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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 May 16 2023
Journal Name
Journal Of Engineering
The Effect of Spatial Organization on the Sustainability of the Neighborhood Unit in the Residential Environment
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Contemporary residential neighborhoods suffer from weak sustainability of urban residential environments as a result of the adoption of inefficient spatial organization at the neighborhood unit level. This resulted negative characteristics which affected the achievement of sustainable development plans for the residential environment that constitute the majority of the urban fabric of cities.

The physical affordances ,within the vocabulary of recent times,overcame the spiritual ones and affected the residential environment. Accordingly,the concept of space changed in contemporary residential areas through the dominance of the physical aspect (mass) on the symbolic aspect (space).The modern technology occupied an important level b

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Publication Date
Sun Sep 07 2014
Journal Name
Baghdad Science Journal
A comparative taxonomic study of nutlets of Stachys L. in Iraq
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Nutlets of 22 taxa of Stachys (13 species and seven subspecies and two varieties), representing seven of the currently recognized sections distributed in northern Iraq were examined by light microscope. The basic shape of nutlets in most taxa studied is Obovoid, but Oblong also found in S.megalodanta Hausskn.& Bornm. ex P.H.Davis, S.setirefa C.A.Mey. subsp daenensis (Gandog.) Rech.f.and S. kurdica Boiss.& Hohen. var.kurdica, while the Subgloboid shape found in S. iberica M.Bieb. and S. inflata Benth., more over the Broad triangular shape was found in S. nephrophylla Rech.f. and S.lanigera (Bornm.) Rech.f.., the biggest size of nutlets was found in S.inflata L. and the smallest was in S.melampyroides Hand.-Mzt. Regarding sculpturing pa

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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
EVALUATING THE EFFECTIVE CREATIVE LEADERSHIP ROLE OF THE DEAN AND HEADS OF SCIENTIFIC DEPARTMENTS IN THE COLLEGE OF PHYSICAL EDUCATION AND SPORTS SCIENCES AL-MUSTANSIRIYAUNIVERSITY
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Publication Date
Tue May 01 2018
Journal Name
Journal Of Global Pharma Technology
Evalution of the effect of Gigaspora margarita and Glomus desriticola fungi in stimulating the resistance of the capsicum annuum L. plant towards chromium and lead
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The present study was conducted to evaluate the effect of fungi Gigaspora margarita and Glomus desriticola in stimulating the resistance of the capsicum annuum L. towards the chromium and lead after 60 days, planting and using the pots in the glass house. The highest concentration of chromium and lead in the root was found in the presence of the mycorrhizal mixture (194.93, 150.40) μg / g, respectively, compared to the lowest concentration (90.69, 79.37) μg / g respectively, while the highest concentration of chromium and lead in the shoot was found in the presence of the mycorrhizal mixture (94.63, 79.33) μg / g respectively, compared with the lowest concentration in the control treatment (72.58, 60.70) μg / g respectively. The results

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Publication Date
Wed Feb 15 2017
Journal Name
International Journal Of Poultry Science
Effects of Ionized Water on Certain Egg Quality Traits and the Levels of Proteins and Enzymes in the Blood of the Japanese Quail Coturnix japonica
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Objective: This experiment was conducted to study the effects of ionized water on certain egg quality traits and the levels of proteins and enzymes in the blood of the Japanese quail Coturnix japonica . Materials and Methods: One hundred 42-day-old quail were randomly distributed among five treatment groups with four replicates for each group. The following treatments were used: T1 (control): The birds were provided normal water, T2: The birds were provided alkaline water (pH = 8), T3: The birds were provided alkaline water (pH = 9), T4: The birds were provided acidic water (pH = 6) and T5: The birds were provided acidic water (pH = 5). A Complete Randomized Design (CRD) was used to investigate the effects of the studied treatments on diffe

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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
EVALUATING THE EFFECTIVE CREATIVE LEADERSHIP ROLE OF THE DEAN AND HEADS OF SCIENTIFIC DEPARTMENTS IN THE COLLEGE OF PHYSICAL EDUCATION AND SPORTS SCIENCES AL-MUSTANSIRIYAUNIVERSITY
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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
EVALUATING THE EFFECTIVE CREATIVE LEADERSHIP ROLE OF THE DEAN AND HEADS OF SCIENTIFIC DEPARTMENTS IN THE COLLEGE OF PHYSICAL EDUCATION AND SPORTS SCIENCES AL-MUSTANSIRIYAUNIVERSITY
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Publication Date
Sun Dec 30 2007
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Effect of Feed Concentration on the Production of Pregelatinized Starch in a Double Drum Dryer
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Double drum dryer is operated for producing pregelatinized maize starches using feed starch slurries of different
solids(7, 10 and13 g/100 g )content . Steam pressure (2,3,and 4 bar), the level of pool between the drums (4,7,and 10
cm) , and speed of drums rotation (3,4,and 6 rpm) are varied together with the feed solids content in a practical range of
values. The response of the dryer is registered by measuring several output variables, i.e. external drum temperature,
product moisture content, mass flow rate.

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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of Planner And Development
Spatial analysis of rural services in the district of Fallujah, Zgharit village, as a model
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          The study of services in villages is one of the imperative matters that must   be focused on, because it leads to increased attention, which reduces the differences between the countryside and the urban. The extent of its.

  It is well known that community services need to be reached by a person, unlike the anchor services that reach people, here the population distribution plays an important and prominent role in signing these services, so the dispersed distribution pattern and the gathering pattern appeared in the distribution, thus an effect on the time and distance that the person walked to obtain The services are community-based. Therefore

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Publication Date
Tue Aug 01 2023
Journal Name
Journal Of Engineering
The Role of Project Health Check Reports in Identifying Indicative Factors of a Troubled Project
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Government-sponsored projects in Iraq significantly improve the economic situation and provide services but face high rates of troubling blocks. This work aims to identify indicative factors of the Troubled Project using periodic health check reports based on a literature review and interviews with Iraqi experts. As a result, a questionnaire was prepared that included four sections. The first is personal information; the second section is information about knowing the level of institutions’ implementation of project management through prepared documents. The third section is about indicative factors for the project's trouble, including 25 workers; the fourth section is about the questions in the periodic reports to che

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