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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 Jul 20 2025
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Study and Investigation of the Charge Transfer Rate Production in N3-Senstized Dye Contact with ZnS Semiconductor System
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In this work, the rate of charge transfer (CT) reaction at the N3-ZnS interface was calculated using a quantitative computational model to evaluate the efficiency of N3-ZnS heterojunction dye-sensitized solar cell devices using different types of solvents. This work discussed the influence of the effective driving energy force on the charge transport rate and performance of N3-ZnS devices with various solvents based on a donor-acceptor model. A solar cell model was used to study the optical efficiency when changing some of its parameters, such as the type of material and the thickness of the film, as they are important factors influencing the quality of the solar cell. It was found that the transition energy varies with different so

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Form that is a Proposed of Procedures for Auditing the Technical Reserves of General Insurances Branches in the Insurance Activity : applied research
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The research aims to identify the theoretical framework of technical reserves in the insurance activity and the role of the auditor in verifying the integrity of the estimates of technical provisions (technical reserves) for the branches of general insurance in insurance companies based on the relevant international auditing standards, as a proposed audit program has been prepared in accordance with international auditing standards that enable the auditor to express a sound opinion on the fairness of the financial statements of these companies , The research has reached many conclusions, the most important of which is the existence of deficiencies in the audit procedures of insurance companies, as the audit program of those companies did

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Publication Date
Fri Jan 01 2021
Journal Name
Aip Conference Proceedings
Preparation and characterization of mawsonite Cu6Fe2SnS8 [CFTS] thin films via the semi-computerized spray pyrolysis technique for photovoltaic applications
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Publication Date
Fri Nov 03 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences( P-issn 1683 - 3597 E-issn 2521 - 3512)
Professional Challenges Facing Pharmacists Working at Public Hospitals in an Iraqi Province: A Qualitative Study
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In Iraq, because of the dramatic turnovers facing the country for three decades, pharmacists continue to experience significant professional challenges in both the public and private sectors. The present study aimed to explore the professional challenges and obstacles facing Iraqi pharmacists working in public hospitals. This qualitative study included face-to-face semi-structured interviews with open-ended questions with hospital pharmacists. The participants were selected purposefully (with ≥ 3 years of experience) to work at governmental hospitals in Karbala province between December 2022 and April 2023. The audio-recording interviews were scripted. Thematic analyses were used to generate themes and subthemes from the interview

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Publication Date
Sun May 08 2011
Journal Name
Journal Of Planner And Development
the best way to deal with the center of the ancient city of Najaf
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The historic cities in the Arab and Islamic world (including the cities of the holy shrines in Iraq) suffer from many and varied problems and most notably it is clear in its origin functional structure. It had been transformed from a basic place to live for a few thousand of the population to the center or part of the main center of large city populations of more than one million. Functional structure of the ancient city have been change with the beginning of the twentieth century and accelerated rate of change in the second half of the last century. The research aims to analyze the problems of the historic centers of holy cities and analyze the methods of dealing with these problems, leading to discrimination method could be the

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Attitude of the University of Baghdad Students towards the Mixed and Single-Sex Learning
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The study aims at finding out:
1. The students' attitude towards the mixed learning at the university.
2. The statistically significant differences in attitude towards the mixed learning at the university according to the specialization variable.
3. The statistically significant differences in attitude towards the mixed learning at the university according to the gender variable.
The researcher has constructed a scale for measuring the students' attitude towards the mixed learning at the university.
After assuring its validity and reliability, the scale has been given to a sample of (100) students. The sample is selected randomly from (4) colleges of the university of Baghdad, (2) for scientific specialization and (2)for h

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Publication Date
Mon Dec 20 2021
Journal Name
لارك
The Theme of the Family in Russian Literature during the "Thaw" on the Material the story of M. Sholokhov "The Fate of a Man"and the story of V. Panova "Seryozha" and F. Abramov "Fatherless".
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The article approaches the characteristics of Russian literature in the time of Khrushchev or the "thaw" period a very short period of Soviet history, characterized by the easing of the dictatorship of power and relaxation in various areas of people's lives. The interest in the research is focused on the importance of interpreting the family portrait in a short but distinct period in the development of Russian/Soviet literature. The research material is the story of Sholokhov's “The Fate of Man” 1956, the story of Panova “Serioga” 1955, and Abramov’s story “Fatherless” 1961. В статье рассматриваются особенности художественной литературы периода хруще

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Publication Date
Sat Dec 01 2012
Journal Name
Iraqi Journal Of Physics
Fabrication of carbon nanopowder by arc discharge technique
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Carbon Nanopowder was fabricated by arc discharge technique at deposition pressure of 10-5 mbar Argon gas on glass substrates. The prepared carbon nano- powder was collected from chamber and purified with nitric acid at 323K .The morphology and crystalline structure of the prepared powder was examined by X-Ray Diffraction (XRD), Atomic Force Microscope (AFM), and Scanning Electron Microscope (SEM). XRD spectrums showed that the powder exhibits amorphous structure and after purification, the powder showed hexagonal structure with a preferential orientation along(002) direction ,where AFM and SEM gave very compatible estimation on the grain size and shape of the nanopowder.

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Publication Date
Thu Sep 01 2016
Journal Name
Injury Prevention
972 The effectiveness of injury prevention program on reducing the incidence of lower limb injuries in adolescent male soccer players
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The highest incidence of injury is seen in adolescent playing pivoting sports such as soccer, basketball, and handball. Objective: To examine the effectiveness of a neuromuscular prevention program in reducing knee and ankle injuries in adolescent male soccer players.

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Publication Date
Wed May 13 2015
Journal Name
International Journal Of Current Microbiology And Applied Sciences
First Record of Hairy Rove Beetle, Creophilus maxillosus (Linnaeus, 1758)(Coleoptera; Staphylinidae) for Iraq
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