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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
Thu Jun 05 2014
Journal Name
Arabian Journal Of Geosciences
Applying the cluster analysis technique in logfacies determination for Mishrif Formation, Amara oil field, South Eastern Iraq
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Publication Date
Tue Jun 30 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY OF SOME IMMUNOLOGICAL PARAMETERS IN PATIENT THAT INFUCTED WITH Streptococcus pyogenes: STUDY OF SOME IMMUNOLOGICAL PARAMETERS IN PATIENT THAT INFUCTED WITH Streptococcus pyogenes
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A streptococci has recognized as Streptococcus spp., associate with acute pharyngitis. S. pyogenes infection Has detected in the Hospital and Health Center in Tikrit city. Throat swabs sample has obtained and cultured on a sheep blood agar plate. Identification of S. pyogenes was performed by using the VITEK 2 automatic system. It detected of 50 samples from children included 25 were positive for S. pyogenes infection. were aged 10-35 years old and included 30 male and 20 female. . While 25 sample Negative of S. pyogenes infection (The control group included 25 clinically healthy children without S. pyogenes infection matched for age and sex with cases pateints). No significa

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Publication Date
Sun Aug 03 2025
Journal Name
Journal Of Economics And Administrative Sciences
The role of leadership skills in organizational trust Analytical research center in the Ministry of Higher Education and Scientific Research, Iraq
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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The role of leadership skills in organizational trust Analytical research center in the Ministry of Higher Education and Scientific Research, Iraq
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Formed leadership skills and organizational trust Based on intellectual that underpinned the current research, as represented leadership skills variable interpretative represented in organizational trust-response variable.

The research aims to test the relationship and the impact of leadership skills dimensions in organizational trust dimensions for the purpose of achieving its objectives were formulated hypotheses main relate to test the effect and the relationship between the variables of research for the purpose of testing those hypotheses applied research on a sample of heads of departments and officials of the people at the center of the Ministry of Higher Education and Scientific Research, where th

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Publication Date
Sun Dec 27 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation the Risk Factors that are Associated with Osteoporosis in Post Kidney Transplantation in a Sample of Iraqi Patients
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Renal transplantation is a principal treatment option for end-stage kidney failure. Bone loss and fracture are serious complication of kidney transplantation, associated with morbidity and mortality. The pathogenesis of post transplantation bone loss is multifactorial and complex

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Oscillation of the per capita growth rate
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in this paper cquations of the per capita growth rate are considered sufficient conditions for oscillation of all solutions are obtained the asymptotie behavior of the nonoscillatory solution of all souliotions are obtained

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Publication Date
Mon Jun 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The phenomenon of negative behavior has studied as a social and psychological phenomenon that effect on the performance and life of workers inside and outside the organization. The adoption of this phenomenon is studied in terms of the role of the interna
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The phenomenon of negative behavior has studied as a social and psychological phenomenon that effect on the performance and life of workers inside and outside the organization. The adoption of this phenomenon is studied in terms of the role of the internal environment of the organization in addressing this behavior, being the variables belong to the field of organizational behavior to see the results of those variables on the Iraqi organizations, since the specificities of it differ from the rest of the Arab and foreign environments. Therefore, this study focused on testing the relationship of the internal environment of the organization and its role in addressing the negative behavior of the workers.

thi

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
A Comprehensive Review on Medical Image Steganography Based on LSB Technique and Potential Challenges
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The rapid development of telemedicine services and the requirements for exchanging medical information between physicians, consultants, and health institutions have made the protection of patients’ information an important priority for any future e-health system. The protection of medical information, including the cover (i.e. medical image), has a specificity that slightly differs from the requirements for protecting other information. It is necessary to preserve the cover greatly due to its importance on the reception side as medical staff use this information to provide a diagnosis to save a patient's life. If the cover is tampered with, this leads to failure in achieving the goal of telemedicine. Therefore, this work provides an in

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Publication Date
Wed Dec 13 2017
Journal Name
Al-khwarizmi Engineering Journal
Large Eddy Simulation in Duct Flow
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In this paper, the problem of developing turbulent flow in rectangular duct is investigated by obtaining numerical results of the velocity profiles in duct by using large eddy simulation model in two dimensions with different Reynolds numbers, filter equations and mesh sizes. Reynolds numbers range from (11,000) to (110,000) for velocities (1 m/sec) to (50 m/sec) with (56×56), (76×76) and (96×96) mesh sizes with different filter equations. The numerical results of the large eddy simulation model are compared with k-ε model and analytic velocity distribution and validated with experimental data of other researcher. The large eddy simulation model has a good agreement with experimental data for high Reynolds number with the first, seco

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Publication Date
Mon Jun 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Theoretical Study and calculation The cold Reaction Rate of Deuteron Fusion In Nickel Metal Using Bose–Einstein Condensate Theory
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In this paper, we focused on the investigated and studied the cold fusion reaction rate for D-D using the theory of Bose-Einstein condensation and depending on the quantum mechanics consideration. The quantum theory was based on the concept of single conventional of deuterons in Nickel-metal due to Bose-Einstein condensation, it has supplied a consistent description and explained of the experimental data. The analysis theory model has capable of explaining the physical behaviour of deuteron induced nuclear reactions in Nickel metals upon the five-star matter, it's the most expected for a quantitative predicted of the physical theory. Based on the Bose-Einstein condensation theorem formulation, we calculation the cold fusion reaction rate fo

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