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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
Sun Oct 01 2023
Journal Name
Solid State Communications
Influence of In-dopant on the optoelectronic properties of thermal evaporated CuAlTe2 films
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Publication Date
Wed Dec 20 2023
Journal Name
Health Education And Health Promotion
Influence of Educational Program of Cholera Disease on Nannies' Practices in the Nurseries
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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of the Risk Factors of Coronary Artery Diseases in Al-Nasiriyah City
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Objective: to assess the risk factors of coronary artery disease patients.
Methodology: A non-probability (purposive) sample of (100) patients. The study population consisted of
a sample of adults from both genders whose ages were 30 years and more, and was newly diagnosed as
having CAD by coronary angiography in the cardiac catheterization unit of An Nasiriyah heart center.
Results: The result of the study showed that the most common modifiable risk factors were low HDL-C
levels (58%), smoking (53%), hypertension (46%), diabetes mellitus (34%), obesity (30%), high
triglycerides (19%), hypercholesterolemia (17%), and high LDLC (14%). All these factors were positively
and significantly associated with the development

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Publication Date
Tue Dec 03 2013
Journal Name
Al-kindy College Medical Journal
The Role of Tibialis Posterior Tendon Transfer in Correction of Foot Drop Deformity
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Backgr ound: The transfer of the tibialis posterior tendon to the anterior aspect of the ankle not only replaces the function of the paralyzed muscles, but also removes the deforming force on the medial aspect of the foot. Objecti ves: In this study, we evaluated patients who underwent tibialis posterior tendon transfer for the treatment of foot drop, and comparison through interosseous membrane route versus anterior to lower tibia route of tibialis posterior tendon transfer, with evaluation of the results according to carayon criteria Methods: Nine patients with foot drop secondary to different causes treated with tibialis posterior tendon transfer from January 2011 to January 2012 were followed up for a mean of 12 months in Al Kindy Teach

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The role of relaxation program for reducing anxiety of patients in dental clinic
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The role of relaxation program for reducing anxiety of patients in dental clinic  

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Publication Date
Sun Jun 20 2021
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
MULTIVARIATE ANALYSIS OF THE STEM ANATOMICAL CHARACTERS OF TERMINALIA L. (COMBRETACEAE) IN EGYPT
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A comparative investigation of the anatomical characters through a microscopical examination of the prepared transverse sections of the stem was carried out. Six plates with 32 photomicrographs were provided to convincingly show the considerable variations of anatomical characters within the nine examined species. The matrix of 18 anatomical characters which included nine quantitative and nine qualitative was applied for the clustering analysis (CA) followed by the principal component analysis (PCA) using the Multivariate Analysis of Ecological Data, PC-ORD.
The results exhibited significant variations among the species resulting in the construction of an artificial key; this key accurately represents a sufficient tool to display the

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Publication Date
Sat Jan 01 2022
Journal Name
Open Engineering
Field tests of grouted ground anchors in the sandy soil of Najaf, Iraq
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Abstract<p>This article presents test results documentation for four grouted ground anchors embedded in sandy soil. Three anchors were trial, while one was a working anchor. One trial anchor is instrumented with eight resistance-type strain gauges glued on the corrugated pipe and embedded within the grouted body. An acceptance test was made for all anchors to determine the working load. Acceptance criteria suggested by the Post-Tensioning Institute were applied, and the working anchor did not pass the creep criterion, so it was taken out of service. The strain measurements indicated that the compression stresses were generated along the free length, while the tension stresses were generated alon</p> ... Show More
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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
The Role of Association of Southeast Asian Nations (Asean) in Achieving Regional Security
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The organizational structure of relations between states is among the main features that distinguished the twentieth century as the era of international organization, especially after the increase in the number of political units after World War II in which regionalism was crystallized as a phenomenon. It is not modern, as there are many blocs such as the European Union that have developed in it, the idea of ​​regional bloc is prominent, especially in Europe, as it emerged after a controversy revolved around what was called globalism in the face of Globalism vs. Regionalism. Regional, as the proponents of the global orientation saw the establishment of a global organization that includes all countries, as the best way to achieve inte

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The reality of administrative creativity of secondary schools' managers in Al-zarqaa province
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The study focuses on identifying the reality of administrative creativity of secondary schools' managers in Al-zarqaa province. The descriptive approach was adopted to conduct this study. To achieve the study objective, the author designed a questionnaire composed of (24) items included (4) domains applied on (80) male and female school managers were selected randomly. The results showed that the administrative creativity level of secondary school's managers over all domains were too high which ranked as school management domain followed by public community domain then teacher domain and finally, school environment domain. Additionally, each of male, private sector, and experience over 10 years revealed significant differences.

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Diagnostic Accuracy of Different Radiological Investigations in the Diagnosis of Perforated Duodenal Ulcer
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Background; Perforated duodenal ulcer (PDU) is a common surgical emergency that is associated with high mortality and morbidity. Early diagnosis and prompt surgical treatment is required to prevent grave complications.
Objective; The study was designed to evaluate the diagnostic accuracy of different radiological investigations in the diagnosis of perforated duodenal ulcer.
Methods; A prospective study of 185 pts with PDU at al kindy teaching hospital, Baghdad, Iraq from June 2008- august 2010. patients were examined clinically and investigated by blood test, chest x ray, plain X ray of the abdomen. Ultrasonography (U/S) and CT scanning done for those patients with negative X- ray finding. Resuscitation by intravenous fluid and ant

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