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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
Thu Jan 31 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Appropriate for Use Under Advanced Manu Facturing Technology: An Application in Baghdad Soft Drinks Company " Private Contribution
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Big developments in technology have led to upset the balance of ideas, given of its own post new properties for products not provided by traditional technology, especially economic units operating within the industrial sector, and therefore it is important to develop the Iraqi industrial sector and interest to do its vital role in light Of progress technological.The research aims to Find the use of advanced manufacturing technologies that lead to customized production and quality appropriate whether they are low quality and low cost or low cost and suitable quality or high quality and high cost to win customer satisfaction.While the important conclusions is that the application of advanced manufacturing technology is not limited to techn

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Publication Date
Sun Jun 25 2023
Journal Name
International Journal Of Drug Delivery Technology
Synthesis, Characterization, Antioxidant and Antibacterial Studies for New Schiff Base Complexes derived from 4-Bromo-O-toluidine
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In this article, new Schiff base ligand LH-prepared Mn(II), Co(II), Ni(II), Cu(II), Zn(II), Cd(II), Hg(II), Pd(II), and Pt(II) materials were analyzed using spectroscopy (1 Metal: 2 LH). The ligand was identified using techniques such as FTIR, UV-vis, 1H-13C-NMR, and mass spectra, and their complexes were identified using CHN microanalysis, UV-vis and FTIR spectral studies, atomic absorption, chloride content, molar conductivity measurements, and magnetic susceptibility. According to the measurements, the ligand was bound to the divalent metal ions as a bidentate through oxygen and nitrogen atoms. The complexes that were created had microbicide activity against two different bacterial species and one type of fungus. DPPH techniques were bei

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Publication Date
Sat Apr 01 2017
Journal Name
2017 International Conference On Environmental Impacts Of The Oil And Gas Industries: Kurdistan Region Of Iraq As A Case Study (eiogi)
Inverse fluidized bed for chromium ions removal from wastewater and produced water using peanut shells as adsorbent
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Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
Serum Adropin and Apelin as Potential Markers PredictingAcute Heart Failure-associated Renal Dysfunction among Elderly Iraqi Patients
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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
An Efficient Shrinkage Estimators For Generalized Inverse Rayleigh Distribution Based On Bounded And Series Stress-Strength Models
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Abstract<p>In this paper, we investigate two stress-strength models (Bounded and Series) in systems reliability based on Generalized Inverse Rayleigh distribution. To obtain some estimates of shrinkage estimators, Bayesian methods under informative and non-informative assumptions are used. For comparison of the presented methods, Monte Carlo simulations based on the Mean squared Error criteria are applied.</p>
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Publication Date
Thu Jun 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Emulsion Liquid Membrane for Pesticides Removal from Aqueous Solution: Emulsion Stability, Extraction Efficiency and Mass Transfer Studies
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The current study investigated the stability and the extraction efficiency of emulsion liquid membrane (ELM) for Abamectin pesticide removal from aqueous solution. The stability was investigated in terms of droplet emulsion size distribution and emulsion breakage percent. The proposed ELM included a mixture of corn oil and kerosene (1:1) as a diluent, Span 80 (sorbitan monooleate) as a surfactant and hydrochloric acid (HCl) as a stripping agent without utilizing a carrier agent. Parameters such as homogenizer speed, surfactant concentration, emulsification time and internal to organic volume ratio (I/O) were evaluated. Results show that the lower droplet size of 0.9 µm and higher stable emulsion in terms of breakage percent of 1.12 % were

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Publication Date
Tue Jan 16 2018
Journal Name
Design And Manufacture An Automatic Knife For Date Palm Tree Frond Cutting Operates By Frequency Theory Cutting‏ Mra Abdulrazak A. Jasim‏
Design and manufacture an automatic knife for date palm tree frond cutting Operates by frequency theory Cutting‏
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Publication Date
Fri Dec 20 2019
Journal Name
Iet Circuits, Devices &amp; Systems
Multi‐bit error control coding with limited correction for high‐performance and energy‐efficient network on chip
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In the presence of deep submicron noise, providing reliable and energy‐efficient network on‐chip operation is becoming a challenging objective. In this study, the authors propose a hybrid automatic repeat request (HARQ)‐based coding scheme that simultaneously reduces the crosstalk induced bus delay and provides multi‐bit error protection while achieving high‐energy savings. This is achieved by calculating two‐dimensional parities and duplicating all the bits, which provide single error correction and six errors detection. The error correction reduces the performance degradation caused by retransmissions, which when combined with voltage swing reduction, due to its high error detection, high‐energy savings are achieved. The res

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Mon Aug 08 2022
Journal Name
Egyptian Journal Of Chemistry
Synthesis, Characterization, Spectroscopic, Thermal and Biological Studies for New Complexes with N1, N2-bis(3-hydroxyphenyl) Oxalamide
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Publication Date
Sat Jun 02 2018
Journal Name
Agroforestry Systems
Biomass and buffer management practice effects on soil hydraulic properties compared to grain crops for claypan landscapes
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