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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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Mon Jun 30 2003
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study of the Factors Affecting Cells of Sodium Chlorate Production
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Sun Sep 02 2012
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Baghdad Science Journal
Study Of Factors Affecting The Thermal Conductivity Of Iraqi Bentonite
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Thermal conductivity of compacted bentonite is one of the most important properties where this type of clay is proposed for use as a buffer material. In this study, Lee's disc method was used to measure the thermal conductivity of compacted bentonite specimens. The experimental results have been analyzed to observe the three major factors affecting the thermal conductivity of bentonite buffer material. While the clay density reaches to a target value, the measurement is taken to evaluate the thermal conductivity. By repeating this procedure, a relationship between clay dry density and thermal conductivity has been established in specimens after adjusting the water contents of the bentonite by placing its specimens in a drying oven for diffe

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Mon Jun 30 2003
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Iraqi Journal Of Chemical And Petroleum Engineering
Study of the Drying of Ethanol using Zeolite Molecular Sieves
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Sun Feb 10 2019
Journal Name
Iraqi Journal Of Physics
Study of the mechanical properties of Iron-Epoxy composite materials
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Iron-Epoxy composite samples were prepared by added
different weight percentages (0, 5, 10, 15, and 20 wt %) from Iron
particles in the range of (30-40μm) as a particle size. The contents
were mixed carefully, and placed a circular dies with a diameter of
2.5 cm. Different mechanical tests (Shore D Hardness, Tensile
strength, and Impact strength ) were carried out for all samples. The
samples were immersed in water for ten weeks, and after two weeks
the samples were take-out and drying to conducting all mechanical
tests were repeated for all samples. The hardness values increased
when the Iron particle concentration increased while the Impact
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Mon Dec 30 2002
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Iraqi Journal Of Chemical And Petroleum Engineering
Study of the Factors Affecting Cells of Sodium Perchlorate Production
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Tue May 30 2023
Journal Name
Gsc Biological And Pharmaceutical Sciences
Anatomical study of the 3rd metacarpal bone of some mammals
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The current study included the anatomical structure of the metatarsal bone in sheep in terms of the traditional structural description of the bone, as it was found that the metatarsal bone in the fore and hind limbs of adult sheep had no visible differences between it and animals, especially ruminants. The metacarpal \tarsal bone No. 3 was cylindrical in shape, with the presence of the metacarpal \tarsal bones 2 and 4 declines, articulated from the proximal end with the metacarpal and metatarsal bones whereas from the distal part with the fetlock joint and the first phalanx bone. The aim of the study is to determine whether the environment and its changes in Iraq have affected the animals and their bones in terms of length, thicknes

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Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Establishment of method and the development of the teaching methods in the late abbissid period and it s impact on the contemporary leading methods
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Every researcher must say that the world in continually progress toward the best and that
the Arab and Islamic civilization had produced much of systems and virtuous educational
practices which raised from Islamic heritage. This nation was not isolated from external
world, but it was made a clear active for promote the banner of other nations which entered
under her influence to promote Islamic banner and Muslims. Consequently also Muslims are
affected and influenced, this resulted a clear impact in the civilization and educational
ideology especially in the contemporary teaching methods.

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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Importance of obligation to the rules of professional conduct and its impact on tax revenues: An applied research in a sample of companies registered at the Department of the Public Authority for corporate taxes
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The researcher  tried to show the importance of obligation with the rules of professional conduct set by the Association of Accountants and Auditors of Iraqis when expressing an opinion the financial statements submitted tax administration and enhance the confidence of these lists, and adopted in the tax settling accounts process and its impact on tax revenues, and touched a researcher at the theoretical side of the search to the problem of research and of my Is there a trace of non- not to obligation by the rules of professional conduct in Iraq affect the tax revenue with the rules of professional conduct in tax revenue for companies research sample, the research aims to study the rules of professional conduct set by the Associatio

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Publication Date
Sat Mar 14 2020
Journal Name
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Factor study of some BioKinematic variables of the step of crossing barriers (3-6-9) in the 110m run barriers for young runners
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<em>The aim of the research is to set a set of BioKinematic variables for the step of crossing barriers (3–6–9) in a 110-meter barrier for young runners. The researchers concluded the study by interpreting and discussing the results that the most important variables must be relied upon when training and selecting runners that got the best saturation on their factors: 1-The first factor which refers to the total distance of the plan to pass the third barrier + the total distance of the plan to pass the ninth barrier + the total distance Plan to cross the sixth barrier. 2-The second factor which refers to the total vertical speed before passing the third barrier + the total vertical speed before the sixth barrier + the total vertica

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Publication Date
Tue Jun 30 2015
Journal Name
College Of Islamic Sciences
The effect of negation in proving the pathology of the fundamentalists
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This research deals with the study of pathways in terms of the negative effect in proving them
And the fact of this influence among fundamentalists.
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In the first section, I learned about the terms in the title of the research:
Denial and pathology.
In the second section I reviewed the pathways of illness that affect exile in it
Five: the nodding, the fitting, the sounding, the division, the rotation, the inference
A description of the absence of evidence of non-reference to it. And I figured out how
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Arising from the effect of negation in proving those routes.
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