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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 Aug 15 2018
Journal Name
Al-khwarizmi Engineering Journal
Study the Dissociation Enthalpies for R134a Clathrate Hydrate in Binary and Ternary Systems
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In the present work the clathrate hydrate dissociation enthalpies of refrigerant R134a+ water system, and R134a + water + salt system were determined. The heat of dissociation of three types of aqueous salts solutions of NaCl, KBr and NaF at three concentrations (0.09, 0.17and 0.26) mol·kg−1 for each salt type, were enthalpy measured. The Clapeyron equation was used tocalculate heat of dissociation of experimental data for binary and ternary system.In order to find the effect of compressibility factor on heat dissociation enthalpy, the study was conducted by using equation of state proposed by Peng and Robinson Stryjek-Vera (PRSV). The obtained results of dissociation enthalpy for binary system were (143.8) kJ.mol-1

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Engineering
Separation of Lead (Pb2+) and Cadmium (Cd2+) from Single and Binary Salt Aqueous Solutions Using Nanofiltration Membranes
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The present work reports on the performance of three types of nanofiltration membranes in the removal of highly polluting and toxic lead (Pb2+) and cadmium (Cd2+) from single and binary salt aqueous solutions simulating real wastewaters. The effect of the operating variables (pH (5.5-6.5), types of NF membrane and initial ions concentration (10-250 ppm)) on the separation process and water flux was investigated. It was observed that the rejection efficiency increased with increasing pH of solution and decreasing the initial metal ions concentrations. While the flux decreased with increasing pH of solution and increasing initial metal ions concentrations. The maximum rejection of lead and cadmium ion

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Publication Date
Tue Dec 24 2024
Journal Name
Malaysian Journal Of Mathematical Sciences
Exploring the Role of Hunting Cooperation, and Fear in a Prey-Predator Model with Two Age Stages
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The aim of this study is to utilize the behavior of a mathematical model consisting of three-species with Lotka Volterra functional response with incorporating of fear and hunting cooperation factors with both juvenile and adult predators. The existence of equilibrium points of the system was discussed the conditions with variables. The behavior of model referred by local stability in nearness of any an equilibrium point and the conditions for the method of approximating the solution has been studied locally. We define a suitable Lyapunov function that covers every element of the nonlinear system and illustrate that it works. The effect of the death factor was observed in some periods, leading to non-stability. To confirm the theore

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Publication Date
Fri Aug 15 2025
Journal Name
Journal Port Science Research
The Antimicrobial Characteristics of Some Natural Remedies in Root Canal Disinfection and Artificial Intelligence (AI): A Review
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The primary goal of root canal treatment (RCT) is to expel the presence of any necrotic or vital tissue, microbes and their byproducts from the canal space before press forward with the following steps of the RCT procedures. Although this is difficult to attain, various strives had been practiced by employing chemical and mechanical methods to eliminate as much microorganisms as possible and make the canal space valid for the obturation materials to be received. The aim of this review is to demonstrate some of what new remedies that could be used as root canal disinfectant by summarizing the recent studies regarding the efficacy of different natural products against the most persistence microbiota that could be responsible for most

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Publication Date
Fri Mar 01 2024
Journal Name
الذكوات البيض
The problem of employing political discourse and its role in promoting community peace: Iraq as a model
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After 2003, Iraq witnessed new challenges represented by the predominance of sectarian discourses, hatred and extremism at the expense of moderate political discourse and the predominance of sub-affiliations and external agendas at the expense of national affiliation, which led to the creation of an unsafe or stable environment dominated by the character of violence and terrorism. Moderate discourse would work to fuse sub-affiliations into one melting pot in which it would be the first loyalty to the homeland and not to the tribe, party or sect... Etc., and this in turn will contribute to promoting peaceful coexistence between the various other sub-affiliations within the framework of one community construction

Publication Date
Mon Jan 01 2024
Journal Name
Journal Of Medicine And Life
An overview of neuro-ophthalmic disorders at Jenna Ophthalmic Center, Baghdad, Iraq (2021-2022)
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Neuro-ophthalmic disorders are often documented individually for each illness, with little data available on their overall incidence and pattern. The overall incidence of neuro-ophthalmic illnesses in Iraq is still not recorded. This study aimed to evaluate the clinical, demographic, and etiological features of patients seeking consultation at an Iraqi neuro-ophthalmology clinic. A prospective cross-sectional observational research was conducted at the Janna Ophthalmic Center in Baghdad, Iraq. The center serves a diverse patient population from various governorates. All newly diagnosed patients with neuro-ophthalmic disorders who visited the neuro-ophthalmological clinic, regardless of gender or age group, were included. The neuro-ophthalmo

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Publication Date
Sun Sep 05 2010
Journal Name
Baghdad Science Journal
Statistical Model for Polarization Mode Dispersion in Single Mode Fibers
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As the bit rate of fiber optic transmission systems is increased to more than , the system will suffer from an important random phenomena, which is called polarization mode dispersion. This phenomenon contributes effectively to: increasing pulse width, power decreasing, time jittering, and shape distortion. The time jittering means that the pulse center will shift to left or right. So that, time jittering leads to interference between neighboring pulses. On the other hand, increasing bit period will prevent the possibility of sending high rates. In this paper, an accurate mathematical analysis to increase the rates of transmission, which contain all physical random variables that contribute to determine the transmission rates, is presen

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the Current Financial Crisis : Causes and Solutions (Iraqi crisis a model , based on the public budget for the fiscal year 2016)
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The research aims to analysis of the current financial crisis in Iraq through knowing its causes and then propose some solutions that help in remedy the crisis and that on the level of expenditures and revenues, and has been relying on the Federal general budget law of the Republic of Iraq for the fiscal year 2016 to obtain the necessary data in respect of the current expenditures and revenues which necessary to achieve the objective of the research , and through the research results has been reached to a set of conclusions which the most important of them that causes of the current financial crisis in Iraq , mainly belonging to increased expenditures and especially the current ones and the lack of revenues , especially non-oil o

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Publication Date
Sun Dec 01 2019
Journal Name
Al- Mohtaref Journal
Impact of The Use of Electronic Concept Mapping Strategy in Learning and Retaining Some of The Skills of The Ground-Moving Carpet in Women's Artistic Gymnastics
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The study aimed to identify the use of the electronic concept maps method in learning some of the skills of the floor exercises in the artistic gymnastics for third graders ,as well as to identify the best group between the two research groups (experimental And the officer to learn and retain some of the skills of the floor exercises in the artistic gymnastics of the research subject , and the experimental method was used and included the sample research on students of the collage of Physical Education and Sports Sciences/University of Baghdad, third grade, and has selected (10) Students for each group of The experimental and controlling groups randomly by lottery and after the completion of the period of implementation of the experiment wh

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Environmental Science And Development
Estimation of the Concentrations of Some Pollutants Resulting from the Use of Arabian Bakhour and Their Effect in Patients with Asthma in the City of Baghdad
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This research focus on studying 3 types of Bakhour in the markets of Baghdad city and assessing their impact on the quality of life for asthmatic whom used Bakhour at their houses through investigating particles physical properties, also estimating the levels of heavy metals (Cd, Cu, Mn, Pb and Zn), Particulate Matter PM2.5, PM10, Total Volatile Organic Compounds (TVOC) and formaldehyde (HCHO). The quality of life for asthmatic patients whom use Bakhour was assessing by Mini Asthma Quality of Life Questionnaire. The results indicated that shapes of Bakhour particles were irregular or spherical. Burning process generated the higher percent of PM ˂1μm. Type 2 Bakhour showed the highest percent of <1μm which was 73%.The amount of

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