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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 Feb 20 2019
Journal Name
Political Sciences Journal
The concept of violence in political thought (Theoretical study, compared with the concept of terrorism)
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The researcher of human history finds that the first social relations on earth were represented by the violence of Adam, peace be upon him, Cain and Abel. Violence has been a phenomenon of life and society. The history of history is full of all forms of violence and its forms. It speaks of cruelty, oppression and states. History began, in some of its chapters, written with the blood of the victims. It is a testimony to the cruelty of human beings. His human nature and his sin have played a major role that can not be overlooked in the development of important and fundamental developments in some historical turning points where violence was a necessity for life, and its launching change, renewal and reform, and major revolutions in human h

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Publication Date
Tue Mar 15 2022
Journal Name
Al-academy
Experimentation in the works of the artist Muhammad Al-Kinani" an anaylytical study"
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The problem of the tagged research (experimentation in the works of the artist Muhammad al-Kinani is an analytical study) dealt with the nature of the concept of experimentation and its work in the works of Muhammad al-Kinani. Which adopts the removal of the concept of style and artistic style and takes the experience away from the pattern of repetition The importance of the research comes through the identification of the materials founding the artistic work. The current research benefits the specialists in the field of arts from the students of studies with a new and renewed formulation of creativity. The research objectives shed light on the contemporary experiences of the artist Muhammad Al-Kinani and its importance in benefiting res

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Study the Characteristic of the Coupling Parameter ( ? ) in Dusty Plasma by Computer modeling
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Computer modeling has been used to investing the Coulomb coupling parameter ?. The effects of the structure parameter K, grain charge Z, plasma density N, temperature dust grain Td, on the Coulomb coupling parameter had been studied. It was seen that the ? was increasing with increasing Z and N, and decrease with increasing K and T. Also the critical value of ? that the phase transfer of the plasma state from liquid to solid was studied.

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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The effect of the repurchase policy in stock tradingIn financial markets - case study
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The research dealt with the case stock repurchase policy of Emaar Real Estate Company one of listed companies in Dubai Stock exchange. The research has launched from the cognitive dimensions of repurchasing policy which took great concern in the literatures of financial management, and also this policy became as substitute for distributing the monitory profit in the last three decades in the international financial markets, but it did not get any importance in the Arab Markets such as that of the Arab Gulf in addition to the Iraqi Stock Exchange.

The research summarized a set of conclusions, the most important one was the consistence of analysis result with the test of the major two hypotheses (The first

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Publication Date
Tue Dec 22 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The causes of the fire and its impact accidents compensation insurance companies: Applied Research in a sample of the general insurance companies
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      The subject of the evolution of fire insurance of the hottest topics accidents, because it falls within the commercial insurance, as its importance is reflected for being a security source and contentment of the insured person and so it is worth pointing out the importance of fire insurance in enterprises and organizations of all kinds, because of the guarantee of its assets from meridian as well as protection from the effects of the fire therefore ensure continuity in the performance of their activities

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Publication Date
Mon Mar 02 2026
Journal Name
Journal Of Physical Education
The impact of a training field in Lake Al-Razzaza to develop the strength of the legs and arms for young boxers
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Publication Date
Wed May 09 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STRATEGIC VIGILANCE AND ITS IMPACT ON THE QUALITY OF MANAGEMENT DECISION SURVEY STUDY IN THE SUPREME JUDICIAL COUNCIL (DEPARTMENT OF FINANCE & ADMINISTRATION): STRATEGIC VIGILANCE AND ITS IMPACT ON THE QUALITY OF MANAGEMENT DECISION SURVEY STUDY IN THE SUPREME JUDICIAL COUNCIL (DEPARTMENT OF FINANCE & ADMINISTRATION)
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The Objective of the research is to identify the Strategic Vigilance and effect in the Managerial Decision Quality, by knowing the interest of the organization influence the Strategic Vigilance in the Managerial Decision Quality, adopted four dimensions of the Strategic Vigilance is (Environmental Vigilance, Commercial, Competitiveness & Technology) to indicate the extent individually and collectively impact in the Managerial Decision Quality, The questionnaire was used as a main tool to survey the views of a sample of 45 managers, was named Supreme Judicial Council society for research, and the statistical program SPSS, and research found a clear positive impact dimensions Strategic Vigilance in the Manageri

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Publication Date
Wed Feb 22 2012
Journal Name
مجلة تكريت للعلوم الصرفة
Study the activity of ALT and AST in serum of diabetic patients type II
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Publication Date
Sun Jun 04 2017
Journal Name
Baghdad Science Journal
Analysis and Study of the Effect of Atmospheric Turbulence on Laser weapon in Iraq
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One of the most important challenges facing the development of laser weapons is represented by the attenuation of the laser beam as it passed through the layers of atmosphere.This paper presents a theoretical study to simulate the effect of turbulence attenuation and calculates the decrease of laser power in Iraq. The refractive index structure C_n^2 is very important parameter to measure the strength of the atmospheric turbulence, which is affected by microclimate conditions, propagation path, season and time in the day. The results of measurements and predictions are based on the Kolmogorov turbulence theory. It was demonstrated by simulations that the laser weapons in Iraq were severely affected due to the large change in temperatures,

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Publication Date
Wed Jan 01 2020
Journal Name
Biochem. Cell. Arch.
ANATOMICAL AND CHEMICAL STUDY OF ALTHEAE OFFICINALIS L. SPREAD IN THE NORTH OF IRAQ
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