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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 Feb 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The impact of green strategy formulation processes on the adoption of green strategy areas at the functional level
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The research aims at demonstrating the role of the formulation of the green strategy in adopting the areas of the green strategy at the level of jobs in the municipal institutions in the province of Babylon, specifically the Directorate of the municipality of Hilla. The most important areas related to the green strategy were highlighted directly or indirectly, after the indicators of environmental damage emerged from the actions of companies and institutions. The research included a sample size of 222 individual of municipal institutions with different job titles and specializations between the technical and administrative and different levels of academic achievement within the institutions within the Ministry of Construction, Ho

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Publication Date
Sat Oct 20 2018
Journal Name
Journal Of Economics And Administrative Sciences
The effects of trade policy on the diversification of Iraqi exports after 2003 compared to the Malaysian experience
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Abstract

        The Issue of trade policy is one of the most important topics that researchers have been interested in because of its important role in the economy over the ages. This importance has increased due to the increasing of commercial operations at different levels in both developing and developed countries Foreign trade is one of the means of achieving economic development through the economic surpluses resulting from exports and imports, as it is an important pillar of the economy in general and the Iraqi economy in particular, in light of the transformation process that took place for the Iraqi economy in various fields due to the implement

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Publication Date
Tue Sep 19 2017
Journal Name
Journal Of Neoplasm
The stage of breast cancer at the time of diagnosis: correlation with the clinicopathological findings among Iraqi patients
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Background: Breast cancer is the most frequently diagnosed malignancy and the second leading cause of mortality among women in Iraq forming 23% of cancer related deaths. The low survival from the disease is a direct consequence to the advanced stages at diagnoses. Aim: To document the composite stage of breast cancer among Iraqi patients at the time of diagnosis; correlating the observed findings with other clinical and pathological parameters at presentation. Patients and Methods: A retrospective study enrolling the clinical and pathological characteristics of 603 Iraqi female patients diagnosed with breast cancer. The composite stage of breast cancer was determined according to UICC TNM Classification System of Breast Cancer and the Ameri

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Publication Date
Fri Aug 01 2025
Journal Name
مجلة كلية التربية الاساسية
The Effect of the inquiry wheel model on the chemical enlightenment of Second- Year intermediate School female Students
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The aim of the research was to know the effect of the inquiry wheel model on chemical enlightenment among second-grade middle school female students in government daytime middle and secondary schools. Umm AlQura Middle School was chosen by intentional selection to be its students as the research sample for the academic year (2024-2025). Two groups were chosen, one of which was the experimental group studying using the inquiry wheel model and the other the control group studying in the usual way. The equivalence of the two research groups was verified by a set of variables, which were (chronological age in months, previous information test, Raven's intelligence test, chemical enlightenment scale). As for the research tool, the researchers bu

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Publication Date
Sat Sep 12 2020
Journal Name
Al-kindy College Medical Journal
A Brief view on the pediatric COVID- 19 pandemic
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The world is currently challenging the serious effects of the pandemic of the Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Data on pediatric COVID are rare and scattered in the literature. In this article, we presented the updated knowledge on the pediatric COVID-19 from different aspects. We hope it will increase the awareness of the pediatricians and health care professionals on this pandemic.

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Publication Date
Sat Apr 08 2023
Journal Name
Iraqi Journal Of Oil And Gas Research (ijogr)
How to Estimate the Major Petrophysical Properties: A Review
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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Zebra Mussel Dreissena polymorpha a pest infesting the electricity
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The oyster ??????? (planned) (Pallas) of lesions that have entered Iraq recently became spyware severe damage in more than a station from power plants in Iraq, including the power plant in Mussayab Vamahar accumulates in pipes cooling and disrupts their work Vtafrtf heat systems cooling and thereby determiningefficiency and lead to added cost many cleaning or replacement of damaged parts

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Publication Date
Wed Feb 01 2023
Journal Name
Baghdad Science Journal
A Heuristic Approach to the Consecutive Ones Submatrix Problem
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Given a matrix, the Consecutive Ones Submatrix (C1S) problem which aims to find the permutation of columns that maximizes the number of columns having together only one block of consecutive ones in each row is considered here. A heuristic approach will be suggested to solve the problem. Also, the Consecutive Blocks Minimization (CBM) problem which is related to the consecutive ones submatrix will be considered. The new procedure is proposed to improve the column insertion approach. Then real world and random matrices from the set covering problem will be evaluated and computational results will be highlighted.

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Serratiopeptidase a Hope in a Rapid and Better Improvement of Inflammatory Acne Vulgaris
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Acne vulgaris is a very common, chronic disorder, involving inflammation of the pilosebaceous units that can be varied in presentation and difficult to treat. Inflammatory acne may yield both scarring and pigmentary changes so early and adequate therapy will, in all cases, decrease its severity and may entirely suppress this disease. Serratiopeptidase has anti-inflammatory, anti-edemic and fibrinolytic activity and acts rapidly on localized inflammation. Serratiopeptidase was added in aim to hasten acne resolution. During March to July 2010, A comparative study for a 50 healthy patient suffering from acne was divided into 2 groups: 1st group treated by common acne modalities and the 2nd one with same modalities

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Publication Date
Sat Dec 11 2021
Journal Name
Engineering, Technology And Applied Science Research
Efficiency Assessment of a Signalized Roundabout and a Traffic Intersection in Baghdad City
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In Baghdad city, Iraq, the traffic volumes have rapidly grown during the last 15 years. Road networks need to reevaluate and decide if they are operating properly or not regarding the increase in the number of vehicles. Al-Jadriyah intersection (a four-leg signalized intersection) and Kamal Junblat Square (a multi-lane roundabout), which are two important intersections in Baghdad city with high traffic volumes, were selected to be reevaluated by the SIDRA package in this research. Traffic volume and vehicle movement data were abstracted from videotapes by the Smart Traffic Analyzer (STA) Software. The performance measures include delay and LOS. The analysis results by SIDRA Intersection 8.0.1 show that the performance of the roundab

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