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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 Apr 01 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Arthroscopic micro fracture and intra articular whole bone marrow injection for the treatment of articular cartilage lesions in the knee joint. Authors
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Abstract Background: Articular cartilage lesions in the knee joint are frequently seen,its treatment represents a challenge for orthopedic surgeons especially in young age patients and if left untreated,then they can progress to advanced osteoarthritis that may affect the functional status of the patients.Many treatment modalities had developed for these lesions, in the current study arthroscopic micro fracture plus intra articular whole bone marrow(WBM) injection was used as modality of treating these lesions. Objectives: to assess the effectiveness of arthroscopic micro fracture plus WBM intra articular injection as a treatment modality for knee articular cartilage lesions. Patients and Methods : a prospective experimental study was perf

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Publication Date
Thu Aug 06 2009
Journal Name
Dirasat
Geneses of the zinc-lead – barite deposits in the Northern Iraq: ore mineralogy, geochemistry, fluid inclusions, lead isotopes and sulfur isotopes implicatiuons
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Publication Date
Sun Oct 02 2016
Journal Name
Journal Of Educational And Psychological Researches
Personality Types According to Holland's Theory and its Relationship with the Management Changing for some Administrators in the Province of Kurdistan-Iraq
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The figure of personality modes determines its privileged style in the use of modern and advanced technological tools in the process of changing and developing in order to keep up with that. The proses of selection and choosing administrators in the appropriate places are the most important functions of senior management because it is easy to adopt factory buildings or establishments But this is a human world as that of machines world. So it is required to have people in the process of changing those who have a time, Knowledge, skill, ability and strong administrative personal skills, those people (leaders) should to put a clear vision for the selection and application of the change efforts and to create the necessary climate and

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Publication Date
Sun Jun 04 2017
Journal Name
Baghdad Science Journal
The Role of Sox17 Gene Expression in Early Definition of Anterior Pole of the Rabbit Embryo at Early Pre-Gastrulation Stages
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The primitive streak and notochord and previously the anterior marginal crescent (AMC), anterior visceral endoderm (AVE) and the anterior hypoblast (AHB) are embryonic entities which identify main body axes and thus establish body plan in the early stages of embryonic development. All of the anterior pre-gastrulation differentiation structures are addressed terminology as anterior pre-gastrulation differentiation (APD). These structures are defined morphologically and are called in mouse (AVE), in rabbit (AMC) and in the pig (AHB). The anterior hypoblast cells of APD are higher and denser than at the opposite pole of the embryo. Moreover, the APD stretches variously between species and has different shapes in the mammalian embryos, for exam

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Publication Date
Fri Feb 13 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An In Vitro Evaluation of the Effectiveness of Gotu Kola (Centella asiatica) on Inhibiting the Growth of Selected Microorganismsin Human Saliva
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Background: Gotu Kola (Centella asiatica) has been used as a traditional medicine for many years to cure different kinds of diseases. Studies have been reported that Gotu Kola extracts might be used as a cure for oral diseases such as periodontal disease. In the present study, Gotu Kola leaves extracted with water will be used to evaluate its effect on some microorganisms living in the human saliva using minimum inhibitory concentration (MIC) method. Material and Method:Gotu Kola fresh leaves extract have been used with water as a solvent, a rotary evaporator was used to separate the solvent from the extract. The following microorganisms: Streptococci, Lactobacilli, and Staphylococcus aureus have been isolated fromthe Saliva of ten voluntee

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Publication Date
Mon Jun 01 2015
Journal Name
Int. J. Adv. Appl. Math. Andmech.
The effect of external source of disease on the epidemic model
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Publication Date
Tue Feb 01 2022
Journal Name
Baghdad Science Journal
Effects of the Ferrits Addition on the Properties of Polyethylene Terephthalate
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The products of composites material are very sesetive to many variables, such as manufacturing process, additive materials, …. etc. Filler or additive plays a major role to determine the formation of the properties and behavior of the composites. In this study, polyethylene terephthalate-based compounds were produced and characterized. The work is concerned to prepare samples of Polyethylene terephthalate (PET) - zinc-ferrite (ZnFe2O4) with different addition ratio as zinc-ferrite (1, 2, 5, 10, 15 and 20) wt% obtained from mixing the solution with a hot pressing method applied under optimum conditions. The densities of the composites for all samples were calculated. Through the work the diffusion of zinc-ferrite i

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Publication Date
Sat May 16 2009
Journal Name
Journal Of Planner And Development
Quantitative analysis of the economic characteristics of the land transport network
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Highway network could be considered as a function of the developmental level of the region, that it is representing the sensitive nerve of the economic activity and the corner stone for the implementation of development plans and developing the spatial structure. The main theme of this thesis is to show the characteristics of the regional highway network of Anbar and to determine the most important effective spatial characteristics and the dimension of that effect negatively or positively. Further this thesis tries to draw an imagination for the connection between highway network as a spatial phenomenon and the surrounded natural and human variables within the spatial structure of the region. This thesis aiming also to determine the natu

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Publication Date
Mon Dec 31 2012
Journal Name
Al-khwarizmi Engineering Journal
The Effect of Doppler Phenomenon on the Speed of Blood Flow
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This research studying the phenomenon of Doppler (frequency Doppler) as a method through which the direction and speed of the blood cells flows in blood vessels wear measured. This Doppler frequency is relied upon in medicine for measuring the speed of blood flow, because the blood flow is an important concept from the concepts of medicine. It represents the function and efficient of the heart and blood vessels in the body so any defect in this function will appear as a change in the speed of blood flow from the normal value assumed. As this speed changes alot in cases of  disease and morbidity  of the heart, so in order to identify the effect of changing the Doppler frequency on the speed of blood flow and the relationship of

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
The Effect of Additives on The Performance of Hydrostatic Thrust Bearings
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The paper is concerned with, the behavior of the hydrostatic thrust bearings lubricated with liquid-solid lubricants using Einstein viscosity formula, and taking into account the centrifugal force resulting from high speed.  Also studied is the effect of the bearing dimensions on the pressure, flow rate, load capacity, shear stress, power consumption and stiffness.

The theoretical results show an increase in load capacity by (8.3%) in the presence of solid graphite particles with concentration of (16%) by weight as compared with pure oil, with increasing shear stress.  .

In general the performance of hydrostatic thrust bearings improve for load carrying capacity, volume flow rate,

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