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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
Mon Aug 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The impact of production elements responsible on the environmental management system requirements of ISO 14001 - 2004 field study in the North Gas Company
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Abstract

         Most of the industrial organization in the world became suffering from the problem of the pollution of the poisonous chemicals things, this urged to depend on the principle of the responsible production, because it has the positive role by dealing with these chemical things and to safe the health of the society, due to the main goal of this study is to restrict the role responsible production in accomplishing the system of the environmental management through an actual study in the northern gas company in Kirkuk province, the topic has acquired a big importance bacause there were a limited number of studies and res

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The use of green accounting information systems in the oil sector and its impact on reporting on sustainability - an applied study
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Abstract

                  The research seeks to shed light on green accounting information systems, analyze them, identify sustainability reporting and how to improve it, as well as study the importance of the Iraqi oil sector, analyze it, and work on applying green accounting information systems in order to improve the quality of sustainability reporting. Oil as a branch of the General Corporation for the Distribution of Oil and Gas Products to apply the practical aspect and prove the hypothesis of the research. Explaining the company's role in improving environmental conditions

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Publication Date
Sun Mar 01 2020
Journal Name
Iraqi Journal Of Physics
Study of the Nuclear Structure for 38Ar, 59Co, 124Sn, 146Nd, 153Eu and 203Tl Target Nuclei Used in Fabrication the Nuclear Batteries
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The nuclear structure of 38Ar, 59Co, 124Sn, 146Nd, 153Eu and 203Tl target nuclei used in technology for nuclear batteries have been investigation, in order that, these nuclei are very interesting for radioisotope thermo-electric generator (RTG) space studies and for betavoltaic battery microelectronic systems. The single particle radial density distribution, the corresponding root mean square radii (rms), neutron skin thicknesses and binding energies have been investigated within the framework of Hartree-Fock Approximation with Skyrme interaction. The bremsstrahlung spectrums produced by absorption of beta particles in betavoltaic process and backscattered p

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Publication Date
Tue Jan 01 2013
Journal Name
العلوم التربوية والنفسية
The effect of a strategy for creative thinking on the achievement of chemistry and the reading comprehension ability of secondary school female students
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Publication Date
Sun Jun 30 2013
Journal Name
Al-khwarizmi Engineering Journal
Study on the Effect of the Curvature of Solar Collector on Wind Loading Coefficients and Dynamic Response of Solar Collector
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In the current research, the work concentrated on studying the effect of curvature of solar parabolic trough solar collector on wind loading coefficients and dynamic response of solar collector. The response of collector to the aerodynamic loading was estimated numerically and experimentally. The curvature of most public parabolic trough solar collectors was investigated and compared. The dynamic response of solar collector due to wind loading was investigated by using numerical solution of fluid-structure interaction concept. The experimental work was done to verify the numerical results and shows good agreement with numerical results. The numerical results were obtained by using finite element software package (ANSYS 14). It was found

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The contribution of the tax authorities to increase the tax revenues: An applied research on a sample of the supporting bodies in the health sector for the period 1998-2008
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the research was exposed to a study the importance of the role of the supportive entities in providing the useful information to the tax administration and their ability to extend the level of the tax base of taxpayers, through the improvement of the tax payers determination and their tax settle for the purpose of increasing the tax revenue, and shed light on the legal evidence through which these entities become officially assigned to perform a supplementary task to the General Committee for Taxes GCT, to help it to perform its task efficiently, and to study the reasons of the weak cooperation of the supportive entities and their reluctance to provide useful information which leads to limiting the tax base.

The research data hav

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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of The College Of Basic Education
Objective trends of university theses and dissertations of the College of Political Science at the University of Baghdad: an analytical study
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The research sought to identify the objective trends of postgraduate students at the College of Political Science - University of Baghdad for the period from 2000-2012 through the objective trends of university theses and dissertations and what are the most and least studied topics, with a re-adjustment of previously studied topics towards topics that serve issues of concern to society and avoiding topics that have been studied a lot to avoid repetition. The research came out with the following results, the most prominent of which are: The total number of what was accomplished in this college is 401 theses and dissertations, and the dissertations had the largest share of them, as their percentage reached 69%, with 275 theses compared to 126

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Publication Date
Tue Jul 04 2023
Journal Name
Qalaai Zanist Scientific Journal
The Role of The Environmental Observer and The Environmental Police in Protecting the Environment in Iraqi Law
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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of The College Of Basic Education
The impact of cross-training in the development of the skills of the crushing blow and the blow-to-blow stroke under the age of 17
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Publication Date
Fri Mar 01 2024
Journal Name
Al-khwarizmi Engineering Journal
Quantitative Analysis of Isometric Ankle Torque and Muscle Activity during Dorsiflexion and Plantarflexion
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  Foot and ankle movements are essential in various activities like walking, running, and balance, where the mechanics of these movements are affected by the muscles around the ankle joint [1,2]. In this study, the correlations between isometric ankle torque and muscle activity of the tibialis anterior (TA) and gastrocnemius (GAS) in the course of dorsiflexion and plantarflexion was investigated. Eight healthy participants were enrolled for the study, where the ankle torque and surface Electromyography (sEMG) of the main flexors were measured and analyzed. The results showed that ankle torque is higher in plantarflexion than dorsiflexion. In addition, the TA has greater muscle activity during dorsiflexion, while the GAS presents higher ac

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