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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
Mon Jun 30 2025
Journal Name
Modern Sport
The Contribution Rate of Certain Cognitive and Visual Abilities to the Performance of Forehand and Backhand Skills in Tennis
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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The impact of the lack of certain vitamins and minerals intake rate of hair loss in pregnant and breastfeeding women
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The research aims to identify the rates of hair loss during pregnancy and lactation and its relation to the rates get some elements motivator urged through the results of the continued failure to meet the need of daily assessments of these elements, which led to the continuation of Hair Loss

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The obstacles that encounter a program of rehabilitating released prisoners as perceived by prisoners themselves in tubas' province
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The study intends to explore the obstacles that encounter a program of rehabilitating released prisoners as perceived by prisoners themselves in tubas' province. To this end, the researcher used a questionnaire as an instrument which was applied on (150) prisoner had chosen randomly to collect the study data. The findings revealed no significant differences among obstacles the encounter program regarding to the following variables: age, detention period, and number of detention, additionally, the findings found that there is a variance of obstacles mean according to the prisoners themselves, rehabilitation program, and the facility of that program.

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Publication Date
Thu Dec 25 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
Fri Aug 12 2022
Journal Name
Journal Of Research In Medical And Dental Science
Effects of Ozonated Water on Micro Leakage between Enamel and Fissure Sealants Prepared by Different Etching Technique (An in vitro Study)
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Effects of Ozonated Water on Micro Leakage between Enamel and Fissure Sealants Prepared by Different Etching Technique (An in vitro Study), Baraa M Jabar*, Muna S Khalaf

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Publication Date
Wed Oct 11 2023
Journal Name
Journal Of Educational And Psychological Researches
Teaching Problems Faced by Female Teachers of Students with Intellectual Disability in Special Education Programs and the Proposed Solutions for that from their point of view - a qualitative study
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This study aims to identify the teaching problems that teachers of students with intellectual disabilities face, in addition to exploring the solutions suggested by them in order to overcome such problems or challenges. The researchers used a qualitative approach in order to understand the teachers' perceptions about these problems in a more in-depth way. The interview tools (in-depth and semi-structured interviews) were used to collect data from (3) female teachers from special education programs in the Asir region. The results revealed a number of themes including problems related to students, teachers and the teaching methods they use, curricula, school environment, and school administration. Moreover, the results indicated that famil

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Publication Date
Mon Feb 25 2019
Journal Name
Iraqi Journal Of Physics
Determining the concentrations of radon and the rate of annual effective dose in some types of drinking water available in the Iraqi markets
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           In this research, radon concentrations in some types of healthy drinking water samples available in Iraq's market were measured using a technique called Durridge RAD-7-H2O with closed loop. Then the rate of annual effective dose in human taken this water is determined.

          It was found that, radon concentrations in studied samples ranged between 1.2 Bq.m-3 to 142 Bq.m-3. The results of the radon concentrations and the rate of annual effective dose for drinking water samples were significantly lower than the USEPA and WHO recommended limits that equal 500 Bq/m3 and 1 mSv/y resp

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Publication Date
Tue Jun 01 2021
Journal Name
Iraqi Journal Of Physics
Synthesis of Cinnamon Nanoparticles by Using Laser Ablation Technique
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    The natural  polyphenolic  compound that cinnamon contains is well known for its various biological activities, a broad variety of pharmacological and therapeutic properties.  Diversified biomedical and pharmacological applications benefit from organic nanoparticles with controlled properties. Bioactive and non-toxic, cinnamon nanoparticles (CNPs) can be effective antibacterial agents. Driven by this idea, we prepared spherical CNPs using liquid (PLAL) pulse laser ablation technique and defined those NPs. Using Q-switched Nd : YAG With a wavelength of 1064 nm  pulse laser of constant energy 500 mj , And different laser pulses ( 250 , 500 , 750 , 1000 ) pulse /sec a pure cinnamon target submerged in

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Publication Date
Mon Jun 04 2018
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Dissolution Enhancement of Raltegravir by Hot Melt Extrusion Technique
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The objective of the study to develop an amorphous solid dispersion for poorly soluble raltegravir by hot melt extrusion (HME) technique. A novel solubility improving agent plasdone  s630 was utilized. The HME raltegravir was formulated into tablet by direct compression method. The prepared tablets were assessed for all pre and post-compression parameters. The drug- excipients interaction was examined by FTIR and DSC. All formulas displayed complying with pharmacopoeial measures. The study reveals that formula prepared by utilizing drug and plasdone S630 at 1:1.5 proportion and span 20 at concentration about 30mg (trail-6) has given highest dissolution rate than contrasted with various formulas of raltegravir.

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