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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
Mon Aug 08 2022
Journal Name
Indian Ecological Society
Study the Epidermis features of Some Iraqi Veronica L. Species (Plantaginaceae)
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Publication Date
Sun Jan 01 2012
Journal Name
International Journal Of Astronomy And Astrophysics
Study the Radial Expansion of SN 1987A Using Counting Pixels Method
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Publication Date
Mon Jul 01 2013
Journal Name
Journal Of Kerbala University
study the optimum conditions of synthesis AgNP by chemical reduction method
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Abstract :- In this paper, silver nanoparticles had been prepared by chemical reduction method. Many tests had been done to it such as UV-Visible spectrophotometer, XRD, AFM&SEM test. finally an attempt had been done to get the optimum condition to control the grain size of silver Nanoparticles by variation the heating period and other parameters which has an effect in silver Nanoparticles synthesis process. in this method we can get a silver nanoparticles in the size range from 52 to 97 nm.

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Publication Date
Tue Nov 01 2022
Journal Name
Journal Of Engineering
Study The Impact of Geopolymer Mortar Reinforced by Micro Steel Fibers
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In this research, geopolymer mortar had to be designed with 50% to 50% slag and fly ash with and without 1% micro steel fiber at curing temperature of 240℃. The molarity of alkaline solution adjusted with 12 molar sodium hydroxid to sodium silicate was 2 to 1, reaspectivly. The heat of curing increased the geopolymerization proceses of geoplymer mortar, which led to increasing strength, giving the best result and early curing age. The heat was applied for two days by four hours each day. It was discovered in the impact test that the value first crack of each mix was somewhat similar, but the failure increased 72%  for the mixture that did not contain fiber. For the energy observation results it was shown that the mixt

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Publication Date
Mon Oct 01 2018
Journal Name
Iraqi Journal Of Physics
The study of thermal description for non-thermal plasma needle system
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Cold plasma is a relatively low temperature gas, so this feature enables us to use cold plasma to treat thermally sensitive materials including polymers and biologic tissues. In this research, the non-thermal plasma system is designed with diameter (3 mm, 10 mm) Argon at atmospheric pressure as well as to be suitable for use in medical and biotechnological applications.
The thermal description of this system was studied and we observed the effect of the diameter of the plasma needle on the plasma, when the plasma needle slot is increased the plasma temperature decrease, as well as the effect of the voltages applied to the temperature of the plasma, where the temperature increasing with increasing the applied voltage . Results showed t

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of the investments Iraqi fund External Development /an applied study
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The research aims to evaluate Evaluation of the investments Iraqi fund for External development through the application of financial tools to a number of companies of the Iraqi Fund for External Development, and from the point of view to achieve the best returns from investment and the feasibility of the investments of the Iraqi Fund for External Development and the research community represents the Iraqi Fund for External Development and the amount of (28) A company, while the research sample is (4) companies (the Arab Petroleum Transportation Services Company, the Arab Iraqi Company for Livestock Development, the Bauhaus Company for prefabricated buildings and mineral installations, the Arab Fisheries Company) that were chosen

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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)
Study the Prevalence of Helicobacter pylori Infection by Different Diagnostic Methods
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A total of 41 patients with gastro duodenal symptoms (show signs of inflammation with or without duodenal ulcer) . 21 males (51.2%) and 20 female (48.8%) with an average age 0f  (20 – 80) years old under  going gastrointestinal endoscopy at Baghdad teaching hospital in internal disease clinical laboratory , between (February – June)  2009 . Biopsies specimen of antrum , gastric fundus ,& duodenal bulb were examined by the following methods (rapid urease test , Giemsa stain section to detect bacteria , & Haematoxilin and Eosin stained section for pathological study which are considered the gold standard methods , sera or plasma from these patients were tested by immunochromotography (ICM),serological m

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Study the Characterizations of Cement Mortar by Nano Pozzolanic Materials Additions
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This study involves adding nano materials and interaction with cement mortar behavior for several mortar samples under variable curing time with constant water to cement ratio (W/C = 0.5). The effects of adding nano materials on the microstructure of cement mortar were studied by (Scanning Electronic Microscopy (SEM) and X-Ray (for samples at different curing time 28 and 91 days. Small ratio replacements of nano particles (SiO2 or Al2O3) were added to Ordinary Portland Cement (OPC) type (I). The percentage of nano materials additives replacement by weight of ordinary Portland cement includes (1, 2, 3, 4 and 5%) for both types of nano materials with constant (W/C) ratio, also the amount of the fin

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Publication Date
Sun Dec 01 2013
Journal Name
Baghdad Science Journal
Study the Effect of Solar Radiation Pressure at Several Satellite Orbits
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The effects of solar radiation pressure at several satellite (near Earth orbit satellite, low Earth orbit satellite, medium Earth orbit satellite and high Earth orbit satellite ) have been investigated. Computer simulation of the equation of motion with perturbations using step-by-step integration (Cowell's method) designed by matlab a 7.4 where using Jacobian matrix method to increase the accuracy of result.

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Publication Date
Sun Dec 07 2014
Journal Name
Baghdad Science Journal
Study the Changes of Thyroid Hormones Levels Following Major Urological Surgery
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This study was designed to evaluate the effect of major surgery on thyroid hormones and thyrotropin in patient undergoing major lower abdominal surgery. The study included fifty patients scheduled for elective major lower abdominal surgery, the serum levels of T3, T4 and TSH were determined one day preoperatively, intraoperative, one day postoperatively, two days postoperatively, and rT3 was determined one day preoperatively, and one day postoperatively. We observed that the levels of (T3, T4, TSH) increased significantly (P<0.05) intraoperatively, one day postoperatively the levels of T3 and T4 reduced significantly (P<0.05), while TSH reduced not significantly (P>0.05), and two days postoperatively T4 and TSH returned to increase si

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