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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
Fri Dec 31 2021
Journal Name
Political Sciences Journal
The Effect of the change of Energy Factor on the American-Russian Competition in Europe
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Receipt date:3/13/2021 accepted date:5/26/2021 Publication date:12/31/2021

Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

energy is one of the strategic resources within international politics, and this is through the existing competition between the international powers on it, and the global powers have begun to rely on interest in new areas, such as import, depending on new projects an

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Publication Date
Sun Dec 01 2002
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
THE PARASITIC FAUNA OF THE MOORHEN GALLINULA CHLOROPUS CHLOROPUS L. IN THE MIDDLE OF IRAQ
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Examination of the blood and the alimentary canal of moorhens in two sites around
Baghdad area in the middle of Iraq showed that 38% of the examined birds were infected with
one or more of the following parasites, Haemoproteus baghdadensis, H. gallinulae
(Protozoa), Cyclocoelum mutbile (Trematoda), Diorchis inflata, Ligula intestinalis (Cestoda),
Amidostomum fulicae and Porrcaecum sp. (Nematoda) .The stomach analysis revealed that
the bird is omnivorous in feeding including wid range of invertebrate animals with some plant
origin food items.

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Publication Date
Fri Dec 15 2023
Journal Name
Al-academy
The role of the theatrical technical supervisor in developing the skills of preparatory stage learners
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The current study aimed to identify the role of the theatrical technical supervisor in developing and enhancing the skills of middle school students in Baghdad. The sample consisted of 73% of the original community of theatrical technical supervisors, randomly selected from those working in the first, second, and third educational directorates in the Rassafa and Karkh areas. The sample size was 32 theatrical technical supervisors. The study used a questionnaire to collect data on three axes: the cognitive skills developed by the theatrical technical supervisor, the voice and speech skills developed by the supervisor, and the body movement skills developed by the supervisor. The results showed that the theatrical technical supervisor play

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Publication Date
Tue Mar 30 2021
Journal Name
College Of Islamic Sciences
Deliberative in Western and Arab thought Selections from the poems of the Encyclopedia of Fatimids, for example
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This research attempts to dust briefly the concept of deliberativeness in Arabic rhetoric, which was only understood in light of modern Western linguistics, starting with its definition (conformity of speech to the necessity of the case with its eloquence) which contains the elements of the entire creative process as shown by this brief study, in the first chapter that He was labeled (deliberative in Western and Arab thought), and we had started it with deliberation in western thought in the first topic in an attempt to highlight the western concepts of this term so that we could discern its originality in the Arab rhetorical heritage that came next in the second topic (deliberative in Arab thought), explaining the appropriate Th

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Publication Date
Wed Jun 30 2021
Journal Name
Iraqi Geological Journal
The Effect of Weighting Materials on the Rheological Properties of Iraqi and Commercial Bentonite in Direct Emulsion
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Numerous drilling additives and materials are used continuously because they are necessary to support and give the required properties of the drilling fluid so that to ensure the stability of the borehole. This paper aspires to evaluate the rheological properties of bentonite (montmorillonite) Trefawey as an alternative to using commercial bentonite. Monitoring and evaluating of the rheological and filtration properties were prepared. This exertion aims to focus on the effect of hematite, and barite on the rheological properties of the three aforementioned bentonite types. An improvement in the rheological properties of bentonite (montmorillonite). Trefawey was observed after adding the previous heavy materials. Hematite has by some

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Publication Date
Thu Mar 01 2018
Journal Name
Nauchforum
THE PROBLEM OF TRANSLATING METAPHOR IN AN ARTISTIC TEXT (ON THE MATERIAL OF RUSSIAN AND ARABIC LANGUAGES)
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THE PROBLEM OF TRANSLATING METAPHOR IN AN ARTISTIC TEXT (ON THE MATERIAL OF RUSSIAN AND ARABIC LANGUAGES)

Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Elements of the economic intelligence of the organization and its role in achieving economic growth: Applied research
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   The aim of the research is to demonstrate of the relation and the influence of the components of economic intelligence (strategic alertness, information security policy, impact policy) in achieving of economic growth (creativity, competitiveness, quality improvement). The questionnaire was used as a main tool for selected sample. Answers analyzed by using the statistical program (SPSS)  to calculate the arithmetic mean, standard deviation, weight percentage, correlation, F test, and Squared factor (R2).

 The research derived its importance from the distinguished role of information systems in the work of industrial companies, and its impact toward achieving economic growth rates in its various activities. T

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Publication Date
Mon Nov 24 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The prevalence of Candida spp. in the saliva of controlled and uncontrolled diabetes mellitus type II patients
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Background: Diabetes mellitus type 2 has been known for many years as the most common endocrine metabolic disorder that affect the oral cavity and cause many oral diseases including candidiasis. In this study, the incidence of Candida spp. in the saliva of controlled and uncontrolled diabetic patients were determined and compared with non diabetic group. Material and method: The sample consists of 200 subjects: 100 diabetic patients [57 (28.5%) uncontrolled diabetes, 43 (21.5%) controlled diabetes] and 100 (50%) non diabetic groups. Saliva samples was obtained from the subjects and cultured on selective media using appropriate microbiological method to observe the presence of Candida spp. Results: The results revealed a significant associat

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Publication Date
Sun Jan 01 2012
Journal Name
Al-taqni Journal
The Frequency of Urinary Tract Infection According to the Age and Sex in Some of Iraqi Children.
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Publication Date
Tue Feb 02 2021
Journal Name
Journal Of Engineering Science And Technology
INVESTIGATING THE EFFECT OF INLET APERTURE AND BAFFLE POSITION IN IMPROVING THE EFFICIENCY OF PRIMARY SETTLING TANKS
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