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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
Wed Mar 30 2016
Journal Name
College Of Islamic Sciences
Lights statement in the first part    From the Qur'an
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My research tagged [the lights of the statement in the first part of the Koran] came to show that the dear book was developed according to a precise linguistic system is not increased by a word or letter or movement - Aldmh and Kira and the hole - and does not lack anything of it except with the wisdom required by the meanings of the Koranic text or Sura generally . The Koran does not come falsehood from his hands or from behind it is infallible and preserved; because it was revealed by the sage Hamid Hamid ﭽﮗ ﮘ ﮙ ﮚ ﮛ ﮜ ﮝ ﮞ ﭼ [stone]. The Qur'an is safe from any verbal or moral dominance and dominates all the heavenly books and exists at any time and place that speaks the truth ﭽ ﯛ ﯜ ﯝ ﯞ ﯟ ﯹ ﯺﭼ [The

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
The Difficulties Facing the Schools of Challenge and Resilience and their Relationship to Motivation towards School Work for Its Workers in Hebron Governorate
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The current study aims to examine the level of problems faced by university students in distance learning, in addition to identify the differences in these problems in terms of the availability of internet services, gender, college, GPA, interactions, academic cohort, and family economic status. The study sample consisted of (3172) students (57.3% females). The researchers developed a questionnaire with (32) items to measure distance learning problems in four areas: Psychological (9 items), academic (10 items), technological (7 items), and study environment (6 items). The responses are scored on a (5) point Likert Scale ranging from 1 (strongly disagree) to 5 (strongly agree). Means, standard deviations, and Multivariate Analysis of Vari

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Publication Date
Mon Jan 01 2024
Journal Name
Aip Conference Proceedings
Investigating the quality of open street map roads data inside Baghdad city
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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of The Mechanical Behavior Of Materials
Numerical modeling of single closed and open-ended pipe pile embedded in dry soil layers under coupled static and dynamic loadings
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Abstract<p>For the design of a deep foundation, piles are presumed to transfer the axial and lateral loads into the ground. However, the effects of the combined loads are generally ignored in engineering practice since there are uncertainties to the precise definition of soil–pile interactions. Hence, for technical discussions of the soil–pile interactions due to dynamic loads, a three-dimensional finite element model was developed to evaluate the soil pile performance based on the 1 g shaking table test. The static loads consisted of 50% of the allowable vertical pile capacity and 50% of the allowable lateral pile capacity. The dynamic loads were taken from the recorded data of the Kobe e</p> ... Show More
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Publication Date
Wed Mar 01 2023
Journal Name
Baghdad Science Journal
A Characterization of Maximal Outerplanar-Open Distance Pattern Uniform Graphs
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Let A ⊆ V(H) of any graph H, every node w of H be labeled using a set of numbers; , where d(w,v) denotes the distance between node w and the node v in H, known as its open A-distance pattern. A graph H is known as the open distance-pattern uniform (odpu)-graph, if there is a nonempty subset A ⊆V(H) together with  is the same for all . Here  is known as the open distance pattern uniform (odpu-) labeling of the graph H and A is known as an odpu-set of H. The minimum cardinality of vertices in any odpu-set of H, if it exists, will be known as the odpu-number of the graph H. This article gives a characterization of maximal outerplanar-odpu graphs. Also, it establishes that the possible odpu-number of an odpu-maximal outerplanar graph i

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Publication Date
Wed Jul 31 2019
Journal Name
Journal Of Engineering
Evaluation of the Accuracy of Digital Elevation Model Produced from Different Open Source Data
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This study aims to estimate the accuracy of digital elevation models (DEM) which are created with exploitation of open source Google Earth data and comparing with the widely available DEM datasets, Shuttle Radar Topography Mission (SRTM), version 3, and Advanced Spaceborne Thermal Emission and Reflection Radiometer Global Digital Elevation Model (ASTER GDEM), version 2. The GPS technique is used in this study to produce digital elevation raster with a high level of accuracy, as reference raster, compared to the DEM datasets. Baghdad University, Al Jadriya campus, is selected as a study area. Besides, 151 reference points were created within the study area to evaluate the results based on the values of RMS.Furthermore, th

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Publication Date
Wed Jan 01 2025
Journal Name
Journal Of Animal Health And Production
Resveratrol Administration Reverses the Endometriosis-Mediated Outcomes via Tgfβ Signaling in Rats
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Publication Date
Fri Nov 21 2025
Journal Name
Plos Global Public Health
Association of socioeconomic and demographic determinants with clinical outcomes in Iraqi patients with diabetes: A cross-sectional study
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Social determinants of health (SDH) profoundly influence diabetes outcomes; nevertheless, their impact on the Iraqi diabetic population remains under researched. The objectives of this study were To investigate the relationship between particular social determinants of health (SDH) variables namely food and housing insecurity, social support, income, and education and clinical outcomes, including HbA1c levels, medication adherence, and patient satisfaction among Iraqi diabetic patients. A cross-sectional study involving 212 diabetic patients in Iraq was conducted. Participants attending a healthcare facility in Iraq filled out validated questionnaires regarding social determinants of health, medication adherence, and satisfaction. HbA1c rea

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Publication Date
Tue Sep 01 2020
Journal Name
Journal Of Coloproctology
Epidemiological and prognostic single center study of anal carcinoma
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Abstract<p> Background Anorectal carcinoma includes the anal margin, the anal canal, and the lower rectum. The incidences of anal tumors represent 1.4 % of all gastrointestinal tumors.</p><p> Patients and methods Our study is retrospective and was conducted at Baghdad Medical City. Patient’s data were collected from the medical records through a predesigned sheet that included the following information: demographic data, medical history, past-history, presenting symptoms, pathological data, and treatment details.</p><p> Results The median age was 49 years. As regard tumor extension, 85.71 % of patients had anal disease, while anorectal cancer was encount</p> ... Show More
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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of Educational And Psychological Researches
level of awareness of mental health among the students of the Universities of Palestine Technical and Jerusalem open
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The study aimed to identify the level of awareness of mental health among the students of the Universities of Palestine Technical and Jerusalem open in the city of Tulkarem from the perspective of the students and the population of the study ( 8091 ) students at the two universities , and selected intentional sample size was ( 445 ) students , and used the tool questionnaire to measure responses of subjects , and the results showed that there are differences depending on the variable sex and was in favor of females , and depending on the variable University , and was in favor of the Al-Quds Open / variable Study level for the benefit of students of second year , did not show statistical differences depending on the variables of c

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