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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 Dec 30 2004
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Influence of Temperature and Flow Velocity on the Corrosion Inhibition of Low Carbon Tubes in Recirculating Water System by a Dicomponent Inhibitor Blend
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Publication Date
Mon Jan 29 2018
Journal Name
Environmental Earth Sciences
A preliminary assessment of the geochemical factors affecting groundwater and surface water quality around the rural communities in Al-Anbar, Western Desert of Iraq
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Publication Date
Sun Mar 10 2024
Journal Name
Journal Of Sport And Health Research
The effectiveness of a rehabilitation program with aqueous media on the egree of pain and balance for those suffering from sacroiliitis in football players
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Abstract in English  The aim of this study is to identify the effectiveness of rehabilitation exercises in conjunction with aquatic therapy for those suffering from sacroiliitis in football players. The researcher used the experimental approach, using the experimental design (pre-measurement, post-measurement). Similar to the objectives and procedures of the research, the researcher assumed the following: the existence of significant differences. Statistics between pre- and post-measurements in variables in favor of post-measurement for the following variables (degree of pain and level of balance). The experimental approach was used with a pre- and post-measurement design on one group of football players with sacroiliitis, nu

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Publication Date
Fri Mar 20 2020
Journal Name
International Journal Of Dental Hygiene
A randomized double‐blind clinical trial to evaluate the efficacy of chlorhexidine, antioxidant, and hyaluronic acid mouthwashes in the management of biofilm‐induced gingivitis
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Abstract<sec><title>Objectives

To investigate the antiplaque and antigingivitis efficacy in addition to evaluating side effects and subjects’ perceptions of three commercially available mouthwashes.

Methods

This study was a double‐blind, parallel, and short‐term trial. A total of 75 dental students with biofilm‐induced gingivitis were included in the final analysis of the current study. Clinical parameters (plaque index and bleeding on probing) and the staining effect were measured at baseline and after 7 days. In addition, a VAS‐based assessment questionnaire was completed by the participants.

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Publication Date
Thu Jan 30 2020
Journal Name
Journal Of Engineering
Comparison of Single and Group Bored Piles Settlement Based on Field Test and Theoretical Methods
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 Bored piles settlement behavior under vertical loaded is the main factor that affects the design requirements of single or group of piles in soft soils. The estimation of bored pile settlement is a complicated problem because it depends upon many factors which may include ground conditions, validation of bored pile design method through testing and validation of theoretical or numerical prediction of the settlement value. In this study, a prototype single and bored pile group model of arrangement (1*1, 1*2 and 2*2) for total length to diameter ratios (L/D) is 13.33 and clear spacing three times of diameter, subjected to vertical axial loads. The bored piles model used for the test was 2000

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Removal of Nickel and Cadmium Ions from Wastewater by Sorptive Flotation: Single and Binary systems
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The removal of heavy metal ions from wastewater by sorptive flotation using Amberlite IR120 as a resin, and flotation column, was investigated. A combined two-stage process is proposed as an alternative of the heavy metals removal from aqueous solutions. The first stage is the sorption of heavy metals onto Amberlite IR120 followed by dispersed-air flotation. The sorption of metal ions on the resin, depending on contact time, pH, resin dosage, and initial metal concentration was studied in batch method .Various parameters such as pH, air flow rate, and surfactant concentration were investigated in the flotation stage. Sodium lauryl sulfate (SLS) and Hexadecyltrimethyl ammonium bromide (HTAB) were used as anionic and cationic surfactant re

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Publication Date
Tue Jan 01 2019
Wide-range tunable subwavelength band-stop filter for the far-infrared wavelengths based on single-layer graphene sheet
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Publication Date
Sat Jul 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Effect of High Salt Concentrations on some Growth Characteristics and Feed Intake Rate of Ctenopharyngodon idella
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Abstract<p>Grass carp at a weight of 34.68 + 2 g were gradually exposed to four saline concentrations: tap water (0.1), 3, 6, 9, and 12 gm/litter, and the first concentration represented a control treatment. Fish were fed on a diet with a protein content of 30% for ten weeks. Results of the growth experiment showed that the feed conversion rate was 2.46, 3.58, 4.84, 6.77, and -8.56 in the first to fifth treatments, respectively, and the rate feed conversion efficiency was 40.65, 27. 93, 20.66, 14.77 and 11.68 %, while the protein intake was 22.38, 20.44, 18.86, 17.47 and 16.56 g in salt concentrations of 0.1, 3, 6, 9 and 12 g/L, respectively. In another experiment to study the effect of salt acc</p> ... Show More
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Publication Date
Tue Oct 02 2018
Journal Name
Iraqi Journal Of Physics
Effect of gas flow rate on plasma temperature and electron density of atmospheric argon plasma jet
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In this study, method for experimentally determining the electron density (ne) and the electron temperature (Te) in the atmospheric Argon plasma jet is used; it is based on optical emission spectroscopy (OES). Boltzmann plot method used to calculate these parameters measured for different values of gas flow rate. The results show that the electron temperature decreasing with the increase of gas flow rate also indicates an increasing in the electron density of plasma jet with increasing of gas flow rate.

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Publication Date
Wed Feb 01 2023
Journal Name
Baghdad Science Journal
Toxicology of Nuclear Polyhedrosis Virus, Botanical and Synthetic Pesticides on Mortality Rate of Crocidolomia binotalis (Zeller)
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Crocidolomia binotalis (Cb) (Zeller) is one of the main pests of cabbage which is difficult for farmers to control in the Ijen Crater in Indonesia. The demand for cabbage in Indonesia is increasing every year, so intensification efforts are continuously being made. Farmers intensively use synthetic pesticides as the primary control of Cb. The purpose of this study is to examine several control agents that can be used as an alternative to synthetic pesticides. Then, it provides recommendations to Ijen Crater farmers to adapt in reducing the use of synthetic pesticides. The biopesticide used was based on the Nuclear Polyhedrosis Virus strains of Spodoptera litura (SlNPV) and Helicoverpa armigera (HaNPV), botanical pesticides, and

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