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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 Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The impact of strategic approach in the effectiveness of small and medium Enterprises in Iraq
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The purpose of this research highlight the achievement of the effectiveness of small and medium enterprises dimensions and conformable to analyze the relationship between business strategies and human resources management strategies , and launched search of a dilemma thought provoking fundamental questions revolve around the search is the lack of appropriate strategies in these enterprises to help them continuity and permanence in business and markets , as these enterprises lack the human resources management strategies appropriate , as well as business strategies that make them withstand the changes in the market environment is changing and volatile . It was to

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Role of the Arab oil to the achievement of Economic security in the Arab: The Role of the Arab oil to the achievement of Economic security in the Arab
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Abstract:
This research aims to the importance of oil in achieving economic
security in the Arab. Oil is not an ordinary subject and returns it significance to
the followings:
1. The importance of skipping a source of energy.
2. The importance of oil as raw material for petrochemical industry.
3. The importance of the oil sector as an area of foreign investment
4. The importance of oil in the marketing activities, transport, insurance
and various services
In addition to the importance of oil in general and the Arab oil has
additional strategic advantages such as geographic location, And the
magnitude of reserves and production of heavy investment costs are relatively
simple, And the ability to meet the

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Physiology, Nutrition And Physical Education
The effect of effort perception training according to race speed rhythm control for developing speed endurance, adapting maximum heart rate, and achieving 3000 m running/hurdles for men
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Publication Date
Fri Apr 01 2022
Journal Name
Baghdad Science Journal
Colistin as A Good Monotherapy to Restrain the Pathogenicity of Acinetobacter baumannii In vivo and In vitro
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        Acinetobacter baumannii  (A. baumannii) is a major opportunistic nosocomial pathogen, mostly resistant to several groups of antibiotics. Colistin is now used as a last-line treatment for isolates that are highly resistant. The purpose of this study is to identify the importance of LptD; which is involved in the translocation of LPS from the inner membrane to the outer membrane in compartment with LptA and LptC of A. baumannii and its indispensable role as a virulence factor, and the efficiency of colistin as a monotherapy. In the current research, two isolates of A.baumannii were used, the local isolate HHR1 isolated from urine sample and the global strain ATCC 17904, and three antibiot

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Publication Date
Mon Dec 29 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Histological and immunohistochemical evaluation of the effect of local exogenous application of VEGF on bone healing (experimental study in rat)
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Background: The repair of bone defects remains a major clinical orthopaedic challenge. Bone is a highly vascularised tissue reliant on the close spatial and temporal connection between blood vessels and bone cells to maintain skeletal integrity. Angiogenesis thus plays a pivotal role in skeletal development and bone fracture repair. The role of angiogenic and osteogenic factors in the adaptive response and interaction of osteoblasts and endothelial cells during the multi step process of bone development and repair will be highlighted in this study. This study aimed to identify the role of local exogenous vascular endothelial growth factor in bone healing and to analyze the expression of VEGF by immunohistochemistry in created bone defect af

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Publication Date
Sun Jun 12 2011
Journal Name
Baghdad Science Journal
Study the effective of annealing on the structural and sensitivity properties for SnO2 thin films to CO2 Gas
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In this research thin films from SnO2 semiconductor have been prepared by using chemical pyrolysis spray method from solution SnCl2.2H2O at 0.125M concentration on glass at substrate temperature (723K ).Annealing was preformed for prepared thin film at (823K) temperature. The structural and sensing properties of SnO2 thin films for CO2 gas was studied before and after annealing ,as well as we studied the effect temperature annealing on grain size for prepared thin films .

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Publication Date
Wed Jan 15 2020
Journal Name
College Of Islamic Sciences
Ancestor back to achieve the doctrine of the predecessor Sheikh Ibrahim Al-Kurdi Al-Kurani Study and investigation
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This letter dealt with one of the most prominent verbal and contractual issues, which are the similarities of the legal texts, or the so-called news features. The scholars differed as to their interpretation. Most of the verbal schools went on to interpret these texts in a valid interpretation according to the data of the Arabic language, in order to preserve them from the divine self's pronouncement of similar creatures, while we find that the ancestors kept it on its surface with delegating its meanings to God Almighty. This is what Burhan al-Din al-Kurani suggested in this letter, declaring his total rejection of interpretation.

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Publication Date
Sun Nov 03 2002
Journal Name
University Of Baghdad
Parametric Study Of The Optimum Wing - Canard Configuration For The Swept Forward Fighter
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The aerodynamic characteristics of the forward swept wing aircraft have been studied theoretically and an experimentally investigation for the wake field generated by this configuration have been carried out. Low order panel method with the Dirichlet boundary condition have been used to solve the case of the steady, inviscid and compressible flow. Two different panel method techniques have been employed: the source-doublet and the doublet method. The thickness for the various components was considered in the study. Prandtl-Glauert similarity rule has been used to account for the compressibility effects. Experimentally, a model was manufactured from wood with body length (290mm) and main wing span was (204mm). The primary objective of th

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Publication Date
Sat Jan 01 2011
Journal Name
College Of Engineering Journal
Study the Effect of Cutting Conditions for turning process on the Machined Surface
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Surfaces quality is one of the most specified customer requirements for machine parts. The major indication of surfaces quality on machined parts is surface roughness. The research aim is to study the cutting conditions and their effects on the surface roughness. This paper utilizes regression models to predict surface roughness over the machining time for variety of cutting conditions in turning. In the experimental part for turning, different types of materials (Aluminum alloy, Copper alloy, and Gray cast iron) were considered with different cutting speed ( ) and feed rate ( ). A mathematical Model depending on statistical-mathematical method between surface roughness (Rz ) and cutting condition ( , ) were derived, for the three materials

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Publication Date
Mon Apr 09 2018
Journal Name
Al-khwarizmi Engineering Journal
Study the Effect of Forming Media on the Hydroforming Process for Copper Tube
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To observe the effect of media of the internal pressure on the equivalent stress distribution in the tube, an experimental study is done by constructing a testing rig to apply the hydraulic pressure and three dies are manufactured with different bulging configurations (square, cosine, and conical). In the other part, ANSYS APDL is generated to analyze the bulging process with hydraulic and rubber (natural and industrial) media. It was found that when the media is a rubber, the stress is decreased about 9.068% in case of cosine die and 5.4439% in case of conical die and 2.8544% in case of square die. So, it can be concluded that the internal pressure in the rubber media is much better than in hydraulic media. Also, the force needed for fo

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