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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 Apr 30 2019
Journal Name
Journal Of Planner And Development
The environmental impacts of reviving Hor Alsnav By the water of the river of out fall drain in the province of Dhi Qar
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The aim of this study is to explain methods to be followed for the recovery Alsnav Hor, who represents the northwest portion of the Hammar Marsh in the province of Dhi Qar, after the drought in which that happened in 2008. The study included description of the region before the drought, the description of its natural and human environments, the economic events and activities, then the study included drought throughout the region, the environmental impacts caused by drought, its impact on social reality, economic and healthy for its environment, and then reached to the problems of social and economic in the region, depending on the Field studies and documented in the specialized government departments, information analysis for the

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Publication Date
Mon Jul 01 2019
Journal Name
Plant Archives
Effect of the level of corticosteron hormone in the blood of local Iraqi chicken mothers on the sex ratio of the produced offsprings
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This study was conducted to investigate the relationship between corticosterone hormone in the blood of local Iraqi white chicken mothers and the sexual ratio of the hatching chicks. A field experiment located at the Poultry Research Station, Livestock Department, Agricultural Research Department, Ministry of Agriculture for the period from 16 of September 2018 to 25 of December 2018. One hundred and forty birds of Iraqi local chicken mothers (100 females+ 40 males) at the age of 28 weeks were provided from the poultry research station. The birds were raised in individual cages and distributed sequentially to the cages after the numbering of the females. Data were recorded in three periods, each period was of 28 days, and then the general a

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Publication Date
Thu Jun 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Prevalence and localization of the posterior superior alveolar artery in relation to the floor of the maxillary sinus and alveolar crest among sample of Iraqis using computed tomography
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Background: Posterior superior alveolar artery (PSAA) is branch of the maxillary artery. It usually supplies the lateral wall of the sinus and overlying membrane. Evaluation and awareness of the anatomy of maxillary sinus before surgery is crucial to avoid surgical complications. The aim of this study is to examine the prevalence, location of the (PSAA) in relation to the floor of the maxillary sinus and alveolar crest using computerized tomography (CT) scans. Materials and Methods: This study included 180 Iraqi subjects (99 males and 81 females) with age more than 16 years old. CT scans for (right and left) Maxillary sinuses were done for each patient. The information obtained was assessed in a coronal multi planar reconstructions images (

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Publication Date
Mon Dec 23 2019
Journal Name
Opcion
The Effect Of Employing The Strategy Of The TalkativeGroups On The Achievement And Attitudes Of ChemistryFor Fifth Grade Students Applied Scienc
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The study aimed to reveal the impact of employing the strategy of the talk-ative groups on the achievement and academic tendencies of chemistry forstudents of the fifth grade of applied science for the academic year (2018 -2019), and to achieve this goal the researcher used the experimental methodon the sample of the study consisting of (50) students, prepared achievementtest falls Under (60) paragraphs, and the scale of tendencies for chemistryfalls under (30) paragraphs, and after the researcher completed the researchexperiment according to what was planned:The superiority of the experimental group studied according to the strate-gy of the talkative groups was found in the post-application of the test ofachievement and attitudes of chemis

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Publication Date
Fri Feb 09 2024
Journal Name
Eximia
The reality of the moral climate and its relationship to the decision-making of boxing referees from the standpoint of coaches
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The purpose of this paper is to identifying the relationship between the moral climate and the decision-making of boxing referees from the standpoint of the coaches, and the research problem lies through the work of the researchers in training and managing the teams. It was noted that the role of the referees is one of the most important roles played by the workers to achieve the objectives of the federation, and that the moral climate that prevails among the administrative body the union and the referees on the one hand and between the referees and coaches on the other hand are among the factors of the success of everyone’s work and the survival and strengthening of confidence in their work and thus the continuity of success and

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Publication Date
Fri Mar 02 2018
Journal Name
Alustath Journal For Human And Social Sciences
The Relationship Between Spatial Ability And The Physical Structure of concepts to The Students of The College of Education for Pure
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          The research aims to identify the relationship between spatial ability  and the physical structure of concepts to the students of the Faculty of Education for Pure Sciences / Ibn al-Haitham، research involved students from the third class / morning study for the year 2011/2012  totaling (98) male and female students ،distributed into three groups which were selected randomly . The number of students (26 males and females)  represented research sample after excluding repeaters and absentees، the research included two tests ; one test of spatial ability، which included (20) items and other test the physical structure of concepts، which included (12) items distributed into four domains ، the first (linking b

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Publication Date
Wed Mar 01 2023
Journal Name
Baghdad Science Journal
Pharmacokinetic Consideration to Formulate Sustained Release Drugs: Understanding the Controlled Drug Diffusion through the Body Compartment of the Systemic Circulation and Tissue Medium-A Caputo Model
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The aim of this study is to provide an overview of various models to study drug diffusion for a sustained period into and within the human body. Emphasized the mathematical compartment models using fractional derivative (Caputo model) approach to investigate the change in sustained drug concentration in different compartments of the human body system through the oral route or the intravenous route. Law of mass action, first-order kinetics, and Fick's perfusion principle were used to develop mathematical compartment models representing sustained drug diffusion throughout the human body. To adequately predict the sustained drug diffusion into various compartments of the human body, consider fractional derivative (Caputo model) to investiga

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Publication Date
Mon Jan 26 2026
Journal Name
University Of Anbar Sport And Physical Education Sciences
Anxiety and its relationship to the performance of the front hand hop followed by an anterior spherical flip with a half lap on the jumping platform
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Publication Date
Tue Jan 30 2018
Journal Name
International Journal Of Science And Research
The Morphological Description and Histological Structure of the Liver in Marsh Harrier Bird in Iraq (Circus aeruginosus)
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The liver of marsh harrier grossly appeared as large, bi-lobed organ divided into left and right lobes, which are approximately equal in size and not divided into secondary lobes. Histologically, the liver of marsh harrier was found to contain numerous lobules which are not well defined by the connective tissue of the septa except that surrounded the portal triads. The parenchyma of liver composed of irregular branching cords of hepatocytes organized in double rows alternating with tortures path sinusoids which are lined with flattened endothelial cells and large, irregular outlined kupffer cells. Hepatic cords arranged in a radial pattern around the central vein of the liver lobule while in a subscapsular region they run parallel to the ca

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Leadership styles and their role in enhancing the intellectual capital Field research in the Ministry of Foreign
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This study has taken into consideration two vital variables (leadership, leadership styles and intellectual capital). The research aim through the relations between the leadership styles and intellectual capital, to building conceptual frame for the variables of study and exploring the nature of correlation relations between these variables and their effects in enhancing intellectual capital.

      The research was conducted at the Ministry of foreign in Iraq, and included a sample of leaders and subordinates amounted to (186), has been using the questionnaire as a key tool to collect data on the sample.

      For the dealing with

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