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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 Sep 15 2020
Journal Name
Al-academy
The Dialectic of Identity and the Other in Iraqi Contemporary Theatre: انس راهي علي
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  The value of culture in its interaction is composed and formulated according to compatible and incompatible roles which view the identity that adopts that formation although it is in most cases perceived and declared. The attraction and difference characteristic might be implied within subjective and procedural meaning through which it seeks to make the identity mobile subject to identity- shaping cultural causes implying the conflicts that take the shape and culture of real time. As for the end of the twentieth century and afterward where the concepts of hegemony, globalization, cultural invasion, colonial and imperial culture, all these causes made the cultural identity concept appear on the surface of the critical studies as a

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Publication Date
Sat Oct 01 2022
Journal Name
Iraqi Journal Of Veterinary Sciences
The histological and histochemical features of the esophagus in local breed dogs (Canis familiaris)
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Publication Date
Sat Oct 01 2022
Journal Name
Iraqi Journal Of Veterinary Sciences
The histological and histochemical features of the esophagus in local breed dogs (Canis familiaris)
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Publication Date
Tue Apr 18 2023
Journal Name
Bmc Plant Biology
Unravelling the genetic diversity and population structure of common walnut in the Iranian Plateau
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Abstract<sec> <title>Background

Common walnut (Juglans regia L.) has a long cultivation history, given its highly valuable wood and rich nutritious nuts. The Iranian Plateau has been considered as one of the last glaciation refugia and a centre of origin and domestication for the common walnut. However, a prerequisite to conserve or utilize the genetic resources of J. regia in the plateau is a comprehensive evaluation of the genetic diversity that is conspicuously lacking. In this regard, we used 31 polymorphic simple sequence repeat (SSR) markers to delineate the genetic variation and population stru

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Publication Date
Mon Aug 30 2021
Journal Name
مجلة الجامعة العراقية
Contracts in light of the Corona pandemic between the emergency circumstance and force majeure
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The "Corona" pandemic that strikes the world has cast a shadow over contractual obligations, whether between individuals or companies, and emergency accidents and force majeure circumstances have a direct impact on them. Here, the legislation intervenes and sets the legal mechanisms to restore the obligations to their equal status and achieve the economic balance of the contract. Health crises are among the material facts whose effects are reflected and their features can be monitored on legal relations in general and contractual relations in particular, including the extent of the impact that this pandemic can have on the obligations that arise within the framework of a contractual relationship, which can be talked about in my theory Force

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Publication Date
Wed May 02 2018
Journal Name
Indian Journal Of Natural Sciences
Histological and Histochemical Characters of the Pancreas in the Adult Indigenous Gazelle (Gazella subgutturosa)
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LO Hamza, Indian Journal of Natural Sciences, 2018 - Cited by 3

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Publication Date
Thu Jan 03 2002
Journal Name
Iraqi Journal Of Architecture And Planning
The technological indicators of the relationship between structure and form in contemporary interior space
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Publication Date
Wed Jun 15 2022
Journal Name
Al-adab Journal
THE SEMIOTIC COMPONENT OF LACUNS AND THEIR BASIC TYPES IN THE LANGUAGE: THEORETICAL SUBSTANTIATION
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The article attempts to provide the theoretical fundamentals for the semiotic component of lacunae in a language. The definitions of the following notions have been represented: 1) lacunarity as a complex phenomenon that works in the modes of language, speech and speech behaviour; 2) lacuna as a gap, an empty space, which lacks something, which may be characteristic of a written work. The author of the article considers the main classes of lacunae, among which are: 1) generic lacunae, which reflect the absence of a common name for a class of objects; 2) species lacunae are the absence of specific names, names of individual types of objects or phenomena; 3) intralingual lacunae are found within the paradigms of one language; 4) interlanguage

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Publication Date
Tue Jul 25 2017
Journal Name
J. Entomol. Zool. Studies
Histological and histochemical observations of the small Intestine in the indigenous Gazelle (Gazella subgutturosa)
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LO Hamza, NA Al-Mansor, J. Entomol. Zool. Studies, 2017 - Cited by 14

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Publication Date
Sun Mar 31 2024
Journal Name
قضايا سياسية
The Iraqi Woman in the Face of Climate Change: Challenges, Obstacles, and Empowerment Strategies
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استهدف البحث تشخيص وتحليل الاسباب التي تجعل المرأة العراقية أكثر تأثراً من الرجل بعوامل التغيرات المناخية، فضلاً عن زيادة الوعي بقضية المرأة في هذا المجال، لأن موضوع دمجها في صياغة السياسات والاستراتيجيات المتعلقة بالتغير المناخي أصبح قضية عالمية، ويحتل مرتبة متقدمة في مؤشرات تحقيق أهداف التنمية المستدامة، وأستخدمت الباحثة المنهج الوصفي والتحليلي والاحصائي في تحليل محاور البحث، وتوصل البحث الى إستن

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