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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
Fri Mar 07 2025
Journal Name
Jurnal Keperawatan Soedirman
THE EFFECTS OF MUSIC INTERVENTIONS ON CHILDREN'S PAIN SEVERITY AND ANXIETY DURING DRESSING CHANGES IN IRAQ: A RANDOMIZED CONTROLLED TRIAL
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Abstract Daily dressing changes cause distress and pain for victims of burn injuries. The study aimed to determine the effect of music in reducing the pain and anxiety of thermally burned children during routine dressing changes. This quantitative study employed a randomized controlled trial design. The participants comprised 80 children at the Specialized Burns Hospital, in Baghdad, Iraq who were divided into two groups. The intervention group were exposed to three generic musical pieces (children’s music, nature sounds, and classical music) for 10-15 minutes. The researchers used the Objective Pain Scale, State-Trait Anxiety Inventory, and physiological parameters to measure the children’s responses immediately before the dressing cha

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Publication Date
Fri Mar 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Accounting achievement and its impact on the measurement of operational efficiency: Applied research in the company of refineries Center / Al-Doura refinery
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The issue of measurement of operational efficiency and productivity plays a major role in determining the weakness of the company, especially in relation to the productive processes, and thus starting to address these points and improve their performance. Hence the problem of research on how to determine the constraints in the production process, to identify weaknesses in the company. The research aims to clarify the role of throughput accounting in measuring the operational efficiency of the company in addition to clarify some of the constraints and causes behind them. The study concluded a set of conclusions, the most important of which is the availability of throughput accounting indicators that help in measuring operational efficienc

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the relationship between Government spending compression and the window of the currency and its impact on the exchange rate of the Iraqi dinar
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The exchange rate is the backbone of  any economy in the world, whether  developed or developing, where most countries adopted  many policies, in order to ensure the stability of the exchange rate of the currency, because of its importance as a link between the local economy and the others ,And it contribute in the achievement of internal and external balance and despite the many different factors that affect it, but there is wide consensus on the effectiveness of the role of spending and the currency window in the exchange rate of the Iraqi dinar, especially in the Iraqi economy, effectiveness As the increase in government spending lead to an increase in the supply of money and increase domestic demand and high pr

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Publication Date
Tue Aug 06 2013
Journal Name
Robotica
Function approximation technique-based adaptive virtual decomposition control for a serial-chain manipulator
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SUMMARY<p>The virtual decomposition control (VDC) is an efficient tool suitable to deal with the full-dynamics-based control problem of complex robots. However, the regressor-based adaptive control used by VDC to control every subsystem and to estimate the unknown parameters demands specific knowledge about the system physics. Therefore, in this paper, we focus on reorganizing the equation of the VDC for a serial chain manipulator using the adaptive function approximation technique (FAT) without needing specific system physics. The dynamic matrices of the dynamic equation of every subsystem (e.g. link and joint) are approximated by orthogonal functions due to the minimum approximation errors produced. The contr</p> ... Show More
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Publication Date
Mon Aug 01 2022
Journal Name
Baghdad Science Journal
A Novel Technique for Secure Data Cryptosystem Based on Chaotic Key Image Generation
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The advancements in Information and Communication Technology (ICT), within the previous decades, has significantly changed people’s transmit or store their information over the Internet or networks. So, one of the main challenges is to keep these information safe against attacks. Many researchers and institutions realized the importance and benefits of cryptography in achieving the efficiency and effectiveness of various aspects of secure communication.This work adopts a novel technique for secure data cryptosystem based on chaos theory. The proposed algorithm generate 2-Dimensional key matrix having the same dimensions of the original image that includes random numbers obtained from the 1-Dimensional logistic chaotic map for given con

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Measuring and analysing inequality in the Distribution of Economic Welfare in Suleimania Governorate during (2007):
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Abstract

 The issue of inequality in distribution of income and / or consumption expenditure is related to economic welfare because there is an inverse relationship between the economic welfare on the one hand, and the degree of inequality, on the other hand. Despite the fact that inequality is considered as normal phenomenon in every society, but if it exceeded certain limits it will lead to undesirable economic, social and political consequences. Therefore, the availability of indicators about inequality is a necessary tool for planning and evaluation of economic development programs. So, current study is aiming at measuring and analyzing the degree of inequality in distribution of consumpti

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Publication Date
Wed Apr 07 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology,
The Clinical Effect of Super Oxidized Water Mouthwash on The Periodontal Parameters (Plaque Index, Gingival Index And Bleeding on Probing) for Patients with Dental Biofilm Induced Gingivitis
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Publication Date
Mon Aug 04 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of ER: YAG laser on enamel resistance to caries during orthodontic treatment: An in vitro study
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Background: One common undesirable side effect of orthodontic treatment with fixed appliances is the development of incipient caries lesions around brackets, particularly in patients with poor oral hygiene. Different methods have been used to prevent demineralization; the recent effort to improve the resistance against the demineralization is by the application of lasers. Materials and method: Thirty human premolars extracted for orthodontic purposes were used to test the effect of two energy level of ER-YAG laser on enamel resistance to demineralization. The brackets were bonded on the teeth and all the labial surface excluding 2 mm area gingival to the brackets were painted with acid resistance varnish. Three groups were generated. The fi

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Publication Date
Wed Aug 15 2018
Journal Name
Al-khwarizmi Engineering Journal
Experimental and Simulation investigations of Micro Flexible Deep Drawing Using Floating Ring Technique
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Micro metal forming has an application potential in different industrial fields. Flexible tool-assisted sheet metal forming at micro scale is among the forming techniques that have increasingly attracted wide attention of researchers. This forming process is a suitable technique for producing micro components because of its inexpensive process, high quality products and relatively high production rate. This study presents a novel micro deep drawing technique through using floating ring as an assistant die with flexible pad as a main die. The floating ring designed with specified geometry is located between the process workpiece and the rubber pad. The function of the floating ring in this work is to produce SS304 micro cups with profile

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Publication Date
Fri Nov 29 2019
Journal Name
Iraqi Journal Of Physics
Morphological and optical properties of V2O5:TiO2 thin film prepared by PLD technique
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              In this work, pure and doped Vanadium Pentoxide (V2O5) thin films with different concentration of TiO2 (0, 0.1, 0.3, 0.5) wt  were obtained using Pulse laser deposition technique on amorphous glass substrate with thickness of (250)nm. The morphological, UV-Visible and Fourier Transform Infrared Spectroscopy (FT-IR) were studied. TiO2 doping into V2O5 matrix revealed an interesting morphological change from an array of high density pure V2O5 nanorods (~140 nm) to granular structure in TiO2-doped V2O5 thin film .Transform Infrared Spectro

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