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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
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Domestic Technique in Batik Art
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Publication Date
Mon Jan 27 2020
Journal Name
Medico-legal Update
Indications and Adverse Outcomes of Emergency Lower Segment Cesarean Section at 1St and 2Nd Stages of Labor at Al-Elwiya Maternity Teaching Hospital
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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Engineering
GNSS Baseline Configuration Based on First Order Design
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The quality of Global Navigation Satellite Systems (GNSS) networks are considerably influenced by the configuration of the observed baselines. Where, this study aims to find an optimal configuration for GNSS baselines in terms of the number and distribution  of baselines to improve the quality criteria of the GNSS networks. First order design problem (FOD) was applied in this research to optimize GNSS network baselines configuration, and based on sequential adjustment method to solve its objective functions.

FOD for optimum precision (FOD-p) was the proposed model which based on the design criteria of A-optimality and E-optimality. These design criteria were selected as objective functions of precision, whic

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Publication Date
Mon Oct 23 2023
Journal Name
Journal Of Optics
Studying the effect of cadmium chloride and thiourea concentrations on the structural and optical properties of CdS films deposited using the spray pyrolysis technique
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Publication Date
Thu Aug 01 2024
Journal Name
Iop Conference Series: Earth And Environmental Science
Smart Irrigation Technique in the Fixed Irrigation System Based on Soil Moisture Content
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Abstract<p>The growing water demand has raised serious concerns about the future of irrigated agriculture in many parts all over the world, changing environmental conditions and shortage of water (especially in Iraq) have led to the need for a new system that efficiently manages the irrigation of crops. With the increasing population growing at a rapid pace, traditional agriculture will have a tough time meeting future food demands. Water availability and conservation are major concerns for farmers. The configuration of the smart irrigation system was designed based on data specific to the parameters concerning the characteristics of the plant and the properties of soil which are measured once i</p> ... Show More
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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The priorities and emergency treatments of multisystem injuries associated with maxillofacial traumas
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Background: The purpose of this study is to evaluate the care of multiple trauma victims with maxillofacial injuries in terms of epidemiological distributions, types of injuries, the related different modalities of surgical treatments delivered, and their complications. Materials and Methods: This prospective study was performed on 50 patients with multiple traumas including maxillofacial injuries, caused by different etiological factors, who were brought first to the surgical emergencies department of the Medical City then referred to the Maxillofacial unit in the Specialized Surgeries Hospital, Baghdad, Iraq, during the period from April 2007 to April 2008. Information was documented prospectively from the time of the emergency call to

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Prothrombin Time role in Head Injury & Intracranial Hematomas, A prospective Study of 325 cases
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Objective: Aimed to asses the role of PT estimation in early diagnosis and predicting the extent and the outcome of head injury with ICerH and/ or Contusion
Method :PT was measured by Digiclot 818
Group –1: One hundred consecutive head injured patients admitted at Neurosurgical and Al Ramadi teaching hospitals were initially estimated for prothrombin time and subsequently scanned
Group-2 : Two hundred twenty five consecutive non scanned head injured patients admitted to Neurosurgical and Al Ramadi teaching hospitals were estimated with prothrombin time at the time of insult and subsequently for the next two weeks Al – Kindy Col Med J 2012; Vol. 8 No. 1 P: 54
Clinical and neurological evaluation (GCS) score in addition to

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Publication Date
Wed Dec 20 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Systemic Melatonin Supplementation as an Adjunct to Non-Surgical Periodontal Treatment in Obese Patients with Periodontitis
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Background: Obesity is considered an important risk factor for periodontal disease. It has been reported that reactive oxygen species linking both diseases, systemic melatonin supplementation as antioxidant therapy, was addressed as an adjuvant to scaling and root surface debridement (SRP) to enhance the treatment of periodontitis. Objective: To investigate the efficacy of systemic melatonin administration in periodontitis-obese patients as an adjuvant to scaling and root surface debridement (SRP). Methods: A randomized clinical trial was conducted at a dental-specialized center. Eighty subjects were included and allocated into group-I: twenty periodontium-healthy, normal-weight people; group-II: 30 obese patients with stage-III tre

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Publication Date
Wed Sep 09 2020
Journal Name
International Journal Of Innovation, Creativity And Change
Estimation of the Effect of the Government Expenditure Growth Rate on the Rate of Inflation in the Iraqi Economy for the Period (1991- 2015)
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Government expenditure represents one of the controlling financial policies in the economic affairs and management of the economic cycle in order to achieve price stability, raise the rate of output growth and decrease the level of unemployment. The price stability represents one of the macroeconomic goals that all countries seek without exception, regardless of the economic philosophy adopted by each country; in addition to this is raising the productive capacity and reaching the actual output to the level of the expected output, that is, the level of output related to the natural unemployment rate or what is sometimes called the Non-inflationary unemployment rate. The restriction of government expenditure (G=T+∆B/iP+∆M/P) is

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Publication Date
Wed Jan 18 2017
Journal Name
International Conference And Workshops On Basic And Applied Science
Identifying phenolic compounds in some genera belonging in the Amaranthaceae family by HPLC technique
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Identifying phenolic compounds in some genera belonging in the Amaranthaceae family by HPLC technique