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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 May 30 2024
Journal Name
Iraqi Journal Of Science
Single Nucleotide Polymorphism of Interleukin-28β Subunit Genes Predict Host Susceptibility to Hepatitis C virus (HCV) Infection among Iraqi Patients
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Hepatitis C virus (HCV) is a liver disease that affects14 million people. Feasible research was conducted for identifying the genotypes and allele frequency of some single nucleotide polymorphisms (SNPs) of the IL-28β genes and their predictive role in disease incidence in Iraqi patients. The SNPs (rs28416813, rs4803219, rs11881222, and rs8103142) of IL-28β have been associated with susceptibility to several diseases. Ninety eight (98) HCV patients were included in this research; with average age ± SE (42.28 ± 3.44) years. Also, 80 healthy people (with average age ± SE (29.40 ± 2.84) years) were included as a control group. The SNPs were detected by allele-specific PCR (polymerase chain reaction) using specific primers. The re

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Publication Date
Sat Jan 13 2018
Journal Name
Journal Of Engineering
Investigating the Influence of the Cerium loading in prepared Y zeolite from Iraqi kaolin on its Catalytic Performance
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In this study, the effects of different loading doses of cerium in the prepared NaY zeolite from Iraqi kaolin were investigated. Al-Duara  refinery atmospheric residue fluid catalytic cracking was selected as palpation reaction for testing the catalytic activity of cerium loading NaY zeolite.  The insertion of cerium in NaY zeolites has been synthesized by simple ion exchange methods. Three samples of modified zeolite Y have been obtained by replacing the sodium ions in the original sample with cerium and the weight percent added are 0.35, 0.64, and 1.06 respectively. The effects of cerium loading to zeolite Y in different weight percent on the cracking catalysts were studied by employing a laboratory fluidized

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Publication Date
Wed Apr 06 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Management using the Six Sigma approach to cost rationalization of activities : Application in the Iraqi mechanical carpet factory
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The textile industries play a prominent role in reviving the national economy, but they are currently suffering from several problems, including the high costs of their activities, the low quality of their production processes, and accordingly, the hexagonal diffraction approach came to help analyze production activities to determine which of them are the most expensive and do not have a benefit or cost greater than Its benefit as a result of waste and losses that accompany its implementation. And by applying to the Iraqi mechanical carpet factory, the research reached several conclusions, the most important of which is the presence of several sources of waste and loss, such as activities and operations that do not add value, whi

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Publication Date
Wed Jun 20 2018
Journal Name
Al-academy
The effect of CORT educational program on creative thinking for the secondary school students in art education subject
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The current research aims to identify (the effect of CORT program on creative thinking for middle school students in the art education history of ancient art subject).

     The research society continue of the5th of scientific students in ALsadreen secondary school of excellence which related of the Directorate of Education al-sader city, for the academic year (2015/2016), The sample was (35) students for each of the two groups (experimental and control). The equivalence between the research groups was carried out in the IQ variable, the age and the level of the father and mother.

     The researcher used the experimental method of partial control and the post-test. If the course of

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Publication Date
Fri Nov 14 2025
Journal Name
Journal Of Physical Education
The effect of the Perkins-Blyth model on learning some compound skills in soccer for second intermediate students
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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Monetary Policy Management of the Money Supply to Interest rates in Iraqi Economy for the period 2004-2011
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The results show the inability to apply the Taylor rule within inflation and GDP Gaps because the monetary behave is elated from the Iraqi economy.

When applying the Taylor rule to exchange rate with the inflation and the output gap, the results do not match the nominal price announced by the central thing, which proves the lack of commitment by the Central Bank by using the Taylor rule, whether short-run interest rate or exchange rate (Nominal Anchor),  so it did not stay to the Iraqi Central Bank only using the principle of Taylor with the expected inflation rate below the level of output (Macro activity) for the separation of monetary behavior from the real one o

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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
The Effect Of Optimizers On The Generalizability Additive Neural Attention For Customer Support Twitter Dataset In Chatbot Application
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When optimizing the performance of neural network-based chatbots, determining the optimizer is one of the most important aspects. Optimizers primarily control the adjustment of model parameters such as weight and bias to minimize a loss function during training. Adaptive optimizers such as ADAM have become a standard choice and are widely used for their invariant parameter updates' magnitudes concerning gradient scale variations, but often pose generalization problems. Alternatively, Stochastic Gradient Descent (SGD) with Momentum and the extension of ADAM, the ADAMW, offers several advantages. This study aims to compare and examine the effects of these optimizers on the chatbot CST dataset. The effectiveness of each optimizer is evaluat

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Publication Date
Wed May 12 2021
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
The Effect of Defensive Exercises in the Motor Response to Develop Some Defensive Skills for Young Basketball Players
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Publication Date
Tue Sep 01 2020
Journal Name
Al Kut Journal Of Economics And Administrative Sciences
Economic Analysis of The Most Important Factors Affecting Sustainable Agricultural Development in Iraq for The Period 2000-2017
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Publication Date
Wed Sep 15 2021
Journal Name
Al-academy
Deconstruction in the abstract drawings of the artist Shaker Hassan Al Said: مواهب عبد الحميد عبد الله الخفاجي
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Deconstruction is an intellectual stream that emerged as a result of the changes and requirements of the modern era. This stream extended from thought and literature to all arts, and the research included four chapters.
Chapter One: From the research, the research problem was identified in the form of a question: Have the ideas and deconstructive concepts represented in the abstract drawings of the artist Shaker Hassan Al Said?
The importance and limits of the research were reviewed and the goal of the research was to reveal the applications of ideas and deconstructive concepts in the abstract drawings of the artist Shaker Hassan Al Said, in addition to defining the most important terms contained in it.
Chapter Two: Previous

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