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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 Jun 01 2021
Journal Name
International Medical Journal
Surface analysis of the PEKK coating on the cp ti implant using laser technique
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Objective: Evaluation of the poly ether keton keton polymer (PEKK) coating material on the commercial pure titanium disks (CP Ti) with or without laser surface structuring. Design: In vitro experimental study of PEKK polymer coated material on the CP Ti disks with or without laser surface structuring. Materials and methods: coating the surface of the commercial pure titanium (CP Ti) disks with PEKK polymer was performed via using frictional mode CO2 laser, then the samples disks analyzed by using FESEM. Results: the FESEM reveal good adherence and distribution of the PEKK coated material over the CP Ti substrate by using the frictional mode CO2 laser at 2 watt and 6 ms pulse duration. Conclusion: the frictional mode CO2 laser considered an

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Analysis the Surface Morphology of the Porous Media by using Atomic Force Microscope technique
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An atomic force microscope (AFM) technique is utilized to investigate the polystyrene (PS) impact upon the morphological properties of the outer as well as inner surface of poly vinyl chloride (PVC) porous fibers. Noticeable a new shape of the nodules at the outer and inner surfaces, namely "Crater nodules", has been observed. The fibers surface images have seen to be regular nodular texture at the skin of the inner and outer surfaces at low PS content. At PS content of 6 wt.%, the nodules structure was varied from Crater shape to stripe. While with increasing of PS content, the pore density reduces as a result of increasing the size of the pore at the fiber surface. Moreover, the test of 3D-AFM images shows that the roughness of both su

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Physics: Conference Series
The optical properties of C\Mg, nano-rods produced by the explosion wire technique
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Abstract<p>The aim of this research is to study the optical properties of carbon-magnesium plasma resulting from arc discharge with explosive wire technique, where the energy gap of each of carbon and magnesium and the carbon-magnesium bond for three values of the wire exploding current (50,75,100 amperes) was studied. It was found that the energy gap for each of carbon and magnesium decreases with increasing the current, the X-ray diffraction of magnesium and the carbon-magnesium suspension was studied, and FTIR of the carbon-magnesium suspended carbon was studied for three values of the exploding current (50, 75, 100 amperes) and the type of bonds for carbon and magnesium was determined. To ob</p> ... Show More
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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Engineering
Performance Improvement of the Implementation of Concrete Structures in the Construction Sector In Iraq Using The Modern Management Technique “Six Sigma”
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The reality of the field of construction projects in Iraq refers to needing for the development of performance in order to improve quality and reduce defects and errors and to control the time and cost, so there is needing for the application of effective methods in this area, one of the methods that can be applied in this area is the manner of Six Sigma. This research aims to enhance the performance and quality improvement for the construction projects by improving performance in the work of the implementation of the concrete structure depending on the Six Sigma methodology, and for the purpose of achieving the aim of the research, the researcher firstly depends on the theoretical study that include the concepts of qual

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Publication Date
Fri Apr 25 2025
Journal Name
Al–bahith Al–a'alami
SOCIAL MEDIA AND ITS ROLE IN THE PRODUCTION AND NUTRITION OF CRISES: "ANALYTICAL STUDY OF A SAMPLE OF TWITTER DURING THE GULF CRISIS 2017"
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Social networking sites have become very popular since the beginning of the current decade and have become linked to our daily life. We follow the news, Analyses  and opinions on the one issue in a way that attracts millions of users and the number grows every secon On Twitter, one of the most important social networking sites, all social groups rushed from the president to the last citizen to open accounts when they found themselves forced to do so .

During the recent Gulf crisis, Twitter was buzzing with Twitter, which achieved the largest circulation globally. Instead of serving the issue and directing it to serve the Arab interest, most of the publications were on th

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Publication Date
Fri Jun 14 2019
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Myxobolus Infections of the Cyprinid Fishes from Lesser Zab and Greater Zab Rivers, North of Iraq with the Record of Seven Species of Myxobolus for the First Time in Iraq
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 A total of 1453 freshwater fishes, belonging to 14 species of the
family Cyprinidae was collected from Lesser Zab and Greater Zab
rivers in north of Iraq during the period from November 2000 to the
end of November 2001. The inspection of skin, gills and different
internal organs revealed the infection of these fishes with a total of 14
species of Myxobolus which included seven species that represented
their first record in Iraq. These species included M. bulbocordis from
both Barbus sharpeyi and Chondrostoma regium; M. karuni from B
grypus; M. mesopotamiae from B. luteus; M. molnári from B
esocinus; M. pcrsicus from both B. grypus and Cyprinion macrostomum;
M.  Shaagani from both B. b

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Publication Date
Sat Apr 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Strategic Intelligence in High performance organization A Survey Study for the Managers of Diseases and Kidney Transplant Center/ Medicine City-Baghdad
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The topic of strategic intelligence is considered as important topics that acquires the attention of organizations, Because of its role in supplying the decision-making centers by strategic ideas according to the opportunities and threats facing the organization, in an effort to improve the performance of their organizations to reach the high performance organization.

A lot of organizations lack to strategy guides the strategic intelligence towards achieving high performance organization.

This research aims to determine the level of strategic intelligence that characterized the leaders of diseases and kidney transplant center in Medicine city. What is the application level of the

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
Intraoperative Steroid Irrigation in Carpal Tunnel
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Background: Carpal tunnel syndrome
(CTS) is the most common neuropathy of the
upper limb due to compression of the median
nerve at the wrist.
Objectives: to test the benefit of steroid
irrigation of the wound to alleviate the post
operative pain.
Methods: Forty patients had carpal tunnel
release were divided into two groups with and
without steroid irrigation.
Results: Forty patients 38 female and 2 male
with forty CTS had open surgical release were
studied for postoperative pain at the wrist area.
Group 1 (patients treated with surgery alone)
and group 2 (patients treated with surgery and
steroid).In group1, 11 patients (55%) had
persistent agonizing pain at the ulnar side of
the wrist

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Silibinin in Lowering the Intraocular Pressure in Normotensive Rabbits: Interaction with Betaxolol
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Previous reports demonstrated the effectiveness of silibinin hemisuccinate as a potential intraocular pressure-lowering agent. The exact mechanism by which silibinin exerted this effect has not yet been documented, but might suggested to interfere with aqueous humor formation. The present study was designed to evaluate the comparative efficacy of silibinin as IOP lowering agent to that of betaxolol in normotensive rabbits, and the interaction of silibinin with betaxolol as a way for investigating the possible mechanism of action of silibinin in this respect. The effects of instillation of 0.75% silibinin solution and 0.5% betaxolol eye drops in the eyes of normotensive rabbits were evaluated using indentation tonometry. The results showe

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Publication Date
Mon Nov 14 2022
Journal Name
Physica Scripta
A wavelet-based collocation technique to find the discontinuous heat source in inverse heat conduction problems
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Abstract<p>This paper is devoted to an inverse problem of determining discontinuous space-wise dependent heat source in a linear parabolic equation from the measurements at the final moment. In the existing literature, a considerably accurate solution to the inverse problems with an unknown space-wise dependent heat source is impossible without introducing any type of regularization method but here we have to determine the unknown discontinuous space-wise dependent heat source accurately using the Haar wavelet collocation method (HWCM) without applying the regularization technique. This HWCM is based on finite-difference and Haar wavelets approximation to the inverse problem. In contrast to othe</p> ... Show More
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