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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
Al-academy
Designing Interactive Educational Website for Highschool Students in Iraq: أحمد ناجي علي-يوسف مشتاق لطيف
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       publishing has become a large space in the field of interactive education and modern  pages have become dedicated to the service of the educational effort in this area as the research in this context of the urgent scientific necessities, especially as we consider in Iraq from the new countries in the exploitation of these new technologies and investment possibilities of the information network And the contents of different in the framework of so-called distance education Here lies the problem of research in the possibility of finding scientific solutions for the design of interactive inter active website for students of the preparatory stage in Iraq and to find out the scientific ways to find des

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Publication Date
Sun May 27 2018
Journal Name
Journal Of Advanced Transportation
Accident Management System Based on Vehicular Network for an Intelligent Transportation System in Urban Environments
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As cities across the world grow and the mobility of populations increases, there has also been a corresponding increase in the number of vehicles on roads. The result of this has been a proliferation of challenges for authorities with regard to road traffic management. A consequence of this has been congestion of traffic, more accidents, and pollution. Accidents are a still major cause of death, despite the development of sophisticated systems for traffic management and other technologies linked with vehicles. Hence, it is necessary that a common system for accident management is developed. For instance, traffic congestion in most urban areas can be alleviated by the real-time planning of routes. However, the designing of an efficie

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Publication Date
Tue Jun 01 2021
Journal Name
Baghdad Science Journal
Ammonia Removal in Free-Surface Constructed Wetlands Employing Synthetic Floating Islands: Employing synthetic floating islands
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Free water surface constructed wetlands (FSCWs) can be used to complement conventional waste water treatment but removal efficiencies are often limited by a high ratio of water volume to biofilm surface area (i.e. high water depth). Floating treatment wetlands (FTWs) consist of floating matrices which can enhance the surface area available for the development of fixed microbial biofilms and provide a platform for plant growth (which can remove pollutants by uptake).  In this study the potential of FTWs for ammoniacal nitrogen (AN) removal was evaluated using experimental mesocosms operated under steady-state flow conditions with ten different treatments (two water depths, two levels of FTW mat coverage, two different plant densities and

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Publication Date
Mon Oct 31 2022
Journal Name
International Journal Of Intelligent Engineering And Systems
Robot Path Planning in Unknown Environments with Multi-Objectives Using an Improved COOT Optimization Algorithm
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Publication Date
Tue Jun 14 2016
Journal Name
Transactions Of The Asabe
Using Terahertz Time-Domain Spectroscopy to Discriminate among Water Contamination Levels in Diesel Engine Oil
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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of The College Of Languages (jcl)
Qur'anic rhetorical nuances in Persian literature: تاثيردقایق و لطایف بلاغی قرآن كريم در ادب فارسی
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Abstract: Persian literature, after the spread of Islam in Pars, received a lot of influence from the subtle and rhetorical details of the Holy Quran. This effect is more in poetry than in prose because the weights of Persian poetry are closer to the melody of the Qur'an and its weights.The effectiveness of most of the prose works is only in the Quranic themes and words. Persian poetry that has benefited from various sciences of rhetoric, including semantics, eloquence and rhetoric. The degree and manner of influence of each of the didactic, lyrical, epic and travelogue literary types is different from the rhetorical points of the Quran. The instructions under educational literature have benefited the least from Quranic rhetoric. The max

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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Functional Performance For Patients Post Heart's Valves Replacement at Cardiac Surgery Centers in Baghdad City
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Abstract
Objectives: The study is carried out to assess functional performance for heart's valve replacement patients and find out relationship with sociodemographic data and clinical data
Methodology: Descriptive design is carried out at cardiac surgery centers in Baghdad ; Ibn -Al Betar Specialized for cardiac surgery center and Al-Iraqi center for cardiac disease. its initiation from December28the 2013 to September 1st 2014,A non- probability (purposive) sample of 50 adults patients are attended cardiac surgery centers at Baghdad city and who have heart valves replacement. The data collection through development of questionnaire which is composed from three parts(socio demographic data, clinical information, functional performa

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Publication Date
Thu Dec 05 2019
Journal Name
Advances In Intelligent Systems And Computing
An Enhanced Evolutionary Algorithm for Detecting Complexes in Protein Interaction Networks with Heuristic Biological Operator
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Publication Date
Sat Aug 25 2012
Journal Name
Wireless Personal Communications
Multi-Objective Evolutionary Algorithm Based on Decomposition for Energy Efficient Coverage in Wireless Sensor Networks
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Publication Date
Sun Mar 01 2020
Journal Name
Computer Networks
An improved multi-objective evolutionary algorithm for detecting communities in complex networks with graphlet measure
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