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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 Dec 06 2020
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Analysis and testing of the most important factors affecting (COVID-19)
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Factor analysis is distinguished by its ability to shorten and arrange many variables in a small number of linear components. In this research, we will study the essential variables that affect the Coronavirus disease 2019 (COVID-19), which is supposed to contribute to the diagnosis of each patient group based on linear measurements of the disease and determine the method of treatment with application data for (600) patients registered in General AL-KARAMA Hospital in Baghdad from 1/4/2020 to 15/7/2020. The explanation of the variances from the total variance of each factor separately was obtained with six elements, which together explained 69.266% of the measure's variability. The most important variable are cough, idleness, fever, headach

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Publication Date
Mon Sep 30 2002
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Modeling and Simulation of the Boilers at Al-Mussaib Thermal Station
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Publication Date
Sun Mar 06 2011
Journal Name
Baghdad Science Journal
The Relationships between Relatively Cancellation Modules and Certain Types of Modules
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Let R be a commutative ring with identity and M be unitary (left) R-module. The principal aim of this paper is to study the relationships between relatively cancellation module and multiplication modules, pure submodules and Noetherian (Artinian) modules.

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of Planner And Development
The Archtecture Of Holy Thresholds And Functionl Indicators For Its Development
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Obiovisly that the holy thresholds are directly related to Islam and Muslims and related to the general culture of the Islamic peoples. In terms of architecture, it is considered a distinctive architectural scene that reviews the history of this origin and its architectural styles. Recently, with the increase in the number of pilgrims and visitors to the holy shrines, there is a need to develop and expand the buildings and provide them with services and introduce modern technology. The building of the holy thresholds consists of a number of functional design indicators: The general problem of research is that there is no clear theoretical framework for the design indicators for the development of the holy shrines according to the functio

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Publication Date
Sat Aug 10 2024
Journal Name
Cureus
Machine Learning and Vision: Advancing the Frontiers of Diabetic Cataract Management
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Publication Date
Fri Nov 15 2024
Journal Name
Iraqi Journal Of Science
Investigating the Correlations between Physical Parameters of Elliptical and Lenticular Galaxies
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This study aims to investigate the features of stellar-gaseous kinematics and dynamics mass using scaling coefficient relationships (such as the Faber–Jackson relation (FJR)) of two samples of elliptical and lenticular galaxies. These two samples of 80 ellipticals and 97 lenticulars were selected from previous literature works. The Statistical Package for Social Sciences )SPSS( and Matrix Laboratory (MATLAB) program were used to find out the associations of multiple factors under investigation such as main kinematic properties of the gaseous-stellar (effective radius Re, surface density within the effective radius (Ʃeff) , stellar mass in the blue band (Mstar (B)), gas mass ( Mgas), dynamic (Mdyn) and baryonic (Mbar), supermassiv

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Publication Date
Fri Feb 12 2016
Journal Name
International Journal Of Applied Mathematical Research
The dynamics of nutrient, toxic phytoplankton, nontoxic phytoplankton and zooplankton model
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<p>The objective of this paper is to study the dynamical behavior of an aquatic food web system. A mathematical model that includes nutrients, phytoplankton and zooplankton is proposed and analyzed. It is assumed that, the phytoplankton divided into two compartments namely toxic phytoplankton which produces a toxic substance as a defensive strategy against predation by zooplankton, and a nontoxic phytoplankton. All the feeding processes in this food web are formulating according to the Lotka-Volterra functional response. This model is represented mathematically by the set of nonlinear differential equations. The existence, uniqueness and boundedness of the solution of this model are investigated. The local and global stability

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Publication Date
Mon Apr 14 2014
Journal Name
Elsevier Procedia Economics And Finance
Economic Growth and Foreign Direct Investment Inflows: The Case of Qatar
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Recently, Qatar, a well-known oil production country, has been convinced as a successful case in attracting foreign direct investment (FDI) as a smaller economy. This paper aims to investigate how FDI inflows affect Qatar’s business cycles. Time series data was selected from 1990 to 2010 as available. The VAR Impulse Responses and the Granger Causality test were mainly employed by using Eviews. The derived result shows that the FDI inflows and the economic growth in Qatar interact with each other in a relatively long term.

Publication Date
Wed May 01 2019
Journal Name
Journal Of Engineering
Postmodern Architecture between the pillars of philosophical discourse and architectural practice
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Postmodern arguments, formed a critic case of what modernity brought in several levels. Postmodern practice was considered as a proactive case having amorphous concepts and features to what entiled as an intellectual trends postmodern philosophically and intellectually. But, what postmodernism architecture broughts in it essence, was not isolation from the intellectual context and entrepreneurship case, and it was not disconnecting from the intellectual and philosophical era of that period. Lliteratures and philosophical argument precede what (Robert Venturi) and (Charles A Jencks) had brought, albeit it was closer to critics and correction the path of modernity from crystallizing a direction that exceeds modrinity to wh

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Publication Date
Sat Jul 19 2025
Journal Name
Advances In Life Science And Technology
The Effect of Preservatives and Freezing on Museum Saved Fish Samples
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Two means used for saving fish samples, namely Freezing and Preservatives represented by Alcohol and Formalin. The Freezing was used in saving samples collected newly, in addition to use Alcohol and Formalin with different concentrations 70% of Alcohol and 10% of Formalin. The concentrations of some heavy metal elements were examined, such as Potassium, Phosphorus, Calcium, Manganese, Magnesium, Zinc, Iron, Copper and Boron in samples saved in Formalin and Alcohol and frozen at different durations. The concentration of some elements has been changed during the saving duration. The study was performed on the concentration of heavy elements in the Liza abu muscles of saved and frozen fish.

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