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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
Mon Jan 01 2024
Journal Name
Iraqi Journal Of Hematology
Evaluation of Vitamin D level in thalassemia patients: The experience of a single center
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Publication Date
Tue Mar 01 2016
Journal Name
Journal Of Baghdad College Of Dentistry
A Comparison of the Effectiveness of Reciprocating System with Continuous Rotary Systems in Non-Surgical Endodontic Retreatment
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Background: Optimal root canal retreatment was required safe and efficient removal of filling material from root canal. The aim of this in vitro study was to compare the efficacy of reciprocating and continuous motion of four retreatment systems in removal of root canal filling material. Materials and Methods: Forty distal roots of the mandibular first molars teeth were used in this study, these roots were embedded in cold clear acrylic,roots were instrumented using crown down technique and rotary ProTaper systemize Sx to size F2 ,instrumentation were done with copiousirrigation of 2.5% sodium hypochlorite and 17% buffered solution of EDTA was used as final irrigant followed by distilledwater, roots were obturated with AH26 sealer and Prota

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Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Surgical Biopsy in Cervical Lymphadenopathy
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Background: Cervical lymph nodes are the most frequently enlarged and biopsied of all the peripheral lymph nodes and in most of the cases the enlargement results from benign infectious causes, however, the presence of cervical lymphadenopathy (LAP) requires accurate diagnosis to exclude more serious causes. The aim of this study was to analyze cases of Iraqi patients presenting with cervical LAP who underwent surgical lymph node biopsy to establish accurate diagnosis. Materials and Methods: This retrospective study included 25 patients who presented with cervical LAP for whom surgical biopsy was performed to establish a definitive diagnosis. The investigated data included the demographic and clinical parameters in addition to the final his

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Publication Date
Tue Sep 01 2020
Journal Name
Asian Journal Of Pharmacy And Pharmacology
Clinical manifestations and maternal outcomes of COVID-19 in pregnancy: A systematic review
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Publication Date
Sun Jan 01 2023
Journal Name
Rawal Medical Journal
Procalcitonin Level In COVID-19 Patients: A single center study
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Objective: The study the association of procalcitonin (PCT) and c-reactive protein (CRP) levels in COVID-19 patients and it's role as a guide in progress and management of those patients. Methodology: This cross-sectional study analyzed 200 CIOVID-19 patients in a single privet center in Baghdad, Iraq from January 1, 2021 to January 1, 2022. Demographic data like age, sex, and clinical symptoms were recorded. High sensitivity CRP and PCT in the serum were measured via dry fluorescence immunoassay (Lansionbio-China). Results: Out of 200 patients, 50 had moderate Covid and 150 had severe disease. Mean serum PCT levels was 0.039±0.05 ng/mL in the moderate group (range 0.011-0.067) and 0.43±0.21 ng/mL in the severe group (range 0.21

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of Educational And Psychological Researches
The Level of Computer Literacy of the Students at Al Quds Open University in Tulkarm Branch
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The purpose of this study is to assess the level of computer literacy of the students at AlQuds open university in Tulkarm Branch. The study investigates the effects of the variables of gender, specialization, academic level, owning a personal computer, internet communication, and own an email account on the level of computer literacy. A test of computer literacy was constructed by the researchers consisting of (37) multiple choice items with a reliability rate (0.85). The study population consisted of (4100) students, while the sample contained (352) students. The study revealed that the level of computer literacy of the students at AlQuds Open University in Tulkarm Branch was (66.2 %) which is educationally acceptable. It also

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Publication Date
Wed Nov 13 2019
Journal Name
Al-kindy College Medical Journal
Outcome Of Surgical Treatment Of Tuberculosis Of The Spine In Patients With Motor Deficits
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Background: Significant numbers of patients with spinal tuberculosis (TB), especially in developing countries, still present late after disease onset with severe neurological deficits.

Objective:This study was conducted to assess the outcome of surgery in patients with tuberculosis of the spine with motor deficits.

Type of the study: Retrospective study.

Methods: We retrospectively analyzed data obtained in all the patients with severe motor deficits due to spinal TB admitted to and surgically treated in four hospitals in Baghdad/Iraq during the period from January 2012 to January 2014. History, examination, imaging, histological, postoperative, a

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
Narrative infrastructure and its impact on building open and closed endings in the feature film
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The topic of the research tagged (narrative structure and its impact on building open and closed endings in the fictional film) is summarized by studying the mechanism of employing closed and open endings in the fictional film. novelist, then the need for it, as well as the objectives of the research and clarifying its limits as well as its importance. Then moving to the theoretical framework, which included three topics, where the first topic was entitled (the cinematic construction of the film narrative), either the second topic (the structure of complexity and narrative solutions), or the third topic dealt with the subject (the structure of the end and its relationship to the construction of the narrative). After completing the theore

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Publication Date
Thu Jun 25 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Comparing the Efficacy of Paracetamol, Diclofenac, and Ketorolac on Post-Appendectomy Outcomes in Children and Adolescents
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Abstract

urgent surgical intervention and appendectomy until now represent standard treatment for uncomplicated cases of appendicitis. Nausea, vomiting and pain after surgery are the most frequent issues facing patients and affecting patient quality of life and responsible for many cases of readmission after surgery. Ketorolac and diclofenac represent the most commonly prescribed non-steroidal anti-inflammatory used in postoperative setting and they cause many side effects as gastrointestinal, kidney and cardiac adverse effect in addition to increased risk of bleeding. Paracetamol is currently among the most frequently prescribed medication worldwide and it can be used safely for all age groups. This study aimed

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Publication Date
Mon Jan 01 2018
Journal Name
World Journal Of Dentistry
Factors affecting the Duration of Surgical Extraction of Impacted Mandibular Third Molars
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Aim The aim of this study is to evaluate the effect of demographic, clinical, and radiographic factors on the duration of surgical extraction of impacted lower third molars. Materials and methods This retrospective study included patients who underwent surgical removal of impacted lower third molars, and the investigated factors were demographic data including age and gender, radiographic data including the impacted tooth angulation and depth of impaction and ramus relation, and clinical data including the state of eruption of the impacted teeth. These factors were evaluated for association with the duration of surgery. Descriptive statistical analysis included percentages and mean ± standard deviation (SD). Student's t-test was used to co

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