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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 Apr 03 2013
Journal Name
Iraqi Journal Of Medical Sciences
Ligasure versus clamp and tie technique to achieve henostasis in thyroidectomy for benign diseases
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Publication Date
Mon Feb 01 2016
Journal Name
Al-academy
Impact organization of configuration for still life in paintings of first grade students for department of Art Education in subject of colors: احمد مطشر لطيف السبتي
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Problem of research as defined, including the following:what is impact organizing of configuration for still life in paintings of students in the Department of Art Education in subject of colors ?Study of well training for organized in painting of still life is necessary for a teacher of art education to contribute effectively to the performance of his letter, so is this research in response to the public goals for a subject of art education. The current research aims to:1. Impact organization of configuration for still life in paintings of students in the Department of Art Education for the first grade in subject of colors2. Role organization of configuration for still life in the painting to serve the educational process in subject of

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Publication Date
Sun Nov 20 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
ISOLATION AND IDENTIFICATION OF BACTERIA THAT PRODUCE AMYLASE: ISOLATION AND IDENTIFICATION OF BACTERIA THAT PRODUCE AMYLASE
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Thirty six bacteria were isolated from various sourcesc (soil, starch, cooked rice and other foods) and subjected to a series of primary screening tests to obtain the optimal isolation to production of amylase. The volume of producing zone by logal indicator for (Seven) isolates of the secondary screening by measuring the enzymatic activity and specific enzymatic activity. The isolate A4 was found to be the most efficient for production of amylase. Then this isolate was diagnosed through microscopic, vitek 2 system technique. in addition by gentic diagnesis through gene 16s of the genes nitrogen bases by use the polymerase chain reaction (PCR) which reached 1256 bases. In comparison to the available information at the National Center for

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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of the performance of some r- (k,d) class estimators with the (PCTP) estimator that used in estimating the general linear regression model in the presence of autocorrelation and multicollinearity problems at the same time "
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In the analysis of multiple linear regression, the problem of multicollinearity and auto-correlation drew the attention of many researchers, and given the appearance of these two problems together and their bad effect on the estimation, some of the researchers found new methods to address these two problems together at the same time. In this research a comparison for the performance of the Principal Components Two Parameter estimator (PCTP) and The (r-k) class estimator and the r-(k,d) class estimator by conducting a simulation study and through the results and under the mean square error (MSE) criterion to find the best way to address the two problems together. The results showed that the r-(k,d) class estimator is the best esti

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Publication Date
Wed Jul 17 2024
Journal Name
Journal Of Optics
Influence of concentration on optical and structural properties of zinc sulfide films using spray pyrolysis technique
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Publication Date
Sun May 01 2016
Journal Name
Journal Of Engineering
Prediction of Ryznar Index for the treated water from WTPs on Al-Karakh side of Baghdad City using Artificial Neural Network (ANN) technique
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In this research an Artificial Neural Network (ANN) technique was applied for the prediction of Ryznar Index (RI) of the flowing water from WTPs in Al-Karakh side (left side) in Baghdad city for year 2013. Three models (ANN1, ANN2 and ANN3) have been developed and tested using data from Baghdad Mayoralty (Amanat Baghdad) including drinking water quality for the period 2004 to 2013. The results indicate that it is quite possible to use an artificial neural networks in predicting the stability index (RI) with a good degree of accuracy. Where ANN 2 model could be used to predict RI for the effluents from Al-Karakh, Al-Qadisiya and Al-Karama WTPs as the highest correlation coefficient were obtained 92.4, 82.9 and 79.1% respectively. For

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Publication Date
Fri Jan 01 2021
Journal Name
Aip Conference Proceedings
A study of the safety and security conditions followed in the X-ray clinics in the Al-Amiriya-Baghdad
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Publication Date
Thu Feb 07 2019
Journal Name
Iraqi Journal Of Laser
Investigation of Size-dependent Nonlinearity of Ag Nano-Fluids using Self-defocusing Technique
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In this work, the effect of different particle size on the nonlinear optical properties of silver nanoparticles in de-ionized water was studied. The experimental observation of the far field diffraction patterns by CCD camera in two and three dimensions. The maximum change of nonlinear refractive index and the relative phase shift were calculated. The self-defocusing technique was used with a continuous-wave radiation from DPSS Blue laser .The wavelength is 473 nm with an output power of 270 mW. All the Ag colloids samples containing the sizes 15, 30, 50, and 70 nm of silver nanoparticles used in the study were chemically prepared. It was found that the nonlinear refractive index is a particle size dependent and of the order of 10-7 cm2/

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Role of the School Garden, and its Importance in the school Building - A field study in the social school service
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This research concerns the fact of the school garden and how can we tackle this issue. The research starts with a question forwarded to those who are interested in the ministry of education matters; the question is that how is the extent of interest in the school garden project? And how it is activated in the Iraqi Educational Institution program? In addition, the analysis reveals the importance of the school garden since we, as teachers and students, suffer from seeing the view of the trashes, the wastes of school furniture, the stinking water and the weeds and how it is accumulated in the back yard of the school. To add fuel to the fire, the increase in number of the students; year after year. This increase leads to adding more classes

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Publication Date
Fri Mar 29 2024
Journal Name
مجلة العلوم التربوية والنفسية
Needs in the stories of the Brothers Grimm (a study in content analysis)
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The current study aims to identify the needs in the stories of the Brothers Grimm. The research sample consisted of (3) stories, namely: 1- The story of the Thorn Rose (Sleeping Beauty) 2- The story of Snow White 3- The story of Little Red Riding Hood. The number of pages analyzed reached (15.5) pages, and to achieve the research objectives, Murray's classification of needs was adopted, which contains (36) basic needs that are further divided into (129) sub-needs. The idea was adopted as a unit of analysis and repetition as a unit of enumeration, Reliability was extracted in two ways: 1- Agreement between the researcher and himself over time, where the agreement coefficient reached 97%. The second was agreement between the researcher and tw

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