near Al-Shawwaka region, Baghdad city. The description and measurements of this parasite as well as its illustration were given.

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