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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
Sat Apr 01 2023
Journal Name
Heliyon
A comprehensive review on modelling the adsorption process for heavy metal removal from waste water using artificial neural network technique
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Publication Date
Mon Jun 30 2025
Journal Name
Modern Sport
The Contribution Rate of Certain Cognitive and Visual Abilities to the Performance of Forehand and Backhand Skills in Tennis
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Publication Date
Mon Jun 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The phenomenon of negative behavior has studied as a social and psychological phenomenon that effect on the performance and life of workers inside and outside the organization. The adoption of this phenomenon is studied in terms of the role of the interna
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The phenomenon of negative behavior has studied as a social and psychological phenomenon that effect on the performance and life of workers inside and outside the organization. The adoption of this phenomenon is studied in terms of the role of the internal environment of the organization in addressing this behavior, being the variables belong to the field of organizational behavior to see the results of those variables on the Iraqi organizations, since the specificities of it differ from the rest of the Arab and foreign environments. Therefore, this study focused on testing the relationship of the internal environment of the organization and its role in addressing the negative behavior of the workers.

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The impact of the lack of certain vitamins and minerals intake rate of hair loss in pregnant and breastfeeding women
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The research aims to identify the rates of hair loss during pregnancy and lactation and its relation to the rates get some elements motivator urged through the results of the continued failure to meet the need of daily assessments of these elements, which led to the continuation of Hair Loss

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Publication Date
Mon Nov 17 2025
Journal Name
Journal Of Economics And Administrative Sciences
The role of leadership skills in organizational trust Analytical research center in the Ministry of Higher Education and Scientific Research, Iraq
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Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The role of leadership skills in organizational trust Analytical research center in the Ministry of Higher Education and Scientific Research, Iraq
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Formed leadership skills and organizational trust Based on intellectual that underpinned the current research, as represented leadership skills variable interpretative represented in organizational trust-response variable.

The research aims to test the relationship and the impact of leadership skills dimensions in organizational trust dimensions for the purpose of achieving its objectives were formulated hypotheses main relate to test the effect and the relationship between the variables of research for the purpose of testing those hypotheses applied research on a sample of heads of departments and officials of the people at the center of the Ministry of Higher Education and Scientific Research, where th

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Publication Date
Sun Dec 27 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation the Risk Factors that are Associated with Osteoporosis in Post Kidney Transplantation in a Sample of Iraqi Patients
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Renal transplantation is a principal treatment option for end-stage kidney failure. Bone loss and fracture are serious complication of kidney transplantation, associated with morbidity and mortality. The pathogenesis of post transplantation bone loss is multifactorial and complex

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Publication Date
Mon Jun 29 2015
Journal Name
Separation Science And Technology
An acidic injection well technique for enhancement of the removal of copper from contaminated soil by electrokinetic remediation process
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Publication Date
Mon Feb 25 2019
Journal Name
Iraqi Journal Of Physics
Determining the concentrations of radon and the rate of annual effective dose in some types of drinking water available in the Iraqi markets
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           In this research, radon concentrations in some types of healthy drinking water samples available in Iraq's market were measured using a technique called Durridge RAD-7-H2O with closed loop. Then the rate of annual effective dose in human taken this water is determined.

          It was found that, radon concentrations in studied samples ranged between 1.2 Bq.m-3 to 142 Bq.m-3. The results of the radon concentrations and the rate of annual effective dose for drinking water samples were significantly lower than the USEPA and WHO recommended limits that equal 500 Bq/m3 and 1 mSv/y resp

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
A Comprehensive Review on Medical Image Steganography Based on LSB Technique and Potential Challenges
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The rapid development of telemedicine services and the requirements for exchanging medical information between physicians, consultants, and health institutions have made the protection of patients’ information an important priority for any future e-health system. The protection of medical information, including the cover (i.e. medical image), has a specificity that slightly differs from the requirements for protecting other information. It is necessary to preserve the cover greatly due to its importance on the reception side as medical staff use this information to provide a diagnosis to save a patient's life. If the cover is tampered with, this leads to failure in achieving the goal of telemedicine. Therefore, this work provides an in

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