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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
Thu Mar 12 2026
Journal Name
Al–bahith Al–a'alami
The Media Discourse of the Newspaper (El Watan) Towards Social Issues Study in Discourse Analysis
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Journalistic discourse is a fertile through which most of the segments of the society interact in all their platforms: intellectual, cultural, social, and various settings between the vital structures of the state; which makes it the link between the groups and segments of the society.

The role of discourse, moreover, engages in a vital way by establishing a culture of debate on controversial issues that provided a space in the different visions and differing perceptions on how to formulate the discourse and the magnitude of vocabulary for the diagnosis of these issues. Since there is no system of any community empty of the emergence of issues reflecting the public interest which is necessary is reflected in the context discourse

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Publication Date
Sun Jun 06 2010
Journal Name
J Of Mustansiriya College Of Dentistry
the usefulness of Ramfjord teeth to represent the full-mouth pocket depth in epidemiology study
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Publication Date
Sat Dec 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Importance of Strategic Orientation Dimensions in the Iraqi National Security Service: An Analytical Study
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The current research aims to identify the level of strategic orientation and its dimensions (vision, mission, goals, and values) in the Iraqi National Security Service (INSS). The researchers followed the descriptive analytical approach as one of the forms of analysis and organized scientific interpretation to describe a specific phenomenon or problem, adopting the form questionnaire being the main source in collecting data and preparing for this. Based on the program of the Statistical Package of Social Sciences (SPSS 26) to analyze the data and come up with the final research results to identify the opinions of the intended sample on the subject of research, and the questionnaire of (20) paragraphs included the search variable, and was

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Publication Date
Tue Sep 18 2018
Journal Name
Water
A Systematic Operation Program of a Hydropower Plant Based on Minimizing the Principal Stress: Haditha Dam Case Study
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Dam operation and management have become more complex recently because of the need for considering hydraulic structure sustainability and environmental protect on. An Earthfill dam that includes a powerhouse system is considered as a significant multipurpose hydraulic structure. Understanding the effects of running hydropower plant turbines on the dam body is one of the major safety concerns for earthfill dams. In this research, dynamic analysis of earthfill dam, integrated with a hydropower plant system containing six vertical Kaplan turbines (i.e., Haditha dam), is investigated. In the first stage of the study, ANSYS-CFX was used to represent one vertical Kaplan turbine unit by designing a three-dimensional (3-D) finite element (F

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Publication Date
Sun Dec 06 2015
Journal Name
Baghdad Science Journal
The Study of Serum Complement C3, C4 and Immunoglobulin E IgE in Psoriasis Patients
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The present study was aimed to find out the role of humoral immunity in the pathogenesis of psoriasis. Complements C3, C4 and immunoglobulin IgE .The study included 55 Iraqi patients with psoriasis 30 (15 females ,15 males) were untreated with any drugs. The other patient group consisted of 25 (9 female and 16 male) treated with a biological treatment (infliximab) ,and 30 (13 males ,12 females) healthy control group. Blood sample were withdrawn (5) ml of venous blood for both patients and members of the control ,to conduct the Immunological tests to determine the quantitative for each of total IgE by using (ELISA) and C3,C4 by Single Radial Immunodiffuse (SIRD). The results showed significant increase in the level of probability (P <0.0

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Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
Analytical Study of Crude Oil Price Shocks in the Global, Market Reasons and Result
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The global oil market is one of the most important markets in the world and occupies especially for countries consuming and producing countries, and the status of understanding of the mechanism for determining prices in the market help to stand on many factors affecting oil demand and supply of oil and geopolitical factors, climate and alternative sources of energy .. etc. factors, and that the main objective of the research is to study the causes and results left behind by the oil price shocks in the world market, and the movement of these factors be through a cycle of energy that explain the strength of competition between these factors and their effects on prices, when demand increases evolution Large image leads to significan

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Publication Date
Sun Jan 31 2016
Journal Name
Iraqi Journal Of Biotechnology
Morphological, Histological and Ultrustructural Study of the Tongue in House Geecko (Hemidactylus flaviviridis) Lizard
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The aim of this study to investigate the tongue morphology and histology in house gecko Hemidactylus flaviviridis using light and scanning electron –microscopy (SEM ) technique.The morphology result revealed the presence of three parts : apex , body and lingual root .The light microscopy result showed that the tongue is covered with mucous membrane composed of non keratinized stratified squamous epithelium based on lamina propria which contain bundles of striated muscles its fibers in different directions including connective tissue , blood vessels and nerves. The lingual mucosa of the dorsal surface is covered with different pattern of lingual papillae which are widely distributed all over the dorsal surface except the apex. Noticed on t

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Evaluation the Effects of CO2 Laser on Soft and Hard Tissues (in vitro study)
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CO2 laser (10.6 μm) is the most often used laser in the oral surgery due to its high absorption by water of the oral tissues. Several benefits of the use of CO2 laser have been reported for oral surgical procedures. This study aims to evaluate the effect of CO2 laser on soft and hard oral tissues (in vitro study). This study was done on fresh tissues from sheep’s head. CO2Surgical Laser with different operation modes was used; 0.2 mm spot size using different laser parameters on the tongue, and bone making holes, incisions and cutting. The depths and widths of holes and incisions were measured using endodontic file under magnification. The speed of incisions was calculated and the required time for cutting was measured using sport clo

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Publication Date
Tue Dec 01 2015
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
STUDY ON THE EFFECT OF ROYAL JELLY OF BEES (APIS MELLIFERA) ON THE MORPHOLOGY AND SPERM FUNCTION PARAMETERS IN MICE (SWISS ALBINO)
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    The objective of this study was to investigate the effect of Royal jelly RJ on morphology and motility of mice sperms. Sperms were collected from the cauda region of the  epididymis of each 10 mice from the treatment and control groups. Direct activation techniques and evaluation of sperm morphology were carried out. Dhino microscope was used for sperm measurement. The inspection was carried out in Salamatic laboratory for pathological analysis in 2015.The result revealed that all of the sperm function parameters registered significant activation  in the treatment group. There was a significant increase in both the percentage of the sperm motility grade A and the progressive motility (A+B) of the treatment gr

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Electronic trading system and its refletion in the trading of stock market indices –an analytical study of the Iraqi market for securities–
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The research aims at identify the role of the electronic trading system used in the Iraq stock exchange to promote trading activity for the stocks of listed companies in this market.

To prove the hypothesis of research, it was selected the main trading indicators for the market to be a main field in test the research hypothesis.it was selected as the period of time for (9)years span between the years (2005-2013) because they represent the first two articles of equal time periods represent aperiod that preceded the introduction of electronic trading system  while the second represents the period of time that followed 

The research found a number of conclusions but the mo

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