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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 Mar 29 2024
Journal Name
Iraqi Journal Of Science
The Simulation Technique to Estimate the Parameters of Generalized Exponential Rayleigh Model
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     The paper shows how to estimate the three parameters of the generalized exponential Rayleigh distribution by utilizing the three estimation methods, namely, the moment employing estimation method (MEM), ordinary least squares estimation method (OLSEM),  and maximum entropy estimation method (MEEM). The simulation technique is used for all these estimation methods to find the parameters for the generalized exponential Rayleigh distribution. In order to find the best method, we use the mean squares error criterion. Finally, in order to extract the experimental results, one of object oriented programming languages visual basic. net was used

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Publication Date
Sun Dec 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Assess the Reality of the Process of Applying the strategic Innovation In Business organizations : A prospective Study of comparative analysis in anumber of business organizations the Iraqi Industrial
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Abstract :

      The research aims to Estimate the Strength of Strategic Innovation application in terms of application strength , and on the overall level in number of Iraqi Industrial business organizations . After wards determine whether their is differerences among those organizations in application process for the dimensions , and for the overall process .

      The Research revealed number of conclusions including that the process of strategic innovation is applied in a good Level , and demonstrates the desier of the industrial companies Leaders to Launch beyond the familiar products , and to provide new products that

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Publication Date
Mon Sep 14 2020
Journal Name
British Journal Of Neurosurgery
Head injuries caused by the ritual of ‘Tatbir’: a neurosurgical perspective
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Publication Date
Thu Aug 08 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Novel Technique for Alveolar Ridge Expansion: A Comparative Clinical Study
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Background: Piezosurgery improved the split approach by making it safer, easier, and less prone to complications when treating extremely atrophic crests. Densah drills, with their unique design, expand the ridge by densifying bone in a reverse, non-cutting mode. Objective: To assess the effectiveness of sagittal piezosurgery, which involves cutting bone to the full implant depth and then expanding it using osseodensification drills. We use this technique to expand narrow alveolar bones and simultaneously place dental implants in the maxillary and mandibular arches. Methods: Fourteen patients received 31 dental implants. The maxillary arch received 19, and the mandible received 12 dental implants. This study will include patients who

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Publication Date
Wed Apr 01 2020
Journal Name
Indian Journal Of Forensic Medicine And Toxicology
Study the genotoxicity of aqueous and alcoholic extracts of adhatoda vasica on the roots of allium cepa L. By RAPD-PCR technique
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Publication Date
Wed Dec 01 2021
Journal Name
مجلة العلوم و التكنولوجية للنشاطات البدنية و الرياضية
The Effectiveness of Electronic Puppet Educational Theater by Camtasia Studio in Learning Some of The Artistic Gymnastics Skills For First-Grade
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The study aims to design an electronic puppet educational theater by Camtasia studio and identify the effectiveness in learning some of the artistic gymnastics skills for first grade, the research curriculum is experimental by designing two equal groups, and the research sample first grade students are distributed among 4 grade, and by the pumpkin determines two divisions (15 from each) representing the experimental group and control group, the main experiment conducted for 8 weeks by two educational units per week after which the post-tests were conducted, SPSS was used to process the results, and it was found that the electronic puppet educational theater contributed by making the learning process enjoyable and interesting and meeting the

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The contractual budget: the ideal technique in planning and implementing capital budgeting projects: a strategy of preparing the contractual budget for Baghdad local government
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Public budget is the government's tool in achieving the objectives of economic and social development is the accounting curriculum to estimate state revenues and expenditures for years to come, as well as to have legal status as it is after the adoption of an official statement of government units to spend funds on items planned at the same time is a statement collect resources to finance these appropriations, if the primary objective of the budget initially limited to the achievement of financial and legislative control have evolved this function in the area of public administration turned attention from mere imposition of control over the money, which provides information to assist the Department to utilize available resources and prog

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Publication Date
Sun May 12 2019
Journal Name
Al-khwarizmi Engineering Journal
Motion Control of Three Links Robot Manipulator (Open Chain) with Spherical Wrist
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Robot manipulator is a multi-input multi-output system with high complex nonlinear dynamics, requiring an advanced controller in order to track a specific trajectory. In this work, forward and inverse kinematics are presented based on Denavit Hartenberg notation to convert the end effector planned path from cartesian space to joint space and vice versa where a cubic spline interpolation is used for trajectory segments to ensure the continuity in velocity and acceleration.  Also, the derived mathematical dynamic model is based on Eular Lagrange energy method to contain the effect of friction and disturbance torques beside the inertia and Coriolis effect. Two types of controller are applied ; the nonlinear computed torque control (CTC

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Publication Date
Fri Jan 01 2021
Journal Name
Revista Latinoamericana De Hipertensión
Iatrogenic atrial septal defect post radiofrequency ablation in patients with left atrial SVT: Predictors and outcomes
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atrogenic atrial septal defect (IASD), post Catheter ablation during electrophysiological study simply can be assess with Echocardiography nowadays ablation consider the main line in the managements of patients with various type of arrhythmia. This study aims to de-termine the outcomes of Iatrogenic Atrial Septal Defect (IASD) six months post radiofrequency ablation (RF) procedure of left atrial arrhythmia using non-invasive Transtho-racic Echocardiography (TTE) parameters (LVEF, E/e` and ASD size) with sheath size as predictors of atrial septal defect closure. Patients and methods: A prospective study was con-ducted in Iraqi Centre for Heart Diseases included 47 patients post Electrophysiology procedure and ablation of left atrial SVT were

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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of Crestal Bone Resorption around Dental Implants in Flapped and Flapless Surgical Techniques Depending on Cone Beam CT Scan (Comparative Study)
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Background: The long term survival of dental implants is evaluated by the amount of crestal bone loss around the implants. Some initial loss of bone around dental implants is generally expected. There is reason to believe that reflecting a mucoperiosteal flap promotes crestal bone loss in the initial phase after an implant has been inserted. The surgical placement of a dental implant fixture is constantly changing and in recent years, there has been some interest in developing techniques that minimize the invasive nature of the procedure, with flapless implant surgery being advocated. The purpose of this study was to compare the radiographic level of the peri- implant bone after implant placement between traditional flapped surgery and f

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