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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 Mar 07 2010
Journal Name
Baghdad Science Journal
Study of the Singlet and the Triplet States of Two ElectronSystems in the First Excited State
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A study of the singlet and triplet states of two electron systems in the first excited state was performed using a simple quantum mechanical model, which assigns the 1s,and 2s orbital with two different variational parameters. Our results agree with a high level calculation used by Snow and Bills.

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Publication Date
Mon Jul 21 2014
Journal Name
Sensors
Reduction of the Dimensionality of the EEG Channels during Scoliosis Correction Surgeries Using a Wavelet Decomposition Technique
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This paper presents a comparison between the electroencephalogram (EEG) channels during scoliosis correction surgeries. Surgeons use many hand tools and electronic devices that directly affect the EEG channels. These noises do not affect the EEG channels uniformly. This research provides a complete system to find the least affected channel by the noise. The presented system consists of five stages: filtering, wavelet decomposing (Level 4), processing the signal bands using four different criteria (mean, energy, entropy and standard deviation), finding the useful channel according to the criteria’s value and, finally, generating a combinational signal from Channels 1 and 2. Experimentally, two channels of EEG data were recorded fro

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Publication Date
Sun Jun 11 2017
Journal Name
Al-academy
Directorial Vision Between The Closed And Open In The Iraqi Theater Space
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This research deals with the concept of space in the theatrical performance and how the director works between two different spaces, the closed space and the open space. The question was how to use space according to the director's vision in the presentation. The problem of the research was whether the director of the Iraqi filmmaker could see the variable in the architectural space Or the place or space within the exhibition between open and closed, through the formation of the vision of the external components of intellectual and aesthetic and aesthetic, and impact on the relationship between the actor and the recipient to produce a new aesthetic space, and then the purpose of research and importance and limits and terminology The seco

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Christian Taghlib tribe in the first century A.H: The Christian Taghlib tribe in the first century A.H
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Abstract:
Taghlib tribe had an important part in the history of the first century of
hijra. She managed to get the best social, economic and political basis in the
Arab- Islamic state. In this basis Taghlib was the best Dhimies in the Islamic
state. This tribe refused to be among the people of the book, and to be from
the people of dhima. That tribe refused to pay the Jizya and Khraj, but
accepted to pay double Sadaqa in stead of Jizya and Khraj, so in that case
many Muslims become angry.
Although their Christianity was naïve and simple, Taghlib hold it until the
end of the third century A.H. Taghlib did so because her people wanted to
keep their good relation with the Byzantine. Taghlib thought that the

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Publication Date
Tue Oct 01 2019
Journal Name
Ceramics International
A first-principles study of the electronic, structural, and optical properties of CrN and Mo:CrN clusters
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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
The difficulties facing literary sixth students in studying modern and contemporary history from their point of view
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  The research aims to find out the difficulties of studying the subject of modern and contemporary history and its proposed solutions from the point of view of the students of the literary sixth in the secondary schools of the Directorate of Education Rusafa I-Baghdad, the research community of students of the literary sixth stage, which Number(150) students,and to achieve the- And Fisher's equation-and percent weight).The results showed the existence of a number of real difficulties achieved for the study of modern and contemporary history of the sixth literature, and the data showed the existence of Unreal difficulties diagnosed from the students ' point of view .In light of this, the researcher dev

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Publication Date
Mon Aug 31 2020
Journal Name
Bmc Oral Health
The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study
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Abstract<sec><title>Background

The purpose of this study was to evaluate the anesthetic effectiveness of a buccal infiltration technique combined with local massage (using 2% lidocaine) in the extraction of mandibular premolars to be utilized as an alternative to the conventional inferior alveolar nerve block.

Methods

Patients eligible included any subject with a clinical indication for tooth extraction of the mandibular 1st or 2nd premolars. All patients were anesthetized buccally by local infiltration technique followed by an external pressure applied for 1 min directly over the injection area. In each case, another local

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Publication Date
Sun Mar 06 2016
Journal Name
Baghdad Science Journal
The Impact of Operating System on Bandwidth in Open VPN Technology
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The internet is a basic source of information for many specialities and uses. Such information includes sensitive data whose retrieval has been one of the basic functions of the internet. In order to protect the information from falling into the hands of an intruder, a VPN has been established. Through VPN, data privacy and security can be provided. Two main technologies of VPN are to be discussed; IPSec and Open VPN. The complexity of IPSec makes the OpenVPN the best due to the latter’s portability and flexibility to use in many operating systems. In the LAN, VPN can be implemented through Open VPN to establish a double privacy layer(privacy inside privacy). The specific subnet will be used in this paper. The key and certificate will

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Publication Date
Thu Sep 01 2022
Journal Name
Journal Of Stomatology
The effectiveness of limited flap design in surgical removal of fully impacted lower third molars: a comparative clinical study
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Publication Date
Sat Jun 19 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Ginkgo biloba Extract as Monotherapy in Improving the Outcomes of Patients with Metabolic Syndrome: A Pilot Comparative Study with Metformin
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The present study evaluates the effects of Ginkgo biloba extract as monotherapy on the glycemic status, insulin resistance (IR), body mass index (BMI), and visceral adiposity index (VAI), in addition to the inflammatory markers, oxidative status and leptin level in patients with metabolic syndrome in comparison with metformin.

The study is a randomized, double-blind pilot study conducted during the period May to September, 2020. Fifty patients were recruited in the study and they were allocated into two groups (25 per each group): Ginkgo biloba and Metformin groups, they received (120 mg Ginkgo biloba extract/ capsule) and (500 mg Metformin/ capsule) respectively; orally as a single dose for 90 days. Blood samples were taken at z

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