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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
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
University Strategic Planning Necessary to Invest the Outputs of the Distinguished Schools
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The seventh international scientific conference held at the "University of Baghdad" College of Education "Ibn Rushd" 14-15 / 4/2019, confirmed in its recommendations the need to draw clear strategic planning to invest the qualitative inputs from the Ministry of Education and focus on it in higher education, which requires educational institutions to amend from its current strategies or adopting new strategies in a way that contributes to presenting new ways to compete and keep pace with scientific progress and to find realistic and objective working methods. The aim of the current study is to identify the reality of university strategic planning to invest the outputs of the distinguished schools of the heads of public universities. The r

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The role of the Islamic Development Bank Group on Economic Capacity Building
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This paper reflects the evidence of the Islamic Development Bank's role in building human and institutional capacities in Member States and assisting governments in achieving economic development. The Bank's activities in the area of ​​capacity development are an important part in following up the economic developments, And help governments to build and formulate effective policies and institutions to implement more effective macro policies leading to better economic outcomes. It is therefore helpful to help Member States increase their resources, modernize their banking systems, establish effective legal frameworks and improve Reports on macroeconomic and financial statistics. The Bank has faced many challenges and risks tha

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Educational And Psychological Researches
The level of school students understand the basic mathematical concepts Engineering Preparation
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This study aims at recognizing the levels of comprehension of the students of basic schools to the concepts of mathematical geometric and discovering the existing of the differences among students in the level of understanding of the concepts of mathematical geometrical which is due to the change of gender.

The sample of the study is the students of Basic schools, eight level in the basic school of Erbil city, particularly 7-8-and 9 levels in the academic year 2013-2014. The sample consists of 444 students in both genders238 males and 206 females.

The tool of the study is test sheet included 20 items of multiple choice.  The items are valid since are given to a jury of expert

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Publication Date
Tue Jan 01 2013
Journal Name
Iraqi Journal Of Physics
Describing the Wavefront Aberrations of the Hexagonal Aperture Using Modified Zernike Polynomials
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n Segmented Optical Telescope (NGST) with hexagonal segment of spherical primary mirror can provide a 3 arc minutes field of view. Extremely Large Telescopes (ELT) in the 100m dimension would have such unprecedented scientific effectiveness that their construction would constitute a milestone comparable to that of the invention of the telescope itself and provide a truly revolutionary insight into the universe. The scientific case and the conceptual feasibility of giant filled aperture telescopes was our interested. Investigating the requirements of these imply for possible technical options in the case of a 100m telescope. For this telescope the considerable interest is the correction of the optical aberrations for the coming wavefront, th

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Publication Date
Tue Mar 15 2016
Journal Name
Applied Research Journal
ESTIMATE THE RATIO OF TOTAL DISSOLVED SALTS FROM THE HYDROMETER TEST RESULTS
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Publication Date
Wed Dec 18 2019
Journal Name
Baghdad Science Journal
Modeling Human Capital Impact on the Development of the Iraqi Oil Industry
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Iraq has the second largest proven oil reserves in the world. According to oil experts, it is expected that the Iraq's reserves to rise to 200+ billion barrels of high-grade crude.

Oil is a strategic commodity for producing and exporting countries in general, and Iraq in particular, as demonstrated by the international experience that oil is an important means to achieve economic growth, an important tool in the overall economic, social and political development. It is also an important source of hard currency for any national economy and a means to connect the local economy and the global economy. In this paper we focus our attention on selecting the best regression model that explain the effect of human capita

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Publication Date
Mon Oct 01 2018
Journal Name
Iraqi Journal Of Physics
SiO2 particles effect on the mechanical properties of the starch/PVA blends
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The present work studies the mechanical properties of SiO2 μPs, and NPs in St/PVA blends. The samples were prepared by casting method as PVA, St/PVA blends at different concentrations (30, 40, 50, and 60 %). DSC and TGA tests were carried out to the samples evolved. The result showed a single glass transition temperature (Tg) for all St /PVA blends that was attributed to the good miscibility of the blends involved. It was found that (Tg) decrease with starch ratio increase. It was seen that (PVA) of (Tg=105 oC); The glass transition temperature which was decrease with starch ratio that was attributed to glass transition relaxation process due to micro-Brownian motion of the main chain back bond. The endothermic peak at 200 oC was attrib

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Publication Date
Mon Oct 01 2018
Journal Name
Civil Engineering Journal
Developing Water Quality Index to Assess the Quality of the Drinling Water
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In the present study, an attempt has been to develop a new water quality index (WQI) method that depends on the Iraqi specifications for drinking water (IQS 417, 2009) to assess the validity of the Euphrates River for drinking by classifying the quality of the river water at different stations along its entire reach inside the Iraqi lands. The proposed classifications by this method are: Excellent, Good, Acceptable, Poor, and Very poor. Eight water quality parameters have been selected to represent the quality of the river water these are: Ion Hydrogen Concentration (pH), Calcium (Ca), Magnesium (Mg), Sodium (Na), Chloride (Cl), Sulphate (SO_4), Nitrate (NO_3), and Total Dissolved Solids (TDS). The variation of the water quality parameters

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
The shapes of adjacent structures for informing the stage show for children
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This research talked about the importance of adjacent structures for informing the stage show for children. The researcher began from the importance of adjacent structures for informing the show to introduce the various and different proofs, on the level of creativity and artistic shape of the accomplishment over it’s shifts that contribute to formation the show and it's intellectual, artistic, technical and cognitive Marks that contribute in dynamism the interactive show and contact the idea that connect with the design and directional vision for the beauty and cognitive. Lead to the eager operation in attention, sensitive and attractive the child. The research consist of four chapters: The first chapter include methodological framewo

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Use of Replacement Models On Determine the Optimal Time to Replacement
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Abstract:-

            The approach maintenance and replacement one of techniques of operations research whom cares of the failure experienced by a lot of production lines which consist of a set of machines and equipment, which in turn exposed to the failure or work stoppages over the lifetime, which requires reducing the working time of these machines or equipment below what can or conuct  maintenance process once in a while or a replacement for one part of the machine or replace one of the machines in production lines. In this research is the study of the failure s that occur in some parts of one of the machines for the General Company for Vege

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