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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
Sat Jan 01 2022
Journal Name
Middle East African Journal Of Ophthalmology
Obstacles and challenges facing Iraqi women ophthalmologists
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Publication Date
Mon Dec 22 2025
Journal Name
Journal Of Economics And Administrative Sciences
The role of public relations in enhancing the quality of governmental service-a Field study in the Iraqi Airlines
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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The role of public relations in enhancing the quality of governmental service-a Field study in the Iraqi Airlines
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Abstract
        The research has discussed the public relations as dependent variable of its branch dimensions( confidence , commitment, control and satisfaction ) and the governmental service quality as independent variable of its branch dimensions (response, dependency, emphasis, tangibility and sympathy), and the research problem has represented by weakness of service quality presented to the customers dealing with company, which is observed via  field co-existence of the researcher, where he observe that the quality presented in the company services, are inappropriate with the customers expectations level, also there is weakness of attention and recognition by the

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Publication Date
Wed Oct 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The impact properties of strategic thinking in the stages of the application Business process re-engineering: A survey Study of the consultant of a sample of managers and their assistants and consultants in the General Company for Cotton Industries
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Need organizations today to move towards strategic thinking which means analyzing situations faced by particular challenges of change in the external environment, which makes it imperative for The Organization That to reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures, to try to achieve improvement root in the installation of the organization and methodscompletion of its work towards achieving high levels of performance and that is reflected to achieve its objectives, and this is what aims to Current search to deal with implications characteristics of strategic thinking in the stages of application re-engineering business of the company General Industries

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Publication Date
Wed Jun 01 2022
Journal Name
Iraqi Journal Of Physics
Synthesis and Characterization of Ternary BexZn1-xO Nano Thin Films prepared by Pulsed Laser Deposition Technique
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         Beryllium Zinc Oxide (BexZn1-xO) ternary nano thin films were deposited using the pulsed laser deposition (PLD) technique under a vacuum condition of 10-3 torr at room temperature on glass substrates with different films thicknesses, (300, 600 and 900 nm). UV-Vis spectra study found the optical band gap for Be0.2Zn0.8O to be  (3.42, 3.51 and 3.65 eV) for the (300, 600 and 900nm) film thicknesses, respectively which is larger than the value of zinc oxide ZnO (3.36eV) and smaller than that of beryllium oxide BeO (10.6eV). While the X-ray diffraction (XRD) pattern analysis of ZnO, BeO and Be 0.2 Zn 0.8 O powder and nano-thin films indicated a hexa

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Structural and Optical Properties of Cobalt-Doped Zinc Oxide Thin Films Prepared By Spray Pyrolysis Technique
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Undoped and Co-doped zinc oxide (CZO) thin films have been prepared by spray pyrolysis technique using solution of zinc acetate and cobalt chloride. The effect of Co dopants on structural and optical properties has been investigated. The films were found to exhibit maximum transmittance (~90%) and low absorbance. The structural properties of the deposited films were examined by x-ray diffraction (XRD). These films, deposited on glass substrates at (400? C), have a polycrystalline texture with a wurtzite hexagonal structure, and the grain size was decreased with increasing Co concentration, and no change was observed in lattice constants while the optical band gap decreased from (3.18-3.02) eV for direct allowed transition. Other parameters

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Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
Structure dependence of gamma ray irradiation effects on polyurethane and epoxy resin studied by PAL technique
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Positron annihilation lifetime (PAL) technique has been employed to
study the microstructural changes of polyurethane (PU), EUXIT 101
and epoxy risen (EP), EUXIT 60 by Gamma-ray irradiation with the
dose range (95.76 - 957.6) kGy. The size of the free volume hole and
their fraction in PU and EP were determined from ortho-positronium
lifetime component and its intensity in the measured lifetime spectra.
The results show that the irradiation causes significant changes in the
free volume hole size (Vh) and the fractional free volume (Fh), and
thereby the microstructure of PU and EP. The results indicate that
the γ-dose increases the crystallinity in the amorphous regions of PU
and increas

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Publication Date
Sun Mar 01 2020
Journal Name
Plant Archives
Thermodynamic and kinetic analysis of Basic green-4 dye Removal from aqueous solutions using adsorption technique
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In this work, a local sunflower husk (SFH) was used as a natural surface for removing Basic Green-4 (BG4) dye, as a watersoluble pollutant. The effect of initial concentration, contact time, the mass of surface of the dye with the SFH as well as the medium temperature was studied. The application of Langmuir, Freundlich isotherms on the collected data of the adsorption process found to harmonize to Freundlich equation more than that of Langmuir. However, the adsorbed mass of BG4 dye showed a direct increase with the increase of SFH mass and equilibrium was achieved within a 60min window. The interaction of BG4 with SFH surface was spontaneous and exothermic. The empirical kinetic outcomes at ambient temperatures were applied to pseudo 1st a

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Publication Date
Sat Dec 31 2011
Journal Name
Al-khwarizmi Engineering Journal
Using of Coating Technique by Inorganic Flame Retardants to Protect Civil and Industrial Foundations from Fires
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   In the present research the flame retardancy to  buildings and industrial foundations which are manufacturing from advanced polymeric  composite material was increased by coating it with surface layer included flame retardant material.  A(3mm) thick antimony tetroxide was used as a coated layer to retard and prevent the flame spread to the coating surface of polyester resin (SIROPOL 8340-PI) reinforced with hybrid fibers as a woven roving (°45-°0) consist of carbon and kevlar (49) fibers, and exposed it to direct flame generated from gas torch at temperature of (2000ºC), at  different exposed distance (10,15,20mm)and study the rang of resistance for this layer and its ability to protec

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Publication Date
Tue Oct 30 2018
Journal Name
Iraqi Journal Of Physics
Annealing effects on optical and structural properties of chromium oxide thin film deposited by PLD technique
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Optical properties of chromium oxide (Cr2O3) thin films which were prepared by pulse laser deposition method, onto glass substrates. Different laser energy (500-900) mJ were used to obtain Cr2O3 thin films with thickness ranging from 177.3 to 372.4 nm were measured using Tolansky method. Then films were annealed at temperature equal to 300 °C. Absorption spectra were used to determine the absorption coefficient of the films, and the effects of the annealing temperature on the absorption coefficient were investigated. The absorption edge shifted to red range of wavelength, and the optical constants of Cr2O3 films increases as the annealing temperature increased to 300 °C. X-ray diffraction (XRD) study reveals that Cr2O3 thin films are a

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