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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
Sat Dec 01 2012
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
First record of red-back spider Latrodectus scelio thorell, 1870 (Araneae: theridiidae) in Baghdad, Iraq
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ABSTRACT Two females of the red-back spider, Latrodectus scelio Thorell, 1870 were first recorded in Iraq, short description with figure was provided

 

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Publication Date
Tue Dec 23 2025
Journal Name
Journal Of Physical Education
Using Agility Exercises For Developing Some Refereeing Skills Of First Class Assistant Referees In Baghdad
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Agility is considered an important motor ability for assistant referees and it is vital for passing modern tests issued in September 2016. The researcher used the experimental method. The subjects were (10) referees; four of them for pilot study. The experimental group followed the exercises designed by the while the controlling group used the traditional exercises followed by the refereeing committee. All referees were tested the standardized agility test issued by the FIFA. The researchers concluded that agility plays a vital role in developing some refereeing skill. Finally they recommend developing agility for improving refereeing skills.

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Publication Date
Fri Aug 01 2025
Journal Name
Fikrotuna: Jurnal Pendidikan Dan Manajemen Islam
The Difficulties Faced by Teachers in Implementing the Smart Schools Project in Iraq
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This research explores the obstacles teachers encounter in executing the smart schools initiative within the framework of Iraq, where educational facilities and digital preparedness are still at an early stage. Although worldwide trends reveal the growing use of smart technologies in education, Iraq has been hindered by systemic barriers, such as archaic curricula, restricted access to technologies, and an unqualified teaching staff. Data were collected using a validated questionnaire on 122 public school teachers working in Baghdad with a descriptive-analytical methodology. The study divided challenges into five areas: infrastructure, teacher preparedness, administrative support, curricular adaptation and cultural resistanc

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Publication Date
Sat Dec 01 2018
Journal Name
2018 2nd International Conference For Engineering, Technology And Sciences Of Al-kitab (icets)
Good governance of service quality through the adoption of sustainable energy the study of A1- Karkh historic center of in Baghdad city
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Good governance of service quality through the adoption of sustainable energy the study of A1- Karkh historic center of in Baghdad city

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Engineering Science And Technology
Evaluating water quality index of al Hammar Marsh, south of Iraq with the application of GIS technique
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Publication Date
Mon Nov 27 2023
Journal Name
Journal Of Periodontal Research
Ability of gingival crevicular fluid volume, E‐cadherin, and total antioxidant capacity levels for predicting outcomes of nonsurgical periodontal therapy for periodontitis patients
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Abstract<sec><title>Objectives

To determine the potential of gingival crevicular fluid (GCF) volume, E‐cadherin and total antioxidant capacity (TAC) levels to predict the outcomes of nonsurgical periodontal therapy (NSPT) for periodontitis patients.

Background

NSPT is the gold‐standard treatment for periodontal pockets < 6 mm in depth, however, successful outcomes are not always guaranteed due to several factors. Periodontitis‐associated tissue destruction is evidenced by the increased level of soluble E‐cadherin and reduced antioxidants in oral fluids which could be used as predictors for success/failure of N

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Publication Date
Mon Jan 01 2024
Journal Name
Organization, Technology And Management In Construction: An International Journal
The factors that affect constructability in Iraq
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Abstract<p>Applying the constructability concept in the construction industry has proven many benefits in different projects; however, this concept still lacks usage in Iraq. Therefore, it is important to encourage usage of the constructability concept in the construction industry in Iraq. The main purpose of this study is to investigate the factors that affect constructability in Iraq and then classify them according to their importance. A total of 37 factors were collected from an intensive literature review, and they were classified under the sub and main categories. A survey was undertaken in two sessions with open questionnaire and close questionnaire. The results were analysed and the mean</p> ... Show More
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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Engineering
Identificatio n Of Key Factors Affecting Waste Management In Life Cycle Of The Construction Project By Using Delphi Technique
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The problem of generated waste as a result of the implementation of construction projects, has  been aggravated recently because of construction activity experienced by the world, especially Iraq, which is going through a period of reconstruction, where construction waste represents (20-40%) of the total generated waste and has a negative effect on the environment and economic side of the project. In addition, the rate of consumpted  amounts of natural resources are estimated to be about 40% in the construction industry, so it became necessary to reduce waste and to be manage well. This study aims to identify the key factors affecting waste management through the various phases of the project, and this is accom

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Suspicion in the truth that the satisfaction of the student in the criticism of the speech of the poet and the writer to I bin Al-Atheer
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Suspicion in the truth that the satisfaction of the student in the criticism of the speech of the poet and the writer to I bin Al-Atheer

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Simole matimatical technique in leaser cavity design and manufacturing
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In this research design was treated gap laser mathematically and practically Bashaddam model Raasi simple and new and we have found that there is a good match in the practical and theoretical results

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