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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
Mon Dec 03 2018
Journal Name
The Iraqi Postgraduate Medical Journal
Operative Treatment by Plate and Screws Versus Conservative Treatment of Closed Displaced Fracture of the Mid Third of Clavicle in Adults: Comparative Study
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BACKGROUND: Clavicle fractures are common injuries in young active individuals, the mid third of the clavicle is most commonly fractured part(80% of clavicle fracture) OBJECTIVE: To compare the outcomes of operative and non operative management of displaced and or comminuted closed fracture of the mid third of clavicle in young adults PATIENTS AND METHODS: This prospective observational study of 24 patients of fracture of the mid third of the clavicle was conducted in Alkindy teaching hospital from July 2015 to January 2017 and divided into two groups; one managed by operative treatment with plate and screws and the other by non operative sling immobilization after taking the consent and the patients were seen at 2, 4, 6 weeks,3, 6, and 9 m

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Publication Date
Wed Jan 21 2026
Journal Name
Enterpreneurship Journal For Finance And Business
The role of psychological ownerships&#39; dimensions in deterring the effects of toxic leadership: Analytical research in some companies at the Ministry of Industry and Minerals in Iraq
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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
The Impact of the Strategy of Cooperative Integration of Fragmented Information in the Acquisition of Physical Concepts and Science Processes among Fourth Scientific Students
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The current research aims to reveal the impact of the strategy of cooperative integration of fragmented information in the acquisition of physical concepts and science processes among fourth scientific students through the null hypotheses:

1- There is no statistically significant difference at the level of significance (0.05) between the average grades of female students of the experimental group studying physics according to the strategy of cooperative integration of fragmented information and those who follow the traditional method in the test of acquiring physical concepts.

2-There is no statistically significant difference at the level of indication (0.05) between the average grades of female students of the experimen

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Publication Date
Wed Jun 30 2021
Journal Name
College Of Islamic Sciences
The footnote of The Scholar Abdul Rahman Al-Penjawni on collecting mosques and explaining it to the local by the scholar Abdul Rahman Ibn Mulla Mohammed Ibn Mulla Tahir Al-Penjweni Died in: 1319 AH School: (Absolute and restricted) Study and Observation
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Abstract

Indeed, being busy with the understanding of religion is the best sort of worship that the almighty God has given each period of time a number of scholars and wise men. They receive what has been passed down to them from their great ancestors, and those who are willing to learn will learn, their students preserve their knowledge through teaching and writing. Thus, the scholars were pioneers in this field due to the value and importance of their knowledge. They have strived in learning, explaining, and writing new subjects.

One of those scholars is sheikh (Abdulrahman Al-Penjweni) who passed away 1319 AH in one of the villages of the city of Sulaimani in Iraq. He was one of the wisest scholars, a br

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Publication Date
Wed Dec 04 2024
Journal Name
المورد
((The effect of mentioning, deleting, or changing the form of some Arabic letters on the meaning of the context of the sentence in Arabic))
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The letters are exposed in some texts of the classical Arabic language (poetry or prose), or in some of the Qur’anic texts, which are the main sources that were adopted on the day when provisions, rules and linguistic controls were established. I say that some of these letters are exposed in some contexts to deletion, mention, or change in the structure and shape of the letter. As for the omission, it is one of the aspects that distinguished Arabic, as well as other languages, for many purposes that differ among their user.

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Publication Date
Thu May 14 2020
Journal Name
Journal Of Planner And Development
The Impact of the Method of Dealing with the Product of Wars in the Continuity of the Crisis Wars. Beirut city as an Example
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This research investigates the subject of the impact of wars (as a manifestation of crisis) on architecture, and the extent of continuing wars physical and moral results of wars, even after the end of the cause of the crisis. The impact of different rebuilding which exposed to the effects of the war seems different in crisis regions.

The problem of research is about the uncertainty of the impact of the way chooses for reconstructing the buildings after wars in the continuity of the crisis of war. The goals of this research are to clarify the influence of methods of reconstruction of buildings in a city chosen which is Beirut, on the continuation of the war crisis with the argument of demolishing and rebuilding newly or keeping tr

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The Influence of The Kind of Feeding on The Average of Body Growth for The Infant of The Age (3-6) Months in Baghdad.City
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This paper was conducted to identifying the body growth averages for the infants of the age (3-6) months and their relation with brest (natural ) or artificial feeding The results showed that the higher percentage was for the infants with the natural feeding in comparison with those of the artificial or mixed feeding. Also there was a clear increase in the average of the body growth for those with the natural feeding and such results were closer to the standard criterion. While the averages of body growth for those with the artificial or mixed feeding were low. In addition, it was clear that the averages of body growth of the i

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Publication Date
Mon Mar 28 2022
Journal Name
The Open Dentistry Journal
Depression, Anxiety and Stress Among Dentists During COVID-19 Lockdown
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Introduction:

The objective of this study was to investigate the levels of depression, anxiety, and stress among dentists during covid-19 lockdown and to investigate the relationship between stress and each mental health state.

Methods:

A cross-sectional survey on 269 dentists was conducted using DASS-21 and PHQ-9 questionnaires. Bivariate and multivariate models were constructed and the odds ratio (OR) was calculated to assess the strength of the association between an independent categorical variable and the outcome.

Results and Discussion:

Being unsatisfied with the job was as

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Publication Date
Wed Jul 02 2014
Journal Name
Journal Of The Faculty Of Medicine
Unintended durotomy during degenerative lumbar Spine surgery (Incidence and management
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AW Tarik, AW Ali T, A Salah, Journal of faculity of medicine Baghdad university, 2014 - Cited by 3

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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Methods of using the periodic chart in the case of the missing values of the stable AR model (2)
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In this study, we investigate the behavior of the estimated spectral density function of stationary time series in the case of missing values, which are generated by the second order Autoregressive (AR (2)) model, when the error term for the AR(2) model has many of continuous distributions. The Classical and Lomb periodograms used to study the behavior of the estimated spectral density function by using  the simulation.

 

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