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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 Dec 20 2024
Journal Name
Bulletin Of The Iraq Natural History Museum
FIRST RECORD OF THE NORTH AFRICAN CATFISH CLARIAS GARIEPINUS (BURCHELL, 1822) (SILURIFORMES, CLARIIDAE) IN TIGRIS RIVER, IRAQ
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The current study aimed to determine the morphometric and meristic characteristics of the North African catfish Clarias gariepinus (Burchell, 1822). Six specimens of C. gariepinus were collected from the Tigris River, in central Iraq. This study is considered the confirmation first record of this species in Iraq, and the second documentation of this exotic fish. The present species is characterized by a very long dorsal fin, a rounded caudal fin and four pairs of barbels.

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Publication Date
Fri Dec 20 2024
Journal Name
Bulletin Of The Iraq Natural History Museum
FIRST RECORD OF THE NORTH AFRICAN CATFISH CLARIAS GARIEPINUS (BURCHELL, 1822) (SILURIFORMES, CLARIIDAE) IN TIGRIS RIVER, IRAQ
...Show More Authors

The current study aimed to determine the morphometric and meristic characteristics of the North African catfish Clarias gariepinus (Burchell, 1822). Six specimens of C. gariepinus were collected from the Tigris River, in central Iraq. This study is considered the confirmation first record of this species in Iraq, and the second documentation of this exotic fish. The present species is characterized by a very long dorsal fin, a rounded caudal fin and four pairs of barbels.

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Publication Date
Fri Dec 20 2024
Journal Name
Bulletin Of The Iraq Natural History Museum
FIRST RECORD OF THE NORTH AFRICAN CATFISH CLARIAS GARIEPINUS (BURCHELL, 1822) (SILURIFORMES, CLARIIDAE) IN TIGRIS RIVER, IRAQ
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The current study aimed to determine the morphometric and meristic characteristics of the North African catfish Clarias gariepinus (Burchell, 1822). Six specimens of C. gariepinus were collected from the Tigris River, in central Iraq. This study is considered the confirmation first record of this species in Iraq, and the second documentation of this exotic fish. The present species is characterized by a very long dorsal fin, a rounded caudal fin and four pairs of barbels.

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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
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Assisting Students of Al-Quds Open University to Design Computerized Lessons According to ADDIE
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This Action research aimed at Assisting Students of Faculty of Educational Sciences  at Al-Quds Open University to design computerized  lessons using the Power Point software and according to ADDIE model. The study sample consisted of 40 students  who were taking a course titled Technology of Education during the second semester of the 2014-2015 academic year and three academic instructors . To collect the required date  , the researchers used  focus group technique and structured interviews to get information from the 40 students and the three academic instructors involved in the course Technology of Education in QOU /Nablus Branch. In addition to these methods, a workshop with a guiding checklist was employed 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
Sun Jul 21 2024
Journal Name
Journal Of Clinical Medicine
Microbiological and Salivary Biomarkers Successfully Predict Site-Specific and Whole-Mouth Outcomes of Nonsurgical Periodontal Treatment
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Background/Objectives: Nonsurgical periodontal treatment (NSPT) is the gold-standard technique for treating periodontitis. However, an individual’s susceptibility or the inadequate removal of subgingival biofilms could lead to unfavorable responses to NSPT. This study aimed to assess the potential of salivary and microbiological biomarkers in predicting the site-specific and whole-mouth outcomes of NSPT. Methods: A total of 68 periodontitis patients exhibiting 1111 periodontal pockets 4 to 6 mm in depth completed the active phase of periodontal treatment. Clinical periodontal parameters, saliva, and subgingival biofilm samples were collected from each patient at baseline and three months after NSPT. A quantitative PCR assay was us

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Publication Date
Sun Dec 19 2021
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIRST PHOTOGRAPHIC RECORDS AND NEW DISTRIBUTION RANGE OF THE ENDANGERED LONG-TAILED NESOKIA NESOKIA BUNNII (KHAJURIA, 1981)
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In the 1970s, the world knew the long-tailed nesokia Nesokia bunnii (Khajuria, 1981) (Rodentia, Muridae) from the Mesopotamian marshes of Garden of Eden in Southern Iraq. This distinct rodent was known from only five voucher specimens collected at the confluence of Tigris and Euphrates Rivers in southern Iraq while its occurrence in Southwestern Iran had
never been reported. In the 1990s, a large extent of its natural habitat was catastrophically desiccated and the animal was last seen in the 1970s. Since then, the status of this elusive rodent was shrouded in mystery. In 2007, an extraordinary photograph of a carcass of this species came to the light from Hawizeh Marsh which was interpreted as concrete evidence of the species’ pers

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Publication Date
Tue Aug 31 2021
Journal Name
Karbala International Journal Of Modern Science
Adaptive reconstruction of the heterogeneous scan line ETM+ correction technique
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