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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
Tue Dec 16 2008
Journal Name
Journal Of Planner And Development
City of Baghdad Analysis of the mechanisms of economic action in the development and development
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The economy of a city has an important role not only in its establishment but also in its development. This is quite clear in the city of Baghdad throughout its history since its building in 762 A.D. In addition, most of its problems that the city is suffering from are basically related to not giving enough importance to the economic factors in the master planning of Baghdad since 1950’s. This may explain the failiars of master plans in dealing with the actual population growth and the city's inability to absorb such increases and interrelated and diverse activities which are negatively reflected on the economic variables particularly the effect on the land values, and the strong competitions amongst the land uses without previ

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Publication Date
Sat May 28 2022
Journal Name
Egyptian Journal Of Chemistry
Study the kinetics of electrochemical removal of cobalt from aqueous solutions using a Flow-by Fixed Bed Bio-electrochemical Reactor
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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
Determine The Factors Affecting Product Quality Using FMEA Analysis: A Case Study in Al Zawraa State Company
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The research aims to identify the factors that affect the quality of the product by using the Failure Mode and Effect Analysis (FMEA) tool and to suggest measures to reduce the deviations or defects in the production process. I used the case study approach to reach its goals, and the air filter product line was chosen in the air filters factory of Al-Zawraa General Company. The research sample was due to the emergence of many defects of different impact and the continuing demand for the product. I collected data and information from the factory records for two years (2018-2019) and used a scheme Pareto Fishbone Diagram as well as an FMEA tool to analyze data and generate results.

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Publication Date
Tue Sep 05 2023
Journal Name
Migration Letters
The Impact of Climate Change on the Increase in the Frequency of Drought in the Eastern Region of Iraq
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Aim: This abstract aims to highlight the critical nature of climate change as a pressing challenge facing humanity in the 21st century. It underscores the severe consequences it poses to essential facets of human existence, including water and energy resources, agricultural production, and the broader environmental systems. Method: The abstract primarily utilizes a descriptive approach to emphasize the impact of climate change on the Middle East, particularly the Arab region. It relies on a review of existing knowledge and data related to climate change and its effects on ecosystems and drought patterns. Results: The abstract outlines the direct and indirect repercussions of climate change on human life and the environment. It draws atten

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The reality of the application of cost accounting system in the contracting institutions in the kingdom of Saudi Arabia
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The study aimed to identify the reality of the application of cost accounting system in the contracting institutions in Saudi Arabia, and the extent of the reflection of the application of this system on the effectiveness and efficiency of the general performance of these institutions. Where the research community consists of the contracting institutions operating in the Saudi Arabia, and then a suitable random sample was selected from seventy one institutions. The researchers used the historical method to track the previous studies as well as the descriptive approach to conducting the field study. The study data were analyzed by SPSS statistical program.

The results of this study conclude that there is a

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Publication Date
Sun Mar 19 2023
Journal Name
Nasaq Journal
The impact of the Roundhouse strategy on the achievement of the fifth grade secondary school in physics and their pivotal thinking
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The aim of the research is to study the effect of the roundhouse strategy on the achievement of fifth grade secondary school in physics and their pivotal thinking. The experiment has been applied for obtaining the data, which were processed statistically using the Statistical Package for Social Sciences, the results revealed that the students of the experimental group who studied using the roundhouse strategy was superior to the students of the control group who studied in the traditional method in the achievement exam. The results also show that there are statistically significant differences between the mean scores of the students of the experimental group and the control group in the pivotal thinking exam, in favor of the experimental gr

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Publication Date
Sun Jun 30 2019
Journal Name
International Journal Of Research In Social Sciences And Humanities
CHARACTERISTICS OF THE POWER CHAIN FUNCTION CURVE AND ITS RELATION TO THE ACCURACY OF THE HIGH-JUMP JUMP IN THE HANDBALL
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The skill high-jump scoring is based on mechanical and physical abilities. The most important of all is the strength used by the player from the moment of preparation to the moment of scoring, which led the researchers to study the characteristics of the series of power chain functions of this skill according to (Biosyn System) The players of the national team's back line have a handball to find out the relationship between the properties of the power chain curve and the accuracy of the high jump to the upper and lower target angles. The aim of the research was to identify the values of the Force Series variables for the skill of the high-jump curve of the handball as well as the relationship between the properties of the power chain functi

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of electronic trading and central filing in the performance of the Iraq Stock Exchange for the period (2008-2018)
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The rapid development of information technology and its use in all areas has had a positive impact on all areas, and financial markets have had a share of this development through the use of an electronic trading system to settle transactions, enhance transparency and disclosure in all activities of these markets and revitalize their performance.

The reason for choosing this topic is that it is a very important topic for what modern technology addresses in trading operations in financial markets. It is worth noting that these innovations have eliminated the need for direct contact with people, but through the Internet and telephone networks, and the new technology has reduced the costs of building systems

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of The College Of Education For Women
The Impact of Anticyclones Merge on the Temperature in the stations of Mosul, Baghdad and Basra for the Period (2005-2015)
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           The Anticyclone Merge affects Iraq’s climate clearly through its impact on the different climatic elements. where it appears while they pass through special and distinctive weather . and most of this affection appears in temperatures, Therefore, this research study the relationship between the repetition and the survival period of the Anticyclone Merge and temperature average by using coefficient correlation (Pearson) that shows there’s strong inverse relationship between the integration of Anticyclones and temperatures average.                        &nbs

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Publication Date
Sun Mar 01 2015
Journal Name
International Journal Of Computer Science And Mobile Computing
Single Face Detection on Skin Color and Edge Detection
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