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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 Sep 30 2019
Journal Name
College Of Islamic Sciences
Fairness in the ancestral quarrel at the meeting of subordinate and representative metaphors
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Having signed my eyes on the manuscript labeled (equity in the ancestral quarrel at the meeting of subordinate and representative metaphors) I was impressed by the process of achieving it; That manuscript came to light; to be seen by specialists in Arabic rhetoric and students of science, and supplement the library of rhetoric one of the sources ..

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
Simplicity and complexity in the visual layout of the designs Children magazine covers
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The magazine covers the subjects of (simplicity and complexity in the visual layout of the designs of magazine coverings of children) Chapter I The problem and importance of the goal and limits of research and addition to Terminology. In the second chapter the theoretical framework in which the first topic the role of simplicity and complexity in the design and the second section Visual design and design relations and the third research design in magazine covers and the third chapter includes the methodology of research and analysis and the results and conclusions and sources and the most important result of the research is (simplicity and complexity of design, Continuity and vitality and attract the attention of the receiver through the

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Publication Date
Sun Nov 23 2025
Journal Name
Journal Of Babylon Center For Humanities Studies
The motives of pain in the play (Bells and Trains) by Yehuda Amichai
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The upbringing of Yehuda Amichai and the conditions he lived in had a great influence on his deep sense of pain, which made him think of death and suicide. Especially after the Nazis came to power in Germany, and his emigration with his family. Amichai searched for love throughout his life, and his failure was one of the most important factors affecting his psyche, which is A deep influence that made him live in harsh and painful pains that broke him, and prevented her from achieving his ambitions in life.Dramatic texts are characterized by repetition in writing and presentation. It is a textual discourse that has two advantages, first, that it can be read as a literary text like all other literary texts, and second, that it can be consider

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Publication Date
Mon Mar 15 2021
Journal Name
Al-academy
The effectiveness of media communication and its problems in the contemporary theatrical presentation
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Publication Date
Mon Oct 31 2022
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
The adoption of green management in Iraqi construction industry: The challenges and benefits
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Publication Date
Tue Apr 19 2022
Journal Name
Ishraqat Tanmawia
The reality of the divorce problem in Iraqi society Reasons, solutions and results
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Praise be to God, who created people from one soul, and made her husband, and prayers and peace be upon His Messenger, Mercy given and the grace given, and on a machine and companions pure. Divorce cases have increased in recent years in a worrying manner, especially since divorce has unforeseen consequences at the individual and social levels. The source of concern stems from the fact that the cohesion and integrity of society starts from a family as it is the cornerstone of the social structure, which is the foundation upon which the large society is based. Marital life may suffer from problems and obstacles that are difficult to solve, so the man presents the divorce of his wife and that the phenomenon of divorce is not a result of it, b

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Publication Date
Wed Dec 11 2019
Journal Name
Journal Of The College Of Education For Women
Turkish Policy Towards Africa in the Era of the Justice and Development Party
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Turkish policy towards Africa witnessed important developments over time that began before the Ottoman era and then developed during the Ottoman era when the Ottoman state played an important role in maintaining security by confronting Portuguese interventions in North Africa and sending military aid. Thus, the Ottoman state was able to develop its policy towards Africa for important considerations based mainly on the employment of the religious factor and the spread of Islam for the African acceptance of the Ottomans in the African territories and thus, achieve economic, strategic and political motives. Later, these relations declined in the Republican era due to the weak political and economic potential of Turkey on the one hand and th

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
Rashid Street and its impact in the political twenties of the last century
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Rasheed Street has had great importance by the nature of what was seen as being of vital events of a key facility in the Iraqi capital Baghdad since ancient times until now .
And such as cultural and historical memory-rich street for Iraq, pulsating nerve since the beginning of the last century thanks to the commercial and intellectual stature, as well as being a tourist landmark frequented alleys most of the tourists coming to Iraq , which counted for them a source of tourist attraction, given the religious diversity of fungal who excelled by the street, as we find in exchange for his Church of the Virgin Mary, the time which was built in the middle of the Caliphs Mosque towering minarets and promised that the oldest and largest of t

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Publication Date
Mon Jan 01 2024
Journal Name
Communications In Mathematical Biology And Neuroscience
The contribution of amensalism and parasitism in the three-species ecological system's dynamic
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Publication Date
Wed Dec 28 2022
Journal Name
Al–bahith Al–a'alami
Frames of Al-Alam TV channel’s handling of the Iraqi and Lebanese protests Analytical study of the main news bulletin for the period from October 1, 2019, to December 31, 2019
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        In October 2019, Iraq and Lebanon witnessed widespread protests, which aroused the interest of the media, as they began with demands for the provision of services, then escalated with the overthrow of the political system. The researchers chose a satellite channel that represents a direction for a country accused of entering the line of protests. This paper aims to analyze the main bulletin of Al-Alam channel to find out how it deals with the protests in the news. It is classified descriptively, using the survey method and the method of content analysis. The study community was represented by the main news bulletin of Al-Alam channel. The researchers adopted a deliberate sample for the period from 1/10/2019 to

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