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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 Apr 01 2023
Journal Name
Heliyon
A comprehensive review on modelling the adsorption process for heavy metal removal from waste water using artificial neural network technique
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Publication Date
Thu Mar 01 2018
Journal Name
مجلة الباحث في العلوم الإنسانية و الإجتماعية
The Rate of Performance of Scientific Committees in the University of Baghdad in Accordance to the Department’s Heads’ Viewpoint
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The research aims at recognition of The rate of performing tasks done by the scientific committees in the scientific departments in the University of Baghdad, within the evaluative perspective of the departments’ Heads. To find any statistically significant differences in the responses of the research sample to the rates performance of the scientific committees in scientific departments in the University of Baghdad, within the evaluative perspective of the departments’ Heads, according to the two variables of the social gender; male and females, and field of specialization of Scientific and Humanities. The research sample consisted if (107) heads of the scientific department in the University of Baghdad. The researchers designed a

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Publication Date
Fri Jan 01 2021
Journal Name
International Journal Of Agricultural And Statistical Sciences
MODELING DEATH RATE OF THE COVID-19 PANDEMIC IN IRAQ
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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.

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Trends of Fiscal Policy in bearing the financial burden of the government and the Extent Leadership in Iraq during the period 2004- 2014
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Abstract

There has been a heated controversy over the role the financial policy plays and how sufficient   it   is   in affording   the   financial   burden. This   burden   is   known as the operational   current expenses   which   the   governments   of   various countries mainly afford,   despite the   discrepancy   in   the   government’s   economic   policy.   After   the deterioration and deficit in the state budget in all countries nowadays, it was necessary to find an appropri

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Publication Date
Mon Feb 08 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
AWN-similarity: Towards developing free open-source frameworks for measuring Arabic semantic similarity under Windows / Linux operating systems
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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
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Organizational culture and its role in improving the quality of educational service at the university center Tindouf from the perspective of professors.
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This paper examines the impact of the organizational culture prevailing at the university center, Ali KafiTindouf, on the quality of the educational service provided by the university center Ali KafiTindouf from the point of view of the teachers of the center. The questionnaire method was used to determine the effect between the variables studied, by the distribution of 33 questionnaires on a random sample of the study community.

The study found that the organizational culture prevailing at the university center of Ali KafiTindouf contributed to reaching higher levels in the awareness and quality of the educational service provided by the teachers of the center.<

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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
Mon Jun 29 2015
Journal Name
Separation Science And Technology
An acidic injection well technique for enhancement of the removal of copper from contaminated soil by electrokinetic remediation process
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