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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 Jun 01 2024
Journal Name
Iraqi Journal Of Physics
A Study the Addition of Silver Dioxide on Some Optical Properties of Phosphate Bioactive Glass
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This study investigates the influence of silver oxide (Ag2O) concentration on the optical characteristics of phosphate bioactive glasses (PBGs). PBGs have emerged as promising alternatives to conventional silicate glasses in the medical field due to their excellent bioactivity and chemical resistance. Samples with varying Ag2O concentrations (0, 0.25, 0.5, and 0.75g) were sintered at 780°C for 2 hrs in an electric furnace. The samples were subjected to Fourier transfer infrared spectroscopy (FTIR), ultraviolet-visible (UV-Vis) spectroscopy, and photoluminescence (PL) tests to assess their functional groups and optical properties. By analyzing the FTIR spectrum of phosphate bioactive glass containing different amounts of Ag2O, it is

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Publication Date
Thu Sep 01 2022
Journal Name
Brazilian Journal Of Chemical Engineering
A computational study on the potential application of Ca12O12 cluster for sensing of fungicide molecule
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Density functional theory calculations are employed to investigate the impact of edifenphos molecule on the reactivity and electronic sensitivity of pure calcium oxide (CaO) nanocluster. The strong adsorption of edifenphos molecule on CaO nanocluster occurs by the sulfur head of the adsorbate, and the amount of the energy of this adsorption is around − 84.40 kcal/mol. The adsorption of edifenphos molecules results in a decrease in the values of Eg of CaO from 4.67 to 3.56 eV, as well as an increase in the electrical conductance. Moreover, the work function of CaO nanocluster is significantly affected, which changes the current of the field emission electron. Eventually, the recovery time is calculated around 99 ms at ambient temperature f

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Publication Date
Sat Aug 31 2019
Journal Name
Iraqi Journal Of Physics
A Study of the Spectroscopic Performance of Laser Produced CdTe(x):S(1-x) Plasma
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Abstract

In this work, the plasma parameters (electron temperature (Te), electron density( ne), plasma frequency (fp) and Debye length (λD)) have been studied by using the spectrometer that collect the spectrum of Laser produce CdTe(X):S(1-X) plasma at X=0.5 with different energies. The results of electron temperature for CdTe range 0.758-0.768 eV also the electron density 3.648 1018 – 4.560 1018 cm-3  have been measured under vacuum reaching 2.5 10-2 mbar .Optical properties of CdTe:S were determined through the optical transmission method using ultraviolet visible spectrophotometer within the r

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Publication Date
Sun May 01 2022
Journal Name
Civil Engineering Journal
Phases of Urban Development Impact on the Assessment of Thermal Comfort: A Comparative Environmental Study
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Millions of pilgrims and visitors from numerous parts of the world flock to Karbala (one of the most prominent ideological and religious places in central Iraq) each year to visit the holy shrines in Karbala due to their sanctity. Many improvements have been made to the Two Holy Shrines (THS), the Shrines of Imam Husayn and Imam Abbas, and the area between them (ATHS), due to the high temperatures in this region and to improve pedestrian thermal comfort. Studies on improving outdoor thermal comfort in Karbala are scarce. Hence, this research aims to look into historical and current architectural changes and how they affect thermal comfort. On the hottest summer day, the ENVI-met software program was used to simulate the building des

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Publication Date
Sat Jan 01 2022
Journal Name
Lecture Notes In Civil Engineering
Evaluation the Level of Service of Signalized Intersection: Al-Amreia Intersection as a Case Study
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Abstract<p>One of the main element in the network is the intersection which consider as the critical points because there are many conflict in this element. The capability and quality of operation of an intersection was assessed to provide a better understanding of the network's traffic efficiency. In Baghdad city, the capital of/Iraq the majority of the intersections are operated under the congestion status and with level of service F, therefore theses intersection are consider as high spot point of delay in the network of Baghdad city. In this study we selected Al-Ameria signalized intersection as a case study to represent the delay problem in the intersections in Baghdad. The intersection is located in the w</p> ... Show More
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Publication Date
Sun May 01 2022
Journal Name
Civil Engineering Journal
Phases of Urban Development Impact on the Assessment of Thermal Comfort: A Comparative Environmental Study
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Millions of pilgrims and visitors from numerous parts of the world flock to Karbala (one of the most prominent ideological and religious places in central Iraq) each year to visit the holy shrines in Karbala due to their sanctity. Many improvements have been made to the Two Holy Shrines (THS), the Shrines of Imam Husayn and Imam Abbas, and the area between them (ATHS), due to the high temperatures in this region and to improve pedestrian thermal comfort. Studies on improving outdoor thermal comfort in Karbala are scarce. Hence, this research aims to look into historical and current architectural changes and how they affect thermal comfort. On the hottest summer day, the ENVI-met software program was used to simulate the building des

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Illegal migration and the European Union " a perusal of securing the phenomenon"
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Abstract This study seeks to deal academically with how the EU treats clandestine immigration, through adopting a purley security approach, based on the European understanding of security threats posed to the security of communities and States in EU at all levels. So they agreed upon criminalizing this threat within the bloc while using repressive tools and steps to limit illegal immigrants flow to European territories. Accordingly, the EU gave the phenomen a security character. So it takes it from low politics level , that of employment and economic field to that of high politics, as a new security problem lying within a new security language embraced by ruling European elites, in other words EU touched on this issue as a speech act emp

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
A Unit Plan Based Upon The MI Theory: A theoretical study with an application Inside The Classroom
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This research basically gives an introduction about the multiple intelligence
theory and its implication into the classroom. It presents a unit plan based upon the
MI theory followed by a report which explains the application of the plan by the
researcher on the first class student of computer department in college of sciences/
University of Al-Mustansiryia and the teacher's and the students' reaction to it.
The research starts with a short introduction about the MI theory is a great
theory that could help students to learn better in a relaxed learning situation. It is
presented by Howard Gardener first when he published his book "Frames of
Minds" in 1983 in which he describes how the brain has multiple intelligen

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Publication Date
Sat Dec 20 2025
Journal Name
Journal Of Sport Sciences
The school system and its relationship to the evolution of some indicators of physical and functional skills in a lesson and basketball
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Publication Date
Mon Feb 19 2018
Journal Name
Al-academy
The Mechanisms of build up the dramatic construction in the films of the world of nature - National Geographic's films as a model-
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The subject of  research entitled "The Mechanisms of build up the dramatic construction in the films of the world of nature - National Geographic's films as a model" emerges from the importance of the subject of the dramatic construction and its departure from its classic style due to the evolution of the visual  presentation and its instruments and the specificity and emergence of a form of television production represented by the films of the world of nature which began to occupy an important space in the map of television and television channels specialized in this subject, which drove the researcher to study the mechanisms of producing the dramatic construction in this kind of film s. This research came in three  chapt

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