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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 Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
The Use of English as Lingua Franca in the Classes of UKM: as A Case of Study
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           English has for long been one of the most widely used media of communication globally, especially in the Malaysian universities. It has been termed as a Lingua Franca because it is shared with other languages which are considered first languages by different speakers. For this reason, English as a Lingua Franca (ELF) has attracted a number of researchers to investigate its variety via other languages in various communities. The objective of this paper is therefore to establish the strategies which are employing by the international students at the National University of Malaysia/ UniversitiKebangsaan Malaysia (UKM) as an example of one of the Malaysian universities; when they e

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Publication Date
Sat Apr 01 2023
Journal Name
Full Text Book Of Minar Congress8
SECTION OF VETERINARY MEDICINE: MICROBIOLOGY, IMMUNITY AND VIROLOGY. THE BACTERIAL CONTAMINATION WITH PROTEUS AND E. COLI IN CERVIX AND UTERINE OF COWS DURING THE DIFFERENT ESTRUS PHASES
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The herein research was carried out in order to identified the presence of bacteria in cervix and uterine lumen in Iraqi cattle during the different estrus phase with focusing on Protus and E coli. Estrus phases were determined by the structures which found on ovary (follicular growth for pro-estrus, mature growing follicle for estrus, hemorrhagic corpus luteam for meta-estrus and active corpus luteam for di-eatrus). Forty cervical swabs (ten for each estrus phase) and forty uterine swabs (ten for each estrus phase) were taken from macroscopically healthy reproductive animals after slaughtering and cultivated on nutrient agar and blood agar, the bacterial isolation were identified with biochemical teats. The present study found that

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Solution of Nonlinear High Order Multi-Point Boundary Value Problems By Semi-Analytic Technique
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In this paper, we present new algorithm for the solution of the nonlinear high order multi-point boundary value problem with suitable multi boundary conditions. The algorithm is based on the semi-analytic technique and the solutions are calculated in the form of a rapid convergent series. It is observed that the method gives more realistic series solution that converges very rapidly in physical problems. Illustrative examples are provided to demonstrate the efficiency and simplicity of the proposed method in solving this type of multi- point boundary value problems.

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Publication Date
Tue May 01 2018
Journal Name
Iop Conference Series: Materials Science And Engineering
Evaluation of Electromagnetic Near-Field Measurement Technique as Non-Destructive Testing for Composite Structures
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Publication Date
Sun Jan 01 2023
Journal Name
8th Engineering And 2nd International Conference For College Of Engineering – University Of Baghdad: Coec8-2021 Proceedings
Preliminary quality assurance of printgrammetry technique-3D modeling from Google Earth 3D imagery data
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Publication Date
Tue Dec 01 2015
Journal Name
Second Engineering Scientific Conference
SEPARATION OF ALKALOIDS FROM PLANTS BY BULK LIQUID MEMBRANE TECHNIQUE USING ROTATING DISCS CONTACTOR
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This paper describes the transport of Alkaloids through Rotating Discs Contactor (RDC) using n-decane as a liquid membrane. The transport of Pelletierine Alkaloid from a source phase through bulk liquid membrane to the receiving phase has been investigated. The general behaviour of Pertraction process indicates that% Extraction of pelletierine Alkaloid increased with increase in the number of stages and the agitation speed but high agitation speed was not favoured due to the increased risk of droplet formation during the operation. The pH of source and receiving phases were also investigated. The effect of organic solvent membrane on the extraction of Pelletierine was evaluated using ndecane, n-hexane and methyl cyclohexane. The results sho

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Publication Date
Wed Dec 01 2021
Journal Name
Iraqi Journal Of Physics
Optical, Structural, Morphological Properties of Chromium (III) Oxide Nanostructure Synthesized Using Spray Pyrolysis Technique
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Nanostructure of chromium oxide (Cr2O3-NPs) with rhombohedral structure were successfully prepared by spray pyrolysis technique using Aqueous solution of Chromium (III) chloride CrCl3 as solution. The films were deposited on glass substrates heated to 450°C using X-ray diffraction (XRD) shows the nature of polycrystalline samples. The calculated lattice constant value for the grown Cr2O3 nanostructures is a = b = 4.959 Å & c = 13.594 Å and the average crystallize size (46.3-55.6) nm calculated from diffraction peaks, Spectral analysis revealed FTIR peak characteristic vibrations of Cr-O Extended and Two sharp peaks present at 630 and 578 cm-1 attributed to Cr-O “stretching

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Publication Date
Wed Jun 19 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Impact of the Knowledge Economy in the Tax Examination Survey: Study of A Simple of Auditors Views in the General Commission of Tax
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   The organizations and institutions of the developed countries have given attention to the subject of the knowledge economy by using advanced technology in the function of tax examination because of the important and effective role in ensuring the accuracy of the tax accounting process procedures, But the General Commission of taxes is still using traditional methods in the field of  tax examination which affects the performance of its work. This research aims to explain the level of effect on introducing advanced methods of Economics and knowledge represented by advanced communication technology in the field of practicing tax examination function in the General Commission of taxes, A questionnaire has been used as a mea

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Publication Date
Tue Jun 30 2015
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Raised excessive consumption on environment and price levels during the period 2005- 2013.: Raised excessive consumption on environment and price levels during the period 2005- 2013.
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When the financial resources of individuals and groups available, this will lead to increase the consumption ranges and sometimes reached to excessive especially to the categories that have little awareness about economic importance and its reflections. it seems that consumerism has increased in many countries including Iraq because of many factors, and the most important one is the availability of financial resources as a result of the increase in oil exports as well as the spread of consumption media department at various levels especially.

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Publication Date
Fri Jun 12 2026
Journal Name
Journal Of Physical Education
Strength Variable Analysis With the Height of Body Mass Center In High Spike Position 4 In Volleyball League Players
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