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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 Aug 02 2016
Journal Name
The Iraqi Journal Of Agricultural Sciences
AN ECONOMIC ANALISYS FOR PRICING POLICY AND POLICY OF FORIGEN TRADE OF AGRICULTURAL SECTOR IN IRAQ DURING 2003-2013
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There is no doubt that Agricultural Policy is the main responsible for the degrading in Agricultural sector in Iraq during the period 2003-2013, and that was very clear from magnitude of indicators because of little sharing of each of agricultural product in GDP because it was (9.38%) in average during the study period and the annual changing of it was negative (-5.82%), and there is increasing in deficit of trade balance in Agriculture during the study period about (4185.73) million US$, and the percentage of agricultural exports from total exports was (0.14%) in average only. The foreign trade policy in Agricultural products also cannot determine map of Revealed Comparative Advantage (RCA) of Agricultural products and crops. The study sh

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Publication Date
Sat Jan 21 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Environmental parameters drive the phytoplankton community structure: a case study in Baghdad Tourist Island Lake, Iraq
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Phytoplankton community is a model for of monitoring  aquatic systems and interpreting the environmental change in aquatic systems. The present study aimed to forecast environmental parameters that drive the change of phytoplankton community structure in the lake. The present study was carried out in Baghdad Tourist Island Lake (BTIL) for the period From October 2021 to May 2022. The study included the quality and quantity of phytoplankton, moreover, the highest and lowest value of the physical and chemical parameters were (Water temperature (13-30 °C), Light penetration (94-275cm), electric conductivity (837-1128 µS/cm), salinity (0.5-0.7 ‰), pH (7-8.2), total alkalinity (126-226 mg CaCO3/L), total Hardness (297-395 mg CaCO3/L

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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of Studies And Researches Of Sport Education
The effectiveness of the use of yoga exercises and its impact on the reactions of the two Alvesologih nervous and respiratory systems in the correction of antenna pistol shooting accuracy
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Publication Date
Sun Dec 31 2023
Journal Name
College Of Islamic Sciences
Variation in general formulas in the strength of its foundation and the reasons for the discrepancy
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A legal discourse in the Qur’an and Sunnah is almost devoid of the use of one of the general formulas, and due to its frequent rotation in the tongue of the legislator, the formulas may overlap their members in apparently contradictory provisions, which makes the individual from the general members appear to the beholder to be covered by two contradictory provisions, and this research came to present what might happen to him The legal text interpreter of weighting between the two opposing texts is the strength of the generality that is established by the generality formula, so the two strongest formulas in the inclusion of its members outweigh the weaker of them and precede them, and the research decided that the formulas vary

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Publication Date
Sat Nov 22 2025
Journal Name
Al-anbar University Journal Of Law And Political Sciences
The reasons for the fall of sanctions in the decisions and customs provisions in Iraqi law
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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of Educational And Psychological Researches
The impact of the model and follows on the collection and Retention of fifth grade students (oiterary) in history
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The first chapter the importance of research and need for education scientists see that the roots of the use of a specimen Wheatley in learning and teaching back to Grayson Wheatley, one of the largest supporters of a modern construction, which lay the groundwork for the specimen stage and the form in which it is. That was attributed to him, often called his name called while some educators based learning strategy on the issue. He sees the learner in this model make him a meaningful understanding of problems during his progress, thereby acting with his colleagues to find solutions to them in small groups. He

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The evolution of demographic variables and their relationship to the demographic opportunity in Iraq and the possibility of investing
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The variables of quantitative and qualitative Population role in the economic development process and it was said the human center of development and population is the goal of development and its tool , and Iraq suffers from problems in the economic growth and the standard of living and development in general, and if I want him evolution and development sectors must pay for these demographic changes especially , to study and that invest Pmaasb in the interest of the man
The study of the demographic situation in Iraq and at the provincial level to track paths demographic change and its impact on the entry of Iraq to the demographic window due to the change in the age structure of the population and how to use them and invested well in

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Publication Date
Thu Jun 30 2022
Journal Name
Sports Culture
Analysis of the kinetic path of some physical measurements and kinetic abilities in terms of the direct attack in the foil
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Through the researchers' acquaintance with the previous studies, the problem was identified as that the preparation of training curricula in all its units must be based on accurate scientific foundations. Positively affect the type of attack and its implication in the presence of correlational relations, whether direct or indirect, i.e., precedence in training and in preparing units Therefore, the researcher decided to build a causal model to know the relationships to show the best model of the direct straight attack. The study aimed to build a causal model for the most important physical measurements and kinetic capabilities of the direct straight attack in the research sample. The two researchers used the descriptive approach in t

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Publication Date
Sat Nov 22 2025
Journal Name
Modern Sport
The reality of technological leadership in youth and sports directorates in the southern region from the point of view of employees
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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Strategic Leadership in the adoption of Talent Management Practices Field research in the Ministry of Science and Technology
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The current research aims at testing test the relationship and the impact of strategic leadership (strategic vision, Core competencies , human capital, organizational culture and Ethical practices) in the talent management (to attract talent, performance management talent, developing talent and retain talent) among managers in the Ministry of Science and Technology Iraq, and figuring out  a number of recommendations to the ministry to help achieve its desired objectives, and to clarify the relationship between the variables to find the main and secondary aim of the research two major hypotheses have been formed which split into ten sub-hypotheses. Collecting data on  a form questionnaire has been relied on as an essenti

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