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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
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
Outcome of surgical treatment of highgrade intramedullary astrocytomas
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Background: Intramedullary astrocytomas
account for about 1% of all CNS tumors and
6–8% of spinal cord tumors. The vast majority
of intramedullary astrocytomas are slowgrowing
lesions.
Objectives: The goal in this study was to
review a series of patients who underwent
surgical removal of intramedullary high-grade
astrocytomas, focusing on the functional
outcome and the effect of multimodality
treatment on the survival of patients with high
grade intramedullary astrocytoma.
Methods: Between June 1999 and June 2004,
22 patients underwent removal of
intramedullary high-grade astrocytomas in four
neurosurgical hospital in Baghdad/ Iraq
(Neurosurgical hospital, Al Shaheed Adnan
Hospital for

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Publication Date
Sun Nov 27 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
open-source enterprise resource planning system Odoo roll in rationalizing the costs of the Ishtar Sheraton Hotel/ applied research
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The Accommodation industry in Iraq suffers from many problems, especially after 2003, when the Accommodation industry was exposed to many crises due to the security and political situation in Iraq, which negatively affected the administrative operations inside the industry and created many problems, the most important of which are deterioration, high costs and poor performance, so some hotel administrations sought To find alternative solutions that help in the advancement of hotels, one of the proposals is to go to technology, as technology is currently one of the most important solutions to solve large complex problems, as the world has turned to automation to solve complex problems such as increasing production, reducing costs, and rai

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Publication Date
Thu Apr 20 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Nano SC-Open Sets in Nano Topological Spaces
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The objective of this paper is to define and introduce a new type of nano semi-open set which called nano -open set as a strong form of nano semi-open set which is related to nano closed sets in nano topological spaces. In this paper, we find all forms of the family of nano -open sets in term of upper and lower approximations of sets and we can easily find nano -open sets and they are a gate to more study.  Several types of nano open sets are known, so we study relationship between the nano -open sets with the other known types of nano open sets in nano topological spaces. The Operators such as nano -interior and nano -closure are the part of this paper.

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Publication Date
Sat Feb 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Performance of piled raft foundations under the effect of dewatering nearby an open pit
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Abstract<p>The dewatering arrangement is required in execution works and it needs more attention due to the additional vertical settlement produced on the adjacent pile foundations. Raft foundations are being increasingly utilized for construction in cases of subsoil conditions with a high water table. Also, soil displacements in adjacent un-braced deep open pit may be a reason for high damages to the close buildings and foundations systems. The aim of this study is to examine the behaviour of piled raft foundations considering different pile locations under the effect of line drain and stage drilling of nearby open foundation pit. The line drain was used as dewatering process through the soil i</p> ... Show More
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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Using Factor Analysis In Determine the Important Influenced Factors In Student Outcomes Pheonema From Primary School In The Province Of Baghdad
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Abstract

The Purpose of This Research is The  Main Factors  In out Comes Phenomena From Primary School Which in Creased in Lost Period in Iraq And to Find Solutions to The This Problem.

In Order to Achieve Al The Aim The Research Choose a Systematic Random Sample of School Records For Students in Some Primary Schools in Karkh and Rusafa and Year of Study (2010-2015) and Size (40) Samples, included  (16) Variable , Collected in Form Prepared by The Research As a Way to Analyze The Data.

Remember to Summarize The (6) Main components Pay a Student to Drop out of Primary Schools in The Province of Baghdad are Arranged As Follows:

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Publication Date
Sat Apr 29 2023
Journal Name
International Journal Of Biomaterials
The Influence of the Hyaluronic Acid Gel on the Postoperative Sequelae following Surgical Removal of the Impacted Mandibular Third Molar in Comparison with the A-PRF: A Randomized Controlled Trial
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One of the most common procedures in oral surgery is the removal of impacted mandibular third molars, often followed by pain, swelling, alveolitis, and trismus. Purpose. To compare the outcomes of the intrasocket application of 1% hyaluronic acid oral gel (HA) and advanced platelet-rich fibrin (A-PRF) on the expected postoperative complications, pain, swelling, and trismus follow the surgical extraction of the impacted mandibular third molar. Material and Methods. A randomized controlled trial was conducted at the Oral and Maxillofacial Surgery Unit, Dental Teaching Hospital. Healthy patients who required surgical removal of the impacted mandibular third molar were divided randomly into three groups. The extraction site of the group

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Publication Date
Sun Nov 01 2020
Journal Name
Systematic Reviews In Pharmacy
Systematic Reviews in Pharmacy | open access Journals
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Systematic Reviews in Pharmacy is a monthly Peer-review open access Journal,different scientists involved in Pharmaceutical research and development

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Publication Date
Sun Jun 21 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Enhancement of Aqueous Solubility and Dissolution Rate of Etoricoxib by Solid Dispersion Technique
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Etoricoxib (EXB) is a highly selective cox-2 inhibitor which belongs to the non-steroidal anti-inflammatory drug (NSAID). EXB is a class II drug according to the biopharmaceutical classification system (BCS), which possess a very low aqueous solubility in water.  In the present study, many trials were made to improve the aqueous solubility and dissolution rate of EXB by solid dispersion technique.

Eighteenth EXB formulas were formulated as a solid dispersion using a variety of hydrophilic polymers (as carriers)   including poloxamer 407 (PXM 407), poloxamer 188 (PXM 188) and polyethylene glycol 4000 (PEG 4000) at different drug: polymer ratios (1:1, 1:3 and 1:5). These formulas were prepared by two methods; solvent

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Publication Date
Fri Jun 04 2021
Journal Name
Journal Of Interdisciplinary Mathematics
Employ shrinkage technique during estimate normal distribution mean
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Publication Date
Fri Jan 01 2016
Journal Name
International Archives Of Medicine
The role of MRI in the diagnosis of intra articular knee derangement: A prospective study
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