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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
Wed Jun 11 2008
Journal Name
Journal Of Al-nahrain University
ANALYSIS OF A MOLECULAR DYNAMICS SIMULATION OF THE ACETYLCHOLINESTERASE ENZYME AND ITS COMPLEX WITH (AXILLARIDINE-A) INHIBITOR
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Molecular dynamics (MD) simulations were carried out in order to investigate the binding mode of axillaridine-A at the active site of human acetylcholinesterase (AChE) enzyme. 2.0 nanosecond of MD simulations was made for the protein and the complex to dynamically explore the active site and the behavior of the ligand at the peripheral AChE binding site. These calculations for the enzyme alone showed that the active site of AChE is located at the bottom of a deep and narrow cavity whose surface is lined with rings of aromatic residues and Tyr72 is almost perpendicular to the Trp286 ring and forms a stable - interaction. The size of the active site of the complex decreases with time due to increase the interaction. Axillaridine-A forms

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Publication Date
Mon Jan 01 2024
Journal Name
Baghdad Science Journal
Classification of Arabic Alphabets Using a Combination of a Convolutional Neural Network and the Morphological Gradient Method
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The field of Optical Character Recognition (OCR) is the process of converting an image of text into a machine-readable text format. The classification of Arabic manuscripts in general is part of this field. In recent years, the processing of Arabian image databases by deep learning architectures has experienced a remarkable development. However, this remains insufficient to satisfy the enormous wealth of Arabic manuscripts. In this research, a deep learning architecture is used to address the issue of classifying Arabic letters written by hand. The method based on a convolutional neural network (CNN) architecture as a self-extractor and classifier. Considering the nature of the dataset images (binary images), the contours of the alphabet

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Publication Date
Sat Aug 28 2021
Journal Name
Journal Of Pharmaceutical Research International
Effect of Formulation Parameter on Dissolution Rate of Flurbiprofen Using Liquisolid Compact
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Attempts were made to improve solubility and the liquisolid technology dissolving of medication flurbiprofen. Liquisolid pill was developed utilizing transcutol-HP, polyethylene glycol 400, Avecil PH 102 carrier material and Aerosil 200 layer coating material. Suitable excipient amounts were determined to produce liquisolid powder using a mathematical model. On the other hand, flurbiprofen tablet with the identical composition, directly compressed, was manufactured for comparison without the addition of any unvolatile solvent. Both powder combination characterizations and after-compression tablets were evaluated. The pure drug and physical combination, and chosen liquisolid tablets were studied in order to exclude interacting with t

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Publication Date
Wed Jun 03 2020
Journal Name
Political Sciences Journal
The world'srefugeesbetween the aggravation of the situation and the endeavors of international organizations
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Human witnessed over the centuries many of the important issues faced by the international community was centered on human rights in general and the persecution of refugees, especially according to many forms may be directly or indirectly leaves behind economic crises, social and humanitarian push world countries to rethink the mechanisms and the feasibility of developing agreements and laws and the role of international and regional organizations to protect peoplerefugeestatus.

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Publication Date
Wed Oct 04 2023
Journal Name
Journal Of Al-qadisiya In Arts And Educational Sciences
The use of the digital book and the future of the paper book
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The current research aims to know the complementary use of the paper book and the digital book by defining the paper book and the digital book and knowing the methods and methods of obtaining each of them and indicating the extent of their use and for what purpose and knowing the difficulties that researchers face in using each of them and which is better using the paper book or the digital book in preparing research Studies and for no reason. The research relied on the descriptive approach and the questionnaire as a tool for data collection, and it was distributed to professors and students of Iraqi universities. The research sample reached (219) individuals and reached a set of results, the most important of which are: Preference for the

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Publication Date
Thu Feb 09 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of A cognitive Behavioral Counseling Program in Enhancing Self-Management in Reducing the Academic Procrastination of Tenth grade male Students
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This study aims to find out the effectiveness of a cognitive-behavioral counseling program in enhancing self-management in reducing the academic procrastination of tenth-grade male students. The sample consisted of (26) male students divided into an experimental group of (13) students and a control group of (13) students. Two scales of self-management and academic procrastination were used, prepared by the researcher. The counseling program was prepared by the researcher. The results showed the program's effectiveness in enhancing self-management and reducing academic procrastination in the posttest, as it showed the continuation of this enhancement in self-management and the increase in the reduction of procrastination in the follow-up

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Publication Date
Thu Jun 01 2023
Journal Name
جعفر الصادق
The Role of Criminal Policy in Iraq in Protecting and Improving the Environment
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Publication Date
Thu May 01 2025
Journal Name
Dirasat: Human And Social Sciences
The Role of Russian Writers and Intellectuals in the 1905 Revolution in Russia
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Objectives: The main objective of this study is to examine the crucial role that Russian writers and intellectuals played in catalyzing the 1905 Revolution in Russia. Specifically, the study sought to analyze how their literary works, philosophical ideas, and political writings challenged Tsarist autocracy, depicted the suffering of the masses, and inspired opposition movements. The study aimed to highlight the defiant writings that contributed to the rise of political figures and the eventual overthrow of the repressive regime. Methods: The historical narrative and analytical methods were employed, conducting a comparative analysis of prominent works by renowned authors such as Tolstoy, Gorky, and Chekhov. This analysis focused on

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Publication Date
Fri Jan 15 2021
Journal Name
Palarch's Journal Of Archaeology Of Egypt/egyptology
Belief and practice in the teaching of pronunciation in the Iraqi EFL context
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IH Abdul-Abbas, QJ Rashid, M RasimYounus, PalArch's Journal of Archaeology of Egypt/Egyptology, 2021 - Cited by 9

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
The Democracy and the Reconstruction of the Citizenship
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This research includes the principles of the democracy، and to which extent it can contribute in establishing these principles. Democracy is not only to hold parliamentary or presidential elections but also the result of these elections wills it lead to the emergence of an integrated regime that can actually expresses the citizen's rights and to which extent those citizens can contribute in that regime and control it. Since 2005، when the first elections took place in Iraq after the US occupation of Iraq 2003، Iraqi people are looking to a rule that represented them and achieve their interests after getting rid of the totalitarian regimes and establishing an institutional regime that work by democratic means in order to achieve the so

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