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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 2017
Journal Name
Journal Of Economics And Administrative Sciences
Vigilance and strategic role in improving the level of nursing services / Applied Research in Ghazi al-Hariri Hospital
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The current research aims to focus on strategic vigilance dimensions and contained (environmental vigilance, technological vigilance, competitive vigilance, vigilance marketing) to improve nursing services, which include a) the quality, timeliness, problem-solving and decision-making, relationships with others, leadership skills) and measure the degree link and influence between strategic vigilance in the hospital respondent and improve nursing service that the problem of the research lies in the weakness of strategic plans and health organizations in general and the hospital surveyed (martyr Ghazi al-Hariri), in particular, the lack of awareness of the hospital researched strategy vigilant management to improve nursing services,

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Publication Date
Wed Jan 31 2024
Journal Name
Iraqi Geological Journal
Distribution of Environmental Isotopes 18O and 2H in Water Resources in the Al-Taji Area, Northern Baghdad, Iraq
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In this study, the stable isotop 18O and 2H has been used to investigate the interaction of surface water (SW), and groundwater (GW) in Al-Taji district/ Northern Baghdad for two seasons (March and August 2022). 16 Samples were collected from water resources in the Al-Taji district (Tigris channel, Tigris River, and groundwater), in each season water samples from 8 Tigris channel, 5 drilled wells, and 3 Tigris River were taken for the analysis of the isotopes 18O and 2H. The average analysis results of 18O and 2H in the Tigris channel, Tigris River, and groundwater were found to be -3.435‰ and -18.6094‰, -2.07167‰ and -17.81‰, -4.125‰ and -34.707‰ respectively. The results, generally, show a comparable range of isotope c

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Publication Date
Wed Jul 17 2024
Journal Name
Central Asian Journal Of Medical And Natural Sciences
Understanding of the Immunological Tolerance Mechanisms Underlying the Maternal-Fetal
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Publication Date
Thu Dec 31 2020
Journal Name
Political Sciences Journal
Foreign policy of the Trump Administration Toward the United Nations
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The Trump administration asserts that the actions of the United States are neither constrained by international organizations nor international controls, as they strive to seek a leadership position in a competitive manner, advance the reform of the United Nations in order to gain strength and support for US interests, and promote conservative social values. This negative policy is the result of the influence and mutual influence of long-term isolationism, the "American exception" and popular trends in the United States, as well as the result of the Trump administration's attempt to employ powerful means to revitalize the United States' strong position in the United Nations. However, the Trump administration’s policy toward the United

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Publication Date
Fri Nov 02 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
The Impact of Household Hazardous Waste upon the Environment Pollution
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Objectives: To determine the impact of the household hazardous waste’s aspects upon the environment
pollution .and to identify the relationship between the households’ demographic characteristics and the aspects
of household hazardous waste.
Methodology: A descriptive study is conducted between December 14th 2004 to October 20th 2005that uses of
an assessment tool. A probability (simple random sampling) of (336) principal’s households which is selected
from the zones around the (14) primary health care centers as focal points, (8) in the urban and (6) in the rural
areas of Baghdad Governorate. After reliability and validity were determined Data are collected through the use
of an assessment tool that is consist

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Publication Date
Sun Jun 30 2013
Journal Name
College Of Islamic Sciences
Abu Ubaidah's interpretative approach to the metaphor of the Qur’an
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In the name of of Allah the Merciful
        Praise be to God, and blessings and peace be upon the Messenger of God, Muhammad, and upon his family and his family and peace, and after:
 The honor of every knowledge of honor is related to it, and since the science of interpretation is related to the Book of God Almighty; it is considered one of the most noble and longest of sciences, and this science began long ago as the early ages of Islam have expanded the Islamic state, and people entered the religion of God in cohorts, and the mixture mixed In tongues, and people did not know much about the meanings of the Qur’an, so the need for authorship in this great knowledge was severe, and pe

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Publication Date
Wed Jan 01 2020
Journal Name
Proceedings Of The 2020 2nd International Conference On Sustainable Manufacturing, Materials And Technologies
The impact of toxicant on the food chain ecological model
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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Mechanical Engineering
Improving the Performance of the Vehicle Suspension System Using Inerter
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Publication Date
Tue Oct 12 2021
Journal Name
Review Of International Geographical Education Online
Tracking the Emergence of the Iraqi Paralympic Committee until 2020
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MII Al-Itabi, WH Abdulameer, OSS Al-Mashhadani, Review of International Geographical Education Online, 2021 - Cited by 1

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Publication Date
Sun Sep 30 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Potato Starch for Enhancing the Properties of the Drilling Fluids
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Different additives are used in drilling fluids when the demanded properties cannot be gotten with clays. Drilling muds needs several additives and materials to give good characteristics. There are local alternatives more suitable for enhancing the rheology and filtration of drilling fluids. An experimental work had been conducted to assess the suitability of using potato starch to enhance rheological properties and filtration in drilling mud. This study investigated the potato starch as a viscosifier and fluid losses agent in drilling fluid. Results from this study proved that rheological properties of potato starch mud increased when pH of drilling fluid is increased.  Potato starch could be used to enhance gel strength at low pH

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