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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 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Measurement of Government Debt Indicators and the most Its important Effects in Iraq for The period of 1990 – 2013
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Indicators of government debt is of extreme importanse in economic activity through knowledge of the economic impact of government debt, if the phenomenon is accepted or prepared to dangerous stage by stage, and there fore it can Through these indicators to measure the degree of indebtedness in relation to the economic activity of the Government on the one hand, the governments  ability to repay  the other hand.

      Due to this it inferred that the degree of indebtedness in Iraq  specificratio has exceed 60% during the period 1990 – 2002 ntejh lack of political and economic stability of the government, which led to the governments  inability to repay the ma

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Publication Date
Fri Jun 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of Molecular Imprinting on the Loading and Release of Poorly Water Soluble Drug in Hydrogel Gontact Lenses
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Therapeutic contact lenses TCLs is an approach used to enhance corneal residence time and reduce frequent instillation, which is a problem with eye drops.  The problem with CLs is loading of hydrophobic drugs. In this research the CLs were prepared with molecular imprinting MI to enhance the loading of itraconazole, which is used as antifungal drug for fungal keratitis. CLs using different  concentration of hydroxyethyl methacrylate HEMA and methacrylic acid MAA were prepared with and without MI using PEGDA (25 μL) and AIBN (37 mg) as crosslinker and initiator respectively. All the prepared CLs were clear and have good folding endurance. MICLs had significantly higher drug loading compared to conventional CLs. The release of i

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Publication Date
Tue Mar 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The effect of intellectual capital on the Total quality management of higher education and scientific research institutions in Baghdad
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         The purpose and goal of the research revolve around the diagnosis of intellectual capital as the logical indicator to study an effective human resource management practice and its influential role in determining the overall quality management of higher education institutions and scientific research in Baghdad.

       To achieve the purpose of the research, an upgraded standard questionnaire was used to collect data and distribute it to the selected sample in a statistical manner from the study population of (5) institutions affiliated with the Ministry of Higher Education and Scientific Resear

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Publication Date
Mon Jan 29 2024
Journal Name
2024 3rd International Conference On Digital Transformation And Applications (icdxa)
The Mediating Role of Cobit 2019 in Managing the Relationship Between Qualitative Characteristics of Accounting Information and Information Asymmetry
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The Mediating Role of Cobit 2019 in Managing the Relationship Between Qualitative Characteristics of Accounting Information and Information Asymmetry

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Publication Date
Mon Jan 01 2018
Journal Name
Indian Journal Of Public Health Research &amp; Development
Environmental Assessment of the Quality of Water and the Hydrochemical Formula Used for Some Groundwater Wells in Karbala Governorate
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Publication Date
Wed Jun 26 2024
Journal Name
Opera Medica Et Physiologica
The Impact of Global DNA Methylation and Hypoxia-Inducible Factor 1 Alpha Levels in the Progression of Breast Cancer
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Publication Date
Thu Dec 01 2022
Journal Name
Baghdad Science Journal
Synthesis, Characterization, and Investigation the Inhibitory Impact of Thiosemicarbazide Derivative toward the Corrosion of Mild Steel in Acidic Media
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        In this study we focused on the determination of influence the novel synthesized thiosemicarbazide derivative "2-(2-hydroxy-3-methoxybenzylidene) hydrazinecarbothioamide" (HMHC) influenced the corrosion inhibition of mild steel (MS) in a 1.0 M hydrochloric acid acidic solution.This is in an effort to preserve the metal material by maintaining it from corrosion.The synthesized inhibitor was characterized using elemental analysis, and NMR-spectroscopy. Then the corrosion inhibition capability of (HMHC) was studied on mild steel in an acidic medium by weight loss technique within variables [temperature, inhibitor concentration, and time]. The immersion periods were [1:00, 3:00, 5:00, 10:00, 24:00, and 72:00] hours and the tem

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Publication Date
Fri Apr 16 2021
Journal Name
Pharmaceutical Medicine
The Epidemic of Substandard and Falsified Medications in Iraq: Evaluating the Effectiveness of National Pharmacovigilance Alerts to Community Pharmacies
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Publication Date
Fri Feb 10 2023
Journal Name
Dentistry Journal
The Role of Social Media in Communication and Learning at the Time of COVID-19 Lockdown—An Online Survey
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This study aimed to assess orthodontic postgraduate students’ use of social media during the COVID-19 lockdown. Ninety-four postgraduate students (67 master’s students and 27 doctoral students) were enrolled in the study and asked to fill in an online questionnaire by answering questions regarding their use of social media during the COVID-19 lockdown. The frequency distributions and percentages were calculated using SPSS software. The results showed that 99% of the students used social media. The most frequently used type of social media was Facebook, 94%, followed by YouTube, 78%, and Instagram, 65%, while Twitter and Linkedin were used less, and no one used Blogger. About 63% of the students used elements of social media to l

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of The College Of Education For Women
The Degree of Availability of Design Thinking Indicators in the content of Arabic Language Curricula at the secondary stage in Syrian Arab Republic
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The study aimed to identify the degree of availability of design Thinking Indicators in The content of the Arabic Language Curricula at the secondary stage in the Syrian Arab Republic; to achieve the goal of the study. The researcher used the Descriptive Approach based on the analysis method according to the Cognitive Theory. The study tools consist of a list of Design Thinking Indicators and a Content Analysis Tool. The researcher completed the Validity and Reliability procedures for the tools. After applying them, the results of the study resulted in the following: Greater Interest than other sub-skills. The results also showed a Divergence of care for the sub-skills and the Difference in their recurrence rate, and the Omission of some

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