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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 Jun 03 2020
Journal Name
Political Sciences Journal
The role of the strategic culture variable in negotiations (Brexit a model)
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Publication Date
Tue Mar 03 2026
Journal Name
Journal Of Economics And Administrative Sciences
The effect of creating knowledge according to the model (Nonaka &amp; Takeuchi, 1995) on organizational ambidexterity: A study on a sample of Iraqi private banks
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Purpose - This study relies on the descriptive and analytical approach through collecting and analyzing the necessary data, as this approach focuses on polling the opinions of the research sample and its directions, and aims to develop a model that studies the relationship between knowledge creation and organizational ambidexterity in Iraqi private banks and verifying its validity experimentally. Design / Methodology / Introduction - A survey was conducted through a questionnaire form to collect data from a sample of (113) managers in private commercial banks. In addition, this study used the AMOS program and the ready-to-use statistical program package (SPSS V.25) to test the proposed hypotheses of the theoretical model experimentally. Res

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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Mechanical Engineering
Process Parameters Optimization in Single Point Incremental Forming Of Al1050
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This work aims to optimize surface roughness, wall angle deviation, and average wall thickness as output responses of ALuminium-1050 alloy cone formed by the single point incremental sheet metal forming process. The experiments are accomplished based on the use of a mixed level Taguchi experimental design with an L18 orthogonal array. Six levels of step depth, three levels of tool diameter, feed rate, and tool rotational speed have been considered as input process parameters. The analyses of variance (ANOVA) have been used to investigate the significance of parameters and the effect of their levels for minimum surface roughness, minimum wall angle deviation, and maximum average wall thickness. The results indicate that step depth and tool r

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Publication Date
Wed Jun 29 2022
Journal Name
International Journal Of Health Sciences
effect of sensory marketing in enhancing customer loyalty by mediating marketing knowledge, survey research in a group of large single market in Baghdad
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Thu Jan 20 2011
Journal Name
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Architectural void is a revolution in the formation of the facades of digital architecture
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Architecture has evolved through the ages as forms, relationships, materials and mechanisms according to the data of each era and up to the era of digital technology, where the change in proportions and aesthetic dimensions of contemporary architectural formation due to the capabilities of digitization has created innovative plastic properties using the void formation in the facades and the introduction of void as a formative and aesthetic element, which led to The emergence of new creative concepts and ideas that contradict traditional ideas and are consistent with the spirit of the times, led to a revolution in the world of architectural form at the level of (architectural ideas and the generation of shapes, materials and construction

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Publication Date
Thu Aug 18 2022
Journal Name
Journal Of Interdisciplinary Mathematics
The dynamics of Coronavirus pandemic disease model in the existence of a curfew strategy
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Publication Date
Wed Sep 15 2021
Journal Name
Al-academy
Characteristics of the folkloric shapes in the works of the potters Sajida al-Mashayikhi and Siham al-Saudi (acomparative study): وفاء حرب عبد اللطيف
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Publication Date
Mon Nov 19 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Study of the impact of foreign direct investment in the Iraqi tax system using the factorial analysis: (principal components)
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The tax system, like any other system, as a set of elements and parts that complement each other and are interrelated and interact to achieve specific goals, and is a natural  reflection of the economic, social and political conditions prevailing in society, and therefore the objectives of tax policy formulated in line with the objectives of economic policy in general, which means that any change in economic policy clearly affects fiscal policy measures and fiscal policy in particular.

The problem of searching for the impact of foreign direct investment in the Iraqi tax system was focused on the study  the of foreign direct investment and therole played in developing and improving the economic reality and its implicatio

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
African landlocked countries problems and outlets in the study and classification of geo-political
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Publication Date
Tue Mar 03 2026
Journal Name
Modern Sport
An analytical study of some of the deterministic variables of the stage of advancement and its relation to the accuracy of the performance of the skill of high jump correction
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