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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
Thu Mar 05 2026
Journal Name
Anatomy And Cell Biology
Comparative morphogenesis of mouse and rat mandibular first molars (M1): a review of developmental timing, structure, and signaling pathways
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Publication Date
Thu Aug 31 2023
Journal Name
Oncology And Radiotherapy
The role of breath holding technique on minimizing cardiac dose in left breast cancer irradiation in the adjuvant setting
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Publication Date
Sun Dec 07 2014
Journal Name
Baghdad Science Journal
Oscillations of First Order Neutral Differential Equations with Positive and Negative Coefficients
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Oscillation criterion is investigated for all solutions of the first-order linear neutral differential equations with positive and negative coefficients. Some sufficient conditions are established so that every solution of eq.(1.1) oscillate. Generalizing of some results in [4] and [5] are given. Examples are given to illustrated our main results.

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Publication Date
Thu Dec 01 2022
Journal Name
Wiadomości Lekarskie
EVALUATION OF TWO CRYOPROTECTANTS USED IN A NEW HUMAN SPERM CRYOPRESERVATION TECHNIQUE
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The aim: To examine the efficiency of different concentrations of Dimethyl sulfoxide (DMSO) and glycerol as a cytoprotectants in protection of human sperms during cryopres¬ervation in this technique. Materials and methods: Thirty oligozoospermic semen samples were used in this study. Samples diagnosed according to WHO 2010 criteria. Sheep’s ovarian follicles obtained from local slaughterhouse and prepared by slicing the ovaries and evacuating the follicular fluid and oocyte. Each semen sample divided into six equal parts, and diluted 1:1 with cryosolution contains 5%, 10%, 15% DMSO or glycerol and injected within the emptied follicles. After freezing and thawing, the semen mixture aspired outside the follicles and sperm concentr

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Publication Date
Thu Aug 18 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Resource consumption accounting technique between traditional cost systems and contemporary cost management techniques in measuring the cost of products - A conceptual vision
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The contemporary business environment is witnessing increasing calls for modifications to the traditional cost system, and a trend towards adopting cost management techniques to provide appropriate financial and non-financial information for senior and executive departments, including the Resource Consumption Accounting (RCA) technique in question, which classifies costs into fixed and variable to support the decision-making process. Moreover, (RCA) combines two approaches to cost estimation, the first based on activity-based cost accounting (ABC) and the second on the German cost accounting method (GPK). The research aims to provide a conceptual vision for resource consumption accounting, after Considering it as an accounting te

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Publication Date
Sat Aug 31 2019
Journal Name
Iraqi Journal Of Physics
The Effect of Laser And Thermal Treatment on the Hardness and Adhesion Force on the Cermet Coating By Thermal Spray Technique
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Ceramic coating compose from a ceramic mixture (MgO, Al2O3) and metall (Al-Ni) were produced by Thermal Spray Technique. The mixed ratio of used materials Al:Ni (50%) and 40% of Al2O3 and 10% MgO. This mixture was spray on a stainless steel substrate of type (316 L) by using thermal spray with flame method and at spraying distances (8, 12, 16 and 20) cm, then the prepared films were treated by laser and thermal treatment. After that performing a hardness and adhesion tests were eximined. The present study shows that the best value of the thermal treatment is 1000 ℃ for 30 mint; the optimum spray distance is 12 cm and most suitable laser is 500 mJ where the microscopic and mechanical character

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
First Order Nonlinear Neutral Delay Differential Equations
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The author obtain results on the asymptotic behavior of the nonoscillatory solutions of first order nonlinear neutral differential equations. Keywords. Neutral differential equations, Oscillatory and Nonoscillatory solutions.

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Publication Date
Wed Dec 11 2019
Journal Name
Journal Of The College Of Education For Women
Alternatives Scenarios for Transportation During The Morning and Evening Peaks (The Entrances of The Jadiriya Complex Study Case) "A Planning Vision"
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The research aims to develop alternatives to transportation at the entrance to the Educational City (University of Baghdad) during the morning and evening peaks, which result from of the traffic congestion at the entrances to the educational city (the University of Baghdad), and affects the emotional, functional, and social performance of the whole city, and leads to hotbeds of confluence and congestion at the entrances in the morning and evening peaks. This movement was measured on the ground for pedestrians and vehicles. Some criteria were adopted to determine the density of road length to the area and density of roads for the number of users and the rate of the area served by roads. The research reviews the experiences of some

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Publication Date
Thu Mar 09 2017
Journal Name
Sensors
A Multimodality Hybrid Gamma-Optical Camera for Intraoperative Imaging
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The development of low profile gamma-ray detectors has encouraged the production of small field of view (SFOV) hand-held imaging devices for use at the patient bedside and in operating theatres. Early development of these SFOV cameras was focussed on a single modality—gamma ray imaging. Recently, a hybrid system—gamma plus optical imaging—has been developed. This combination of optical and gamma cameras enables high spatial resolution multi-modal imaging, giving a superimposed scintigraphic and optical image. Hybrid imaging offers new possibilities for assisting clinicians and surgeons in localising the site of uptake in procedures such as sentinel node detection. The hybrid camera concept can be extended to a multimodal detec

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
Dilemmas in teaching human rights and democracy between the current reality and the difficulties in seeking to spread a culture of human rights
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In the age of information and communication revolution, education as one of life aspects has influenced with that revolution by integrating technology in education, which have become as an important learning tools of the whole educational process . Technology, when used appropriately, can help make science classroom a site of active learning and critical thinking, furthering student inquiry and connections with different materials. It is necessary to develop human rights education programs and materials for discretionary and extracurricular activities as it provide them with the skills and tools so that they are empowered to take action to realize their rights. Human rights education is a critical means of instilling the knowledge، skil

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