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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
Sun Feb 05 2017
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY THE OPTIMUM CONDITIONS FOR THE REMOVAL OF HEAVY METAL ELEMENTS FROM AQUEOUS SOLUTIONS USING CONTAMINATED BACTERIA Bacillus subtilis LOCALLY ISOLATED: STUDY THE OPTIMUM CONDITIONS FOR THE REMOVAL OF HEAVY METAL ELEMENTS FROM AQUEOUS SOLUTIONS USING CONTAMINATED BACTERIA Bacillus subtilis LOCALLY ISOLATED
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We studied the effect of certain environmental conditions for removing heavy metal elements from contaminated aqueous solutions (Cd, Cu, Pb, Fe, Zn, Ni, Cr) using the bacterium Bacillus subtilis to appoint the optimal conditions for removal ,The best optimum temperature range for two isolate was 30-35○C while the hydrogen number for the maximum mineral removal range was 6-7. The best primary mineral removal was 100 mg/L, while the maximum removal for all minerals was obtained after 6 hrs of Cu element time and the maximum removal efficiency was obtained after 24 hrs of Cu element. The results have proved that the best aeration for maximum removal was obtained at rotation speed of 150 rpm/minute. Inoculums of 5ml/100ml which contained 1

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Study to modify the fat cow's milk for children and infants
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This study Ajert to modify the chemical composition of milk fat cows and make it similar to the installation of milk fat mother through the addition of protein and soybean oil to be given Alkhltatnsp sensory protein that the best plan is the ratio of 1:1

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
The Ash'aris and their position on faith, An Ideological Study: الايمان
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The Ash'aris and their position on faith, An Ideological Study

Omed AbdulQader rasool               

College of Islamic Sciences/Salahaddin University-Erbil

Abstract

The concept of faith is very complex, and there are a lot of talk about it among the major Islamic groups such as the Kharijites, the Mu'tazila, the Jahmiyya and others, because of its great importance, and the worldly and eschatological effects it entails according to the elements of faith such as recognition, ratification and action.

The researcher chose one sect, which is the

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Publication Date
Tue Nov 25 2025
Journal Name
Inorganic Chemistry Communications
Synthesis, spectroscopic and single-crystal analysis, and DFT studies of N₂O₂ diamine coordination complexes: solvent-driven geometry switching and NLO properties
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The design of coordination compounds with solvent-responsive optical properties remains a central challenge in molecular photonics. Here, we describe the synthesis and full characterisation of a symmetrical tetradentate diamine ligand, 3,3′-((1,2-phenylenebis(azanediyl))- bis(methanylylidene))bis(pentane-2,4-dione) (H₂L), and its neutral square-planar complexes [M(L)] (M(II) = Co, Ni, Cu). The Cu(II) complex crystallised as [Cu(L)]⋅0.5 (pyrazine), adopting a nearly square-planar geometry (τ₄ = 0.06) in the solid state, as confirmed by single-crystal X-ray diffraction. In DMSO solution, UV–Vis spectra revealed reversible axial coordination of two solvent molecules, driving a transformation to a distorted octahedral geometry. Struc

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Publication Date
Sat Oct 01 2022
Journal Name
Case Studies In Thermal Engineering
Comparative assessment of the performance and combustion attributes of a free piston linear generator fuelled with CNG and CNG-CO2
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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
The servant leadership and its impact in organizational trust An analytical study in oil products distribution company / Baghdad
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Abstract

The research aims at the relationship between Servant leadership dimensions test as an independent variable and an organizational trust as a variable dependent. Thus it was necessary to answer the following question: Is there a correlation relationship and impact between Servant leadership dimensions and organizational trust? To investigate the contents of the answer, the researcher selected a group of employees in Oil Products Distribution Company / Baghdad. The researcher adopted the analytical descriptive approach in completing his research which dealt with a random sample of (190) individuals representing the research society out of the total number of (376) person from the middle and high Leaders. Depending

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Study the Level of Service to Roadways which Leading to Basrah University
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The building of Basrah University located in a rural area at Gramat Ali, its consist of seven colleges and very high number of students, lecturers ,and employers. Therefore, the intersections which leading to university building suffer congestion at morning peak hour (8-9) A.M and evening peak hour (2-3) P.M. In this study we collected the data in intersections which leading to university building at peak hour at same time, then we had analysis this data by using the highway capacity manual (HCM) and program (HCS). Also, we collected that data in University entries with classification of vehicles according to types and number of passengers at peak hour. Then we studied the number of proposals to riddance the congestion, such as the effe

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Publication Date
Mon Feb 02 2026
Journal Name
Al-anbar University Journal Of Law And Political Sciences
The Effect of E-Government on Public Facility Management Methods (Comparative Study)
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Publication Date
Thu Apr 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Groundwater Quality Study Based on the Existence of Escherichia coli as Bioindicator
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Abstract<p>The research aim was to observe the distribution pattern of <italic>Escherichia coli</italic> as groundwater pollution indicator in the most populous area, Matraman Sub-District Area in Jakarta, Indonesia (106°49’35” EL and 06°10’37” SL) consists of six (6) Urban Villages. The existence of <italic>Escherichia coli</italic> was measured with Most Probable Number (MPN) method as mentioned in Indonesian Standard Number 01-2332.1-2006. This research was also measure pollution parameter of Dissolved Oxygen (DO) and pH, and topography analyses used as well to determine groundwater flow direction. Groundwater sampling was conducted in several housings that have </p> ... Show More
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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Physics: Conference Series
Study the Antifungal Activity of ZnS:Mn Nanoparticles Against Some Isolated Pathogenic Fungi
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An aqueous chemical reaction has been used to prepare antifungal ZnS: Mn nanostructures, from manganese chloride, zinc acetate and thioacetamide in aqueous solution. The nanoparticle size has been controlled using thioglycolic acid as a capping factor. The major feature of the ZnS:Mn nanoparticles of average diameter ~ 2.73 nm is that possible preparing the sample from sources non-toxic precursors. The manufactured ZnS:Mn nanoparticles were identified and characterized to investigate the structure, morphology, composition of components of the nanoparticles and optical properties using (XRD, SEM, EDS and UV-Vis spectroscopy) techniques respectively. The agar dilution mechanism used to evaluate of the antifungal activity using ZnS:Mn nanopart

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