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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 Sep 05 2021
Journal Name
Journal Of Arab Statistical Union (jasu)
Using Quality Control and 6-Sigma to Determine The Quality of The Treated Wastewater Discharged From Some Water Purification Plants
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Publication Date
Wed Jun 20 2018
Journal Name
Bulletin Of Iraq Natural History Museum
GENOTYPE VERSUS PHENOTYPE TO DETERMINE THE DEFINITIVE IDENTIFICATION OF THE GENERA CHLORELLA BEIJERINCK, 1890 (CHLORELLACEAE) AND COELASTRELLA CHODAT, 1922 (SCENDESMACEAE)
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Publication Date
Sun Jul 27 2025
Journal Name
Journal Of Physical Education
The Effect of Special Exercises on Developing Strength Endurance and Kayaking Achievement Time (500m) individually for the Advanced Kayak Athletes
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Publication Date
Fri Dec 30 2022
Journal Name
Voprosy Istorii
Changing the agricultural map of Diyala Governorate for the years (1980, 1990, 2000, 2010, 2020) using GIS and remote sensing
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Abstract. Geographical and remote sensing, which gave a picture of the change in the area of agricultural land in the study area for selected years (1980, 1990, 2000, 2010, 2020). In particular and Iraq in general, as this led to a reduction in the areas of agricultural lands and in return an increase in arid lands and their desertifica- tion and the loss of their productive value, which as a result leads to the migration of the population, the change of land sex, the failure to achieve food security and dependence on the import of the food basket.

Publication Date
Sun Jul 01 2018
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
GENOTYPE VERSUS PHENOTYPE TO DETERMINE THE DEFINITIVE IDENTIFICATION OF THE GENERA CHLORELLA BEIJERINCK, 1890 (CHLORELLACEAE) AND COELASTRELLA CHODAT, 1922 (SCENDESMACEAE)
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    Conventional identification of three coccoid green algae isolates was attempted to characterize the studied algae morphologically under compound microscope, which demonstrated confusional phenomenal convergence; all were classified microscopically as the green alga Chlorella vulgaris Beijerinck, 1890.

 

    Phylogenetic studies were conducted to settle the argument about the phenotype by studying the genotype. Genotype the promising field in advance classification by using 18S rRNA and compared to GenBank database using to search the related sequences. The determined sequences showed high a similarity to the strains registered in GenBank.

 

  &

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Publication Date
Mon Apr 01 2024
Journal Name
Iop Conference Series: Earth And Environmental Science
Studying some of the optimal conditionals for the best bacterial isolates from soil and its effects on their growth rates
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Abstract<p>The current study aimed to use some bacterial isolates from the local soil of Baghdad city by study the effects of temperature, pH and incubation period on the growth rates of isolated bacteria and choose the optimal conditions for their diversity and for understanding bacterial growth and their requirements for survival and proliferation. This information can be applied to obtain their high growth rate for use in various fields such as agriculture, medicine and environmental sciences in the future. And it used to assess the degree of variation in across bacteria species in pH, temperature and incubation period. A number of local bacterial isolates as <italic>Enterobacter cloacae</italic></p> ... Show More
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Publication Date
Tue Jan 30 2024
Journal Name
International Journal Of Engineering Pedagogy (ijep)
The Impact of Two Proposed Strategies Based on Active Learning on Students' Achievement at the Computer and Their Social Intelligence
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Active learning is a teaching method that involves students actively participating in activities, exercises, and projects within a rich and diverse educational environment. The teacher plays a role in encouraging students to take responsibility for their own education under their scientific and pedagogical supervision and motivates them to achieve ambitious educational goals that focus on developing an integrated personality for today’s students and tomorrow’s leaders. It is important to understand the impact of two proposed strategies based on active learning on the academic performance of first-class intermediate students in computer subjects and their social intelligence. The research sample was intentionally selected, consis

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Publication Date
Sat Aug 01 2015
Journal Name
Journal Of Engineering
Determination of the Optimum Conditions in Evaluation of Kiwi Juice as Green Corrosion Inhibitor of Steel in Hydrochloric Acid
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The corrosion protection of low carbon steel in 2.5 M HCl solution by kiwi juice was studied at different temperatures and immersion times by weight loss technique. To study the determination of the optimum conditions from statistical design in evaluation of a corrosion inhibitor, three variables, were considered as the most dominant variables. These variables are: temperature, inhibitor concentration (extracted kiwi juice) and immersion time at static conditions.

These three variables are manipulated through the experimental work using central composite rotatable Box – Wilson Experimental Design (BWED) where second order polynomial model was proposed to correlate the studied variables with the corrosion rate o

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Using of Index Biological Integrity of Phytoplankton (P-IBI) in the Assessment of Water Quality in Don River Section
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       The multimetric Phytoplankton Index of Biological Integrity (P-IBI) was applied throughout Rostov on Don city (Russia) on 8 Locations in Don River from April – October 2019. The P-IBI is composed from seven metrics: Species Richness Index (SRI), Density of Phytoplankton and total biomass of phytoplankton and Relative Abundance (RA) for blue-green Algae, Green Algae, Bacillariophyceae and Euglenaphyceae Algae. The average P-IBI values fell within the range of (45.09-52.4). Therefore, water throughout the entire study area was characterized by the equally "poor" quality. Negative points of anthropogenic impact detected at the stations are: Above the city of Rostov-on-Don (1 km, higher duct Aksai) was 38.57 i

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Influence of the basic elements of knowledge management in strategic performance/filed research sample of private banks in Baghdad
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objective  the research to diagnosis and interpretation of the nature of the effect between the  basic elements of knowledge management (tecgnology , structure , culture , process , human resource ) and the strategic performance of the Iraqi private banks, the research community and the level dimensions, and I've tested this research in the private banking sector represented by (7), especially in Baghdad, Iraqi banks, and applied research on sample consisting of 100 distributors in several administrative levels Director (Director, Director of the department, branch manager), and use the researcher questionnaire Head to collect data and information tool, and some private banks annual reports, has sought research to test

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