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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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Thu May 03 2001
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Master's Thesis
The image of the United States of America in the Iraqi press
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Thu Oct 30 2008
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College Of Islamic Sciences
Care of the Holy Quran In the era of the Noble Prophet
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This is a brief research in which I tried to briefly explain the care that the Holy Qur’an received during the era of the Prophet, may God bless him and grant him peace, from the Prophet, may God bless him and grant him peace, and all of his honorable companions, may God bless him and grant him peace. I made this research in an introduction and two chapters, the first chapter I made it entitled: About the Holy Qur’an, in which I talked about general investigations about the Holy Qur’an, such as the definition of the Holy Qur’an and the difference between it and the hadith Qudsi and the hadith of the Prophet, then I mentioned a part of the virtues of the Holy Qur’an in general and the virtues of some surahs in particular, and th

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Wed Feb 05 2020
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The role of the League of Arab States in the Syrian crisis
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Abstract The League of Arab States took many procedures against the Syrian political system, like suspended Syria's membership in the League of Arab States and sent a team of Arab observers headed by Dabi to discuss the situation there and issued some decisions and statements that called the Syrian regime to stop the use of violence and repression against the Syrian opposition.Through these steps, the Arab League has tried to help the Syrian parties to resolve the crisis. However, the role of the league in the Syrian crisis was characterized by weakness in general, and lack of seriousness, which contributed in the aggravation of the situation in Syria, and the intervention of major powers in the internal affairs of Syria.

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Publication Date
Fri Sep 08 2023
Journal Name
International Journal Of Scientific Trends
The Role of Renewable Energy in the Protection of the Iraqi Environment
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In this article, the types of renewable energies and the environmental effects of consuming these energies are studied. Energy is one of the things necessary for economic and social development and improving the quality of life, and the presence of continuous and sustainable economic energy is essential for any economic development and growth. Humankind has been aware of renewable energies such as biomass and geothermal energy for a long time and has used these energies as heat sources for shelter. With the beginning of the extraction of fossil fuels such as oil and coal and unlimited access to these products, the use of renewable energy sources, except in remote places and forest areas, has become limited and forgotten. Currently in Iraq,

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The hydrological regime of the Tigris River in the city of Baghdad
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Water drainage pattern in the rivers and changed the nature of the renewed feeding areas
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annual rate of water drainage in the Tigris River was driven down very significantly,
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Publication Date
Sun Dec 31 2023
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The most prominent philosophical and rhetorical concepts in the perspective of philosophers and theologians
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   And from (the rule of judging something is a branch of its perception)، the researchers began to define these concepts، as evidence of the sincerity of perce

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Publication Date
Fri Mar 22 2019
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Evaluation of the efficacy of caries removal using papain gel (Brix 3000) and smart preparation bur (in vivo comparative study)‏
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Sun Feb 28 2021
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The effect of increasing the volume of debt on the volume of trading (applied research on a sample of private banks listed on the Iraq Stock Exchange)
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This research worked on identifying the effect of increasing the volume of indebtedness by companies listed on the Iraq Stock Exchange on the trading volume of those companies, and this research included some theoretical concepts related to both debt financing and trading volume, and it represents the research community of the joint-stock companies listed in The Iraq Stock Exchange (the banking sector). As for the research sample, it was deliberately chosen represented by companies with continuous trading without stopping, which reached 10 joint-stock companies, and the period of research was extended during the period 2011-2015, and a set of indicators and financial methods were used In measuring research v

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Publication Date
Wed Mar 01 2017
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The effect of a training program for chemistry teachers based on the strategy of both sides of the brain together on the thinking patterns of their students
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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Dynamic Behavior of Pb(II) and Cr(III) Biosorption onto Dead Anaerobic Biomass in Fixed-Bed Column, Single and Binary Systems
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The biosorption of lead (II) and chromium (III) onto dead anaerobic biomass (DAB) in single and binary systems has been studied using fixed bed adsorber. A general rate multi- component model (GRM) has been utilized to predict the fixed bed breakthrough curves for single and dual- component system. This model considers both external and internal mass transfer resistances as well as axial dispersion with non-liner multi-component isotherm (Langmuir model). The effects of important parameters, such as flow rate, initial concentration and bed height on the behavior of breakthrough curves have been studied. The equilibrium isotherm model parameters such as maximum uptake capacities for lead (II) and chromium (III) were found to be 35.12 and

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