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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
Wed Oct 01 2025
Journal Name
Studies In Big Data
Employing AI Tools to Achieve Integration Between the Target Costing Technique, SDG, and Their Role in Improving Administrative Decisions
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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
The difficulties in memorizing literary texts with fourth grade students from teachers’ point of view of and students
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The current research seeks to know the difficulties in memorizing literary texts with fourth grade students from teachers’ point of view of and students
The research contains a community of (10,870) students from schools affiliated to the Directorate of Karkh, second and the number of schools for boys and girls (79) School and the number of teachers (349) who are specialized in teaching Arabic language to fourth grade preparatory students and there was a section of a randomly sample of each of the students, teachers and schools .
Some actions which can be listed below:-The survey which was done by the researcher for the views of the two samples from teachers and students as the number of teachers covered in this research (20) and

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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
Sun Jul 09 2023
Journal Name
Journal Of Engineering
The sustainable urban development in Al_Kharkh historic center
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The problems of urban historic centers are considered some of the subjects which are widely dealt with in urban studies since the middle of the 20th century. literature of urban development have raised it , beside the fact that large number of urban development projects of the historical centers in many cities of the world ,and emerged from the application of these new problems projects added their original urban problems , because these projects have dealt with the physical structures with the neglect of the social and economic sides, which are the base in sustainable development nResearch problem was elaborated as : The unclearly of knowledge of the potentials of the sustainable development in solving the urban problems of historic cen

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Publication Date
Sat Jan 01 2022
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science (ijeecs)
A new smart approach of an efficient energy consumption management by using a machine-learning technique
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Many consumers of electric power have excesses in their electric power consumptions that exceed the permissible limit by the electrical power distribution stations, and then we proposed a validation approach that works intelligently by applying machine learning (ML) technology to teach electrical consumers how to properly consume without wasting energy expended. The validation approach is one of a large combination of intelligent processes related to energy consumption which is called the efficient energy consumption management (EECM) approaches, and it connected with the internet of things (IoT) technology to be linked to Google Firebase Cloud where a utility center used to check whether the consumption of the efficient energy is s

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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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Publication Date
Fri Sep 09 2022
Journal Name
Journal Of Ovonic Research
The effects of CuO doping on structural, electrical and optical properties of CdO thin films deposited by pulsed laser deposition technique
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Thin films of (CdO)x (CuO)1-x (where x = 0.0, 0.2, 0.3, 0.4 and 0.5) were prepared by the pulsed laser deposition. The CuO addition caused an increase in diffraction peaks intensity at (111) and a decrease in diffraction peaks intensity at (200). As CuO content increases, the band gap increases to a maximum of 3.51 eV, maximum resistivity of 8.251x 104 Ω.cm with mobility of 199.5 cm2 / V.s, when x= 0.5. The results show that the conductivity is ntype when x value was changed in the range (0 to 0.4) but further addition of CuO converted the samples to p-type.

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Publication Date
Tue May 01 2018
Journal Name
Journal Of Craniofacial Surgery
Single Session Facial Lipostructure by Using Autologous Fat Mixed With Platelet-Rich Fibrin Injected by Using Facial Autologous Muscular Injection Technique
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Aim:

This study was designed to evaluate the role of single session autologous facial fat grafting in correcting facial asymmetries after mixing it with platelet-rich fibrin (PRF) and injecting them into rich vascular facial muscular plane.

Materials and Methods:

Fifteen patients (12 females and 3 males) with age ranging from 18 years to 40 years were included in this study and followed up during 6 months, all the patients were treated in the Al-Shaheed Ghazi Al-Hariri for specialized surgeries hospital (Medical City, Baghdad, Iraq).

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Monitoring of Defects Concentration in Deformed Aluminum Using Doppler Broadening Technique
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Doppler broadening of the 511 keV positron annihilation ??? ? was used to estimate the concentration of defects ?? different deformation levels of pure alnminum samples. These samples were compressed at room temperature to 15, 22, 28, 38,40, and 75 % thickness reduction. The two-state ^sitron-trapping model has been employed. 'I he s and w lineshape parameters were measured using high-resolution gamma spectrometer with high pure germanium detector of 2.1 keV resolution at 1.33 MeV of 60Co. The change of defects concentration (Co) with the deformation level (e) is found to obey an empirical formula of the form Cd - A £ B where A and ? are positive constants that depend mainly on the deformation procedure and the temperature at which the def

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measuring the cost of consulting services under the traditional cost approach and the performance-based costing technique and its impact on achieving profits : Applied research in the advisory office of Al-Khwarizmi College of Engineering - University of Baghdad
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Abstract:

                    This research aims to apply the Performance Focused Activity Based Costing System in the consultant office of Al-Khwarizmi College of Engineering at the University of Technology for the purpose of measuring the cost of consulting services provided by these offices in order to reduce costs and their reflection in achieving profits. For the purpose of calculating costs accurately, and to test the hypothesis of the research, the research was applied in the office of the consultant of the College of Engineering Al-Khwarizm - University of Baghdad through the financial statement

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