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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
Fri Jun 01 2018
Journal Name
Journal Of Engineering
Experimental Study of Optimum Chilled Water Distribution Configuration in Air Conditioning Terminal Unit Using RSM Technique
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The distribution of chilled water flow rate in terminal unit is an important factor used to evaluate the performance of central air conditioning unit. A prototype of A/C unit has been made, which contains three terminal units with a complete set of accessories (3-way valve, 2-way valve, and sensors) to study the effect of the main parameters, such as total water flow rate and chilled water supply temperature with variable valve opening. In this work, 40 tests were carried out. These tests were in two groups, 20 test for 3-way valve case and 20 test for 2-way valve case. These tests were performed at three levels of valve opening, total water flow rate and water supply temperature according to the design matrices establis

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Publication Date
Wed Jul 30 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Establishment of the possible association between the presence of Helicobacter pylori in the saliva and gastric biopsy by using polymerase chain reaction technique in association with oral manifestation of peptic ulcer disease
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Background: Helicobacter pylori are important gastrointestinal pathogen associated with gastritis, peptic ulcers, and an increased risk of gastric carcinoma. There are several popular methods for detection of H. pylori (invasive and non-invasive methods) each having its own advantages, disadvantages, and limitations, and by using PCR technique the ability to detect H. pylori in saliva samples offers a potential for an alternative test for detection of this microorganism. Materials and methods: The study sample consists of fifty participants of both genders, who undergo Oesophageo-gastrodudenoscopy at the Gastroenterology Department of Al-Kindy Teaching Hospital Baghdad/ Iraq, during five months period from January 2014 to May 2014. They we

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The role of organizational change to achieve strategic success A field research in the Petroleum Research & Development Center-Ministry of Oil
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  This current research deals with the "The role of organizational change in the achievement of strategic success" Who are getting increased attention to being one of the important topics and relatively new, And which have a significant impact on the future of the organization So there is a need for this research, which aims to identify the role of organizational change across dimensions (technology, organizational structure, human resources, organizational culture) in the strategic success through its components (a specific strategy, effective implementation, innovation, customer satisfaction)، And that by two main hypotheses, branched about eight hypothes

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Publication Date
Fri Oct 23 2020
Journal Name
Medico-legal Update
Role of Endoscopic Ultrasound Guided Fine Needle Aspirate for Evaluating Lesions in or Adjacent to Gastrointestinal Tract: A Single Tertiary Care Center Experience
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Publication Date
Wed Dec 01 2010
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIRST RECORD OF FIVE NEMATODE SPECIES IN SOME WATER BIRDS FROM AL-HAMMAR MARSH, SOUTH OF IRAQ
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Parasitological investigation of piscivorous birds in Al-Hammar marsh south of Iraq during December-February 2004 and December 2005 were revealed that water birds infected with five nematode species, which belong to three different superfamilies, Desmidocercella numidica (Seurat, 1920) (Superfamily: Aproctoidea) from three piscivorous birds including Grey heron Ardea cinerea, Bittern Botaurusstellaris, and small white heron Ardeola ralloides; Avioserpens sp. 1 and Avioserpens sp. 2 (Superfamily: Dracunculoidea) from small bittern Ixobrychus minutus and black glossy ibis Plegadisfalcinellus respectively; Baruscapillaria sp. and Baruscapillarinae gen. sp. (Sup

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Publication Date
Wed Jul 30 2025
Journal Name
Journal Of Physical Education
The Effect Of Absolute Strength Training On Knee Injuries Rehabilitation And Special Strength In Muay Thai Fighters
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Publication Date
Thu Dec 31 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
QUALITY EVALUATION OF THE INTERNAL METALLIC COATING FOR SOME FOODS THAT AVAILABLE IN THE LOCAL MARKETS: QUALITY EVALUATION OF THE INTERNAL METALLIC COATING FOR SOME FOODS THAT AVAILABLE IN THE LOCAL MARKETS
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The study aimed to estimate the content of lead and determine the quality of the internal coating of metal cans through electrical conductivity as well as to determine the accuracy of the information card for some types of canned food that available in local markets. The information card test showed that all of these samples contained the name of the food, trade mark, country origin, weight, and components, as was indicated by the company producing in all of them except for the C12 sample which was otherwise, and the batch number was mentioned in all samples except for the C3 and C17 which was not clear and not mentioned in the C21, and the validity period was observed (produce and fini

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Publication Date
Sun Oct 01 2017
Journal Name
Applied Energy
Hourly yield prediction of a double-slope solar still hybrid with rubber scrapers in low-latitude areas based on the particle swarm optimization technique
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Publication Date
Wed Mar 30 2022
Journal Name
Gsc Biological And Pharmaceutical Sciences
Using the silicon (luminal cast plastination technique) for the lower respiratory tract in sheep as an alternative to cement
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The lower respiratory tract of sheep was studied to determine the torsion and branching of the bronchial tree. The respiratory system of ruminants and all living organisms is one of the most important organs in the body that controls the amount of gas exchange between the heart and lungs through the airways, it is clear that in sheep it consists of a narrow bronchial tube that reaches the extent of lung tissue repercussions. He used silicon, water, acid, and at room temperature, and the substance was injected with an injection gun through the trachea and was pushed gently to spread and distribute in all parts of the lungs with moderate manual pressure. The results showed that the mold shape in the lung and the bronchial branches of

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Publication Date
Thu Apr 14 2022
Journal Name
Plos One
The passage of time in Iraq during the covid-19 pandemic
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The covid-19 global pandemic has influenced the day-to-day lives of people across the world. One consequence of this has been significant distortion to the subjective speed at which people feel like time is passing. To date, temporal distortions during covid-19 have mainly been studied in Europe. The current study therefore sought to explore experiences of the passage of time in Iraq. An online questionnaire was used to explore the passage of time during the day, week and the 11 months since the first period of covid-19 restrictions were imposed in Iraq. The questionnaire also measured affective and demographic factors, and task-load. The results showed that distortions to the passage of time were widespread in Iraq. Participants co

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