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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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Tue May 17 2016
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J. Of College Of Education For Women
The Sufferings Of Afro-American Maids in Kathryn Stockett's The Help
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Sun Mar 20 2016
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Al-academy
Indicative coding of the actor’s performance in the Iraqi theater show
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Thu Dec 28 2023
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مجلة الجامعة العراقية
The emergence of the Vietnamese National Movement in China 1921-1946
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The research, which was drawn from his doctoral thesis (People's Policy towards Vietnam 1949-1979), discussed the roots of the connections between the Chinese and Vietnamese communists since the 1920s, the presence of Ho Chi Minh and other Vietnamese communists in China, their influence by the revolutionary struggle of the Chinese Communist Party and their establishment of a group of The Vietnamese Revolutionary Societies and the Indo-Chinese Communist Party until the outbreak of the Vietnamese Revolution and their success in declaring the establishment of the Democratic Republic of Vietnam in 1946. Keywords: Ho Chi Minh, Chinese Communist Party, Indo-Chinese Communist Party, Democratic Republic of Vietnam, Chou En Lai.

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Publication Date
Wed Dec 13 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
The The Predictive Role of Sociodemographic Factors in Nurses' Psychological Hardiness
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Objective(s): The study aims to identify the role of sociodemographic factors in predicting the level of psychological hardiness of nurses.

Methodology: A descriptive correlational study conducted in the Medical City hospitals in the city of Baghdad during the period from November 1, 2022 to May 1, 2023 on a sample of 156 male and female nurses.  The validity of the quest

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Publication Date
Thu Jun 01 2006
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Modern Sport
Evaluating the level of controlling The Ball in Basketball for Youth
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The aim of this research was to evaluate the level of ball control in basketball. There was a great weakness in ball control that affected the mastery of many skills that affect the success of the team. The researcher also found a lack in training programs concerning ball control. The researchers used (9) special tests for ball control out of (41) test applied on young basketball players were (86). The researchers concluded that: 1. Criteria were set for test results of ball control. 2. A level of criteria was set for test results of ball control.

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Publication Date
Fri Apr 01 2016
Journal Name
Astronomy Reports
Ionized gas in the circumgalactic vicinity of the M81 galaxy group
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Tue Aug 15 2023
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Al-academy
The aesthetic effect of vocal recitation in building the theatrical image
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Between the duality of sound and image, the completeness of the actor’s personality at the director comes to announce the birth of the appropriate theatrical role for that character as the basic and inherent element of the artwork, within his working system in the pattern of vocal behavior as well as motor/signal behavior as he searches for aesthetic and skill proficiency at the same time.
This is done through the viewer’s relationship with the theatrical event, which the director considers as an area of active creative activity in relation to (the work of the actor) through vocal recitation and the signs it broadcasts in order to fulfill the requirements of the dramatic situation and what it requires of a visual vision drawn in t

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Sun Sep 30 2001
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Iraqi Journal Of Chemical And Petroleum Engineering
New Development in the Process for the Production of Polybutadiene Rubber
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Mon Jun 01 2009
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Al-khwarizmi Engineering Journal
Analytical Modeling of Stresses in the Wall 0f the Human Heart
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The mechanical function of the heart is governed by the contractile properties of the cells, the mechanical stiffness of the muscle and connective tissue, and pressure and volume loading conditions on the organ. Although ventricular pressures and volumes are available for assessing the global pumping performance of the heart, the distribution of stress and strain that characterize regional ventricular function and change in cell biology must be known. The mechanics of the equatorial region of the left, ventricle was modeled by a thick-walled cylinder. The tangential (circumferential) stress, radial stress and longitudinal stress in the wall of the heart have been calculated. There are also significant torsional shear in the wall during b

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Reflection marketing capabilities in enhancing the reputation of the market organization
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The objective of this research is to determine the impact of marketing capabilities in building the reputation of the market organization. Marketing capabilities are one of the contemporary trends that can be adopted by the organization in the implementation of all its tasks and thus it can be assisted in achieving many advantages which are the most prominent marketing reputation in the environment The research problem indicated that there is a clear failure to employ the dimensions of marketing capabilities in the organization's reputation. The National Center for Engineering Consultancy was selected as the field of application. The questionnaire was used as a tool to obtain the research data that were prepared based on a number

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