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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
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Disease Patterns and outcomes of Neonatal Admissions at Raparin Pediatric Teaching Hospital in Erbil City
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Objectives: This study aims to determine the disease’s patterns and outcomes of admission among neonates hospitalized at the neonatal care unit in Erbil City, and using the findings as a baseline for neonate’s morbidity and mortality assessment in the future. Methodology: A retrospective study carried out at neonatal care unit of Raparin pediatric teaching hospital. An instrument for data collection developed by researcher included (age, gender, cause of admission, diagnosis and outcome upon discharge and causes of death). Content validity of the instrument was determined through the use of panel ex

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Publication Date
Thu Nov 02 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Role of Human β-Defensin-3 in Rheumatoid Arthritis: An Observational Single-Center Study
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Background: It's believed that HBD-3 is involved in the tissue remodeling process of articular cartilage. Also, HBD-3 has anti-inflammatory properties. Objectives: The purpose of this study is to assay human beta-defensine-3 (HBD-3) in serum from rheumatoid arthritis (RA) patients and investigate its correlation with proinflammatory cytokines. Methods: In this case-control study, fifty-eight RA patients were aged 20–65 years, and 29 age-matched healthy subjects (HS) had no inflammatory rheumatic diseases. The disease activity score-28 joint erythrocyte sedimentation rate (DAS28-ESR) was used to measure RA activity. CRP, ACPA, HBD-3, TNF-α, and IL-1β were assessed using the enzyme-linked immunosorbent assay technique (ELISA). Res

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Publication Date
Fri Jul 03 2026
Journal Name
Journal Of Physical Education
The Effect Of Psychological Counselling On The Development Of Psychological Skills and the Level Of First Class Soccer Referees (Baghdad governorate)
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Publication Date
Sat Oct 09 2021
Journal Name
Turkish Journal Of Computer And Mathematics Education
An Analysis of the Mathematics Book for the First Intermediate Grade According to the Dimensions of Mathematical Power
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The current research aims to analyze the mathematics book for the first intermediate grade according to the dimensions of mathematical power by answering the following question: What is the percentage of the availability of the dimensions of mathematical power included in the content of the mathematics textbook for first-grade students, average, in its first, and second parts for the academic year 2020-2021, approved by the Iraqi Ministry of Education / General Directorate of Curricula? The research community was determined by middle school mathematics books, and middle school students for middle ,and high school day schools affiliated to the Directorate of Education in Dhi Qar, and by the intentional test, the research sample was s

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Publication Date
Mon Mar 09 2015
Journal Name
Monthly Notices Of The Royal Astronomical Society
A reliable iterative method for solving Volterra integro-differential equations and some applications for the Lane–Emden equations of the first kind
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Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
The Effect of a Training Program on the Diabetic Patients Utilizing Skills of Insulin Injection Technique
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Objectives: The study aims to evaluate patients’ performance toward insulin injection after training program to
identify the variation in skill of patients in insulin injection technique with regard to some variable (i.e.
educational level and duration of insulin injection.
Methodology: A quasi experimental study has been conducted on diabetic patients.
An observational checklist had been prepared which consisted of 4 main areas with 37 sub-items, which are
syringe preparation for injection, insulin drawing; skin preparation for injection and insulin injection. Each of the
sub-items has 2 options yes or no. One score for positive answer and zero for no.
The sample of the study consisted of (n =30) males and females

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Publication Date
Mon Oct 01 2018
Journal Name
Iraqi Journal Of Science
Theoretical Study of The Electromagnetic Structure of Boron Isotopes Using Local Scale Transformation Technique
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Publication Date
Mon Jan 01 2024
Journal Name
Ieee Access
Patient Monitoring System Based on Internet of Things: A Review and Related Challenges With Open Research Issues
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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
Ministry of Hamdy Al-Bachachy (the first) 3rd of Jun – 28 Aug. 1944 in Iraq The Ministry forum and the political and economical issues
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This study Studied Ministry of Hamdy Al-Buchachy(the first)and explain the features of
this Ministry in a critical time in the history of Iraq. The second world war had began and its
end had reached .The political situation in Iraq is so complicated. The Ministry had made
many things. The Ministry had situated in internal and external complicated time. The
situation in Iraq was so difficult, therefore the recommendor (Abdul-Ilah)asked Hamdy Al-
Bachachy to make be the head of the new governments Al-Bachachy had made irrelevant
government, thus it didn’t last more than three months and the British governorate and of
direct in terference in Iraq who worked to reduce the Iraqi army and the Minister of Defence
refus

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Publication Date
Tue Jun 24 2025
Journal Name
Medicina Moderna - Modern Medicine
Prevalence of Prematurity Outcomes of Overweight Adolescent Pregnancy in One Thousand Premature Neonates in Baghdad
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Background: With the increasing trends of global culinary boom and food revolution, and since adolescents are one of the most important age groups that intereact actively with new emerging waves, the health impacts of overweight adolescent pregnancy could be an evolving issue. Additionally, prematurity has different risks of disease and fatality in different areas and nations. Objectives: We aimed to measure the prevalence of complications of prematurity in 1000 neonates in Baghdad city born to overweight adolescent mothers and general maternal characteristics. Methods: Data of 1000 premature (case) and full-term (control) neonates were collected from hospital records in Baghdad over 12 years. The mothers of our samples were overwei

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