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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
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The role of the plasmid content in multiple resistance to antibiotics Life in isolated Rthomh of cases of diarrhea in children
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Was conducted neutralize content Albulamedi for local isolates using Alacardan dye orange selection experience showed loss of local isolates resistant life antibiotic ampicillin, chloramphenicol

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Publication Date
Mon Dec 30 2024
Journal Name
Modern Sport
The Impact of a Psychological Counselling Program on Unconscious Conflicts and Free Will among Coaches of Selected Athletic Disciplines
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هدف البحث إلى بناء مقياسين تخصصين للنزاعات اللاشعورية وحرية الإرادة لمدربي بعض ألعاب القوى والتعرف على مستوى كل منهما لديهم، وإعداد برنامج إرشادي نفسي مستند لرفع مستوى الحالات اللاشعورية وحرية الإرادة للمدربين الذين يعانون من انخفاض مستوى النزاعات اللاشعورية وحرية الإرادة، والتعرف على تأثير البرنامج الإرشادي نفسي في النزاعات اللاشعورية وحرية الإرادة لدى مدربي بعض ألعاب القوى، لتفترض بذلك الباحثة بإ

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Publication Date
Fri Dec 01 2017
Journal Name
British Journal Of Oral And Maxillofacial Surgery
A novel approach for the three-dimensional evaluation of facial asymmetry of unilateral cleft lip and palate patients (UCLP)
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Publication Date
Wed Oct 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
THE ROLE OF ORGANIZATIONAL CULTURE IN ORGANIZATIONAL CITIZENSHIP BEHAVIOR (Search in the Integrity Commission)
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This research sought to detect the level of organizational culture prevailing in the Integrity Commission as well as the level of the organizational citizenship behavior of staff of the Commission and the impact of organizational culture in these behaviors. To achieve the objectives of the research and test the validity of hypotheses have been used questionnaire derived from measurements ready modern researchers foreigners have been adapted to suit the Iraqi environment, have been distributed  (189) questionnaire on the number of employees from the Integrity Commission, which represented the research sample where the research community has a number is (1365) employees in the Baghdad was the use of a number of statistical met

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Increased epidemic when Akbari in his book Explanation in the expression of the Koran
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Increased epidemic when Akbari in his book Explanation in the expression of the Koran

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
The Role of the Media in Empowering People with Disabilities to Participate in Society
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Disabled people are among the most important groups that need attention, care, and financial and moral care. They cannot fulfill the requirement of life normally without care from a person to meet their special needs. The disability is either mental or physical. The Iraqi government has paid attention to this category by adopting a law for this category, represented by Law No. (38) for the year (2013), which keeps their rights and duties in Iraqi society by  establishing institution of persons with disabilities and special needs of the Ministry of Labor and Social Affairs to create a modern society politically, socially, culturally or economically. In view of the importance of this group in society, the media reinforces the communit

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Publication Date
Wed Feb 11 2026
Journal Name
Journal Of The Iraqi University
THE ROLE OF STRATEGIC AMBIGUITY IN BUILDING THE CUSTOMER’S MENTAL IMAGE: AN EXPLORATORY RESEARCH IN THE NATIONAL INSURANCE COMPANY
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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of agricultura insuranc risk management in achieving the economic development: Applied research in the National Insurance Company
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Abstract                                                    

           The research aims to investigate the existence of correlations and influence between agricultural insurance risk management and economic development in the National Insurance Company with farmers, as agriculture is one of the leading branches of the national economy, ensuring food security and eliminating poverty to ensure sustainable ec

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
The Influence of Manipulating the Virtual Library in Comparison with the Individual Learning via Computer Use in English Language
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The study aims at investigating the effectiveness of the Virtual Library Technology, in developing the achievement of the English Language Skills in the Center of Development and Continuous Education, in comparison with the individual learning via personal computer to investigate the students' attitude towards the use of both approaches. The population of the study includes the participants in the English Language course arranged in the Center. The sample includes 60 students who were randomly chosen from the whole population (participants in English Courses for the year 2009-2010). The sample is randomly chosen and divided into two experimental groups. The first group has learned through classroom technology; while the other group has l

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The redesign of the accounting system to banks in the local environment in accordance with international Islamic banking applications
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At the local level in the early 1990s first established an Islamic bank 1993 is called Iraqi Islamic bank and was established by Dr. abdullatef hmim and with capital of 200 Million Iraqi dinars .

After 2003 began the attention of Iraqis tend to create Islamic banks until now up to 30 banks in the present ,  He confirmed Mr. Governor of the Iraqi Central Bank recently that there is more than 40 iintroduction licence to establish an Islamic bank in Iraq , That banking activity which is compatible with Sharia law widely welcomed by savers and those in need for more development and modernization in order to gain a greater share within the Iraqi market , and allowed the Iraqi Central Bank in recent years

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