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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
Sun May 24 2026
Journal Name
Journal Of Physical Education
Using Agility Exercises For Developing Some Refereeing Skills Of First Class Assistant Referees In Baghdad
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Agility is considered an important motor ability for assistant referees and it is vital for passing modern tests issued in September 2016. The researcher used the experimental method. The subjects were (10) referees; four of them for pilot study. The experimental group followed the exercises designed by the while the controlling group used the traditional exercises followed by the refereeing committee. All referees were tested the standardized agility test issued by the FIFA. The researchers concluded that agility plays a vital role in developing some refereeing skill. Finally they recommend developing agility for improving refereeing skills.

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Publication Date
Sat Dec 01 2012
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
First record of red-back spider Latrodectus scelio thorell, 1870 (Araneae: theridiidae) in Baghdad, Iraq
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ABSTRACT Two females of the red-back spider, Latrodectus scelio Thorell, 1870 were first recorded in Iraq, short description with figure was provided

 

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Simole matimatical technique in leaser cavity design and manufacturing
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In this research design was treated gap laser mathematically and practically Bashaddam model Raasi simple and new and we have found that there is a good match in the practical and theoretical results

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Publication Date
Wed Dec 11 2019
Journal Name
Journal Of The College Of Education For Women
Investigating Difficulties Faced by Iraqi EFL Learners in Identifying the Illocutionary Force of the Reduplicative Words
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A reduplicative word is an important phenomenon in all language studies because it reflects many functions in language communication such as plurality, emphasis, contrast, imitation.  The various instances of reduplicative words in a particular language reflect the richness and uniqueness of that language. Moreover, such variation gives insights into both culture and thought. A reduplicative word is a linguistic phenomenon found in the syntactic, morphological, phonological and semantic levels. The current study aims at investigating the illocutionary force of English reduplicative words in some selected English colloquial utterances. To achieve this aim, an analytical -pragmatic approach has been used by adopting Searle’s (1979)

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Suspicion in the truth that the satisfaction of the student in the criticism of the speech of the poet and the writer to I bin Al-Atheer
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Suspicion in the truth that the satisfaction of the student in the criticism of the speech of the poet and the writer to I bin Al-Atheer

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Publication Date
Wed Jun 01 2022
Journal Name
Iraqi Journal Of Physics
Theoretical Investigations of Electronic and Optical Properties of Vanadium Doped Wurtzite Zinc Oxide from First Principle Calculation Method
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In this study lattice parameters, band structure, and optical characteristics of pure and V-doped ZnO are examined by employing (USP) and (GGA) with the assistance of First-principles calculation (FPC) derived from (DFT). The measurements are performed in the supercell geometry that were optimized. GGA+U, the geometrical structures of all models, are utilized to compute the amount of energy after optimizing all parameters in the models. The volume of the doped system grows as the content of the dopant V is increased. Pure and V-doped ZnO are investigated for band structure and energy bandgaps using the Monkhorst–Pack scheme's k-point sampling techniques in the Brillouin zone (G-A-H-K-G-M-L-H). In the presence of high V content, the ban

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Publication Date
Mon Nov 27 2023
Journal Name
Journal Of Periodontal Research
Ability of gingival crevicular fluid volume, E‐cadherin, and total antioxidant capacity levels for predicting outcomes of nonsurgical periodontal therapy for periodontitis patients
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Abstract<sec><title>Objectives

To determine the potential of gingival crevicular fluid (GCF) volume, E‐cadherin and total antioxidant capacity (TAC) levels to predict the outcomes of nonsurgical periodontal therapy (NSPT) for periodontitis patients.

Background

NSPT is the gold‐standard treatment for periodontal pockets < 6 mm in depth, however, successful outcomes are not always guaranteed due to several factors. Periodontitis‐associated tissue destruction is evidenced by the increased level of soluble E‐cadherin and reduced antioxidants in oral fluids which could be used as predictors for success/failure of N

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The role of administrative supervision scope and the single window to increase the efficiency of investment (Case study: Sudanese Ministry of Investment)
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Investment drives the wheel of the development of different developed and developing countries. Sudan is a model for a developing country facing a lot of difficulties in the field of both local and foreign investment. The present study was focused on the problem of poor diversification and efficiency of both local and foreign investment in Sudan. Also, it clarified the important role of administrative supervision to strengthen the efficiency of investment, taking the experience of the Sudan as a model. The researchers used the well-known descriptive and analytical tools (questionnaire, interview, observation) to complete this study. A well designed questionnaire was used. It included all questions that could cover all aspects of

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Publication Date
Mon Jan 01 2018
Journal Name
Ndt &amp; E International
Porosity evaluation of in-service thermal barrier coated turbine blades using a microwave nondestructive technique
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Publication Date
Wed Nov 01 2023
Journal Name
Clinical Epidemiology And Global Health
The association of interleukin-10 single nucleotide polymorphisms (rs1800871) and serum levels in Iraqi patients with celiac disease: A case-control study
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