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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
Sat Jun 30 2018
Journal Name
College Of Islamic Sciences
Narrative narration in the poetry of Mohammed Abdul Muttalib   (Top poem as a model)
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Poets of the age since ancient times to recount the events of their adventures in a fun story style in which the elements of the story of personalities, time and place, and we do not mean this modern art technique (poetic story) as it is now, but was aimed at the pleasures of the other receiving because it is the rule of the quality of literary output, Other times the narrative of events inspired by his broad imagination and this mixing indicates the story's involvement with Arabic poetry to be (poetic story) and this depends entirely on addressing the poet to the recipient, and requires in this narrative to be familiar with the elements of influence and suspense in the other or turned into a monotonous and dull narrative Influential, un

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Publication Date
Wed Jun 10 2009
Journal Name
Iraqi Journal Of Laser
The performance of a passively Q-switched Cr:YAG4+ in an end- pumped laser system
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A characteristic study of a passively Q-switched diode pumped solid state laser system is presented in this work. For laser a comparison study for the theoretically calculated results with a simulation results using a software which calculates the Q-switched solid state laser parameters was such as energy, peak power and pulse width were performed. There was a good agreement between our theoretical calculations and the simulation values.

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Publication Date
Tue Oct 01 2024
Journal Name
Separation And Purification Technology
A comprehensive review on the use of Ti3C2Tx MXene in membrane-based water treatment
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Publication Date
Mon Aug 01 2016
Journal Name
2016 38th Annual International Conference Of The Ieee Engineering In Medicine And Biology Society (embc)
Changes in the EEG amplitude as a biomarker for early detection of Alzheimer's disease
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The rapid increase in the number of older people with Alzheimer's disease (AD) and other forms of dementia represents one of the major challenges to the health and social care systems. Early detection of AD makes it possible for patients to access appropriate services and to benefit from new treatments and therapies, as and when they become available. The onset of AD starts many years before the clinical symptoms become clear. A biomarker that can measure the brain changes in this period would be useful for early diagnosis of AD. Potentially, the electroencephalogram (EEG) can play a valuable role in early detection of AD. Damage in the brain due to AD leads to changes in the information processing activity of the brain and the EEG which ca

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Publication Date
Sun Jul 12 2020
Journal Name
Baghdad Science Journal
Geomagnetic Kp Index and Planetary Magnetosphere Size Relationship: for Mercury and Jupiter During two Types of Geomagnetic Conditions
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     Kp index correlates with the many magnetosphere properties, which are used to measure the level of magnetic activity. In the solar system, the two different planets, Mercury with weak magnetic field and Jupiter with strong magnetic field, are selected for this study to calculate the planet's magnetosphere radius (RMP) which represents the size of magnetosphere compared with solar activity through Kp index,  through two types of geomagnetic conditions; quiet and strong for the period (2016-2018). From the results, we found that there are reversible relations between them during strong geomagnetic storms, while there are direct relations during quiet geomagnetic conditions. Also it is found that the

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Publication Date
Sat Jan 01 2011
Journal Name
International Journal Of Data Analysis Techniques And Strategies
A class of efficient and modified testimators for the mean of normal distribution using complete data
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Publication Date
Sat Sep 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Synthesis, Characterizations, and Recent Applications of the Silica-based Mobil Composition of Mesoporous Material: A Review
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Silica-based mesoporous materials are a class of porous materials with unique characteristics such as ordered pore structure, large surface area, and large pore volume. This review covers the different types of porous material (zeolite and mesoporous) and the physical properties of mesoporous materials that make them valuable in industry. Mesoporous materials can be divided into two groups: silica-based mesoporous materials and non-silica-based mesoporous materials. The most well-known family of silica-based mesoporous materials is the Mesoporous Molecular Sieves family, which attracts attention because of its beneficial properties. The family includes three members that are differentiated based on their pore arrangement. In this review,

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Publication Date
Sun Dec 07 2008
Journal Name
Baghdad Science Journal
Improvement of the monochrome image hologram by using a random phase and increasing number of Samples
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This paper present a study about effect of the random phase and expansion of the scale sampling factors to improve the monochrome image hologram and compared it with previous produced others. Matlab software is used to synthesize and reconstruction hologram.

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Publication Date
Sat Jan 13 2024
Journal Name
Journal Of Advanced Research In Fluid Mechanics And Thermal Sciences
Influence of Surrounding Air Temperature and Humidity upon the Performance of a Gas Turbine Power Plant
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Nowadays, energy demand continuously rises while energy stocks are dwindling. Using current resources more effectively is crucial for the world. A wide method to effectively utilize energy is to generate electricity using thermal gas turbines (GT). One of the most important problems that gas turbines suffer from is high ambient air temperature especially in summer. The current paper details the effects of ambient conditions on the performance of a gas turbine through energy audits taking into account the influence of ambient conditions on the specific heat capacity ( , isentropic exponent ( ) as well as the gas constant of air . A computer program was developed to examine the operation of a power plant at various ambient temperature

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Publication Date
Thu Apr 29 2021
Journal Name
International Journal Of Pavement Engineering
An assessment of lime-cement stabilisation on the elastic and resilient moduli of a clayey soil
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