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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 Dec 01 2019
Journal Name
Baghdad Science Journal
Comparison of Some Suggested Estimators Based on Differencing Technique in the Partial Linear Model Using Simulation
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In this paper new methods were presented based on technique of differences which is the difference- based modified jackknifed generalized ridge regression estimator(DMJGR) and difference-based generalized  jackknifed ridge regression estimator(DGJR), in estimating the parameters of linear part of the partially linear model. As for the nonlinear part represented by the nonparametric function, it was estimated using Nadaraya Watson smoother. The partially linear model was compared using these proposed methods with other estimators based on differencing technique through the MSE comparison criterion in simulation study.

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Engineering
Compensation of the Nonlinear Power Amplifier by Using SCPWL Predistorter with Genetic Algorithm in OFDM technique
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The High Power Amplifiers (HPAs), which are used in wireless communication, are distinctly characterized by nonlinear properties. The linearity of the HPA can be accomplished by retreating an HPA to put it in a linear region on account of power performance loss. Meanwhile the Orthogonal Frequency Division Multiplex signal is very rough. Therefore, it will be required a large undo to the linear action area that leads to a vital loss in power efficiency. Thereby, back-off is not a positive solution. A Simplicial Canonical Piecewise-Linear (SCPWL) model based digital predistorters are widely employed to compensating the nonlinear distortion that introduced by a HPA component in OFDM technology. In this paper, the genetic al

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Publication Date
Mon Aug 01 2022
Journal Name
Baghdad Science Journal
Application of GIS technique in the studies on fish assemblages in Shatt Al-Arab River, Basrah, Iraq
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The present study has examined the spatiotemporal varieties of the demographics of the Shatt Al-Arab River fishes and their relation to some ecological components. The aim is to forecast these groups in the unexplored parts of the waterway with an emphasis on environmental indices of diversity. Three sites in the river were selected as an observation and study of these species, which lasted from March 2019 to February 2020, the study dealt with factors affecting fishes, as Water Temperature (WT), Dissolved Oxygen (DO), Potential Hydrogen Ion (pH), Salinity (Sal), and Transparency (Tra). Gill nets, cast nets, hooks, and hand nets were adopted to collecting fish. The results indicated that the fish population comprises 60 species represent

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The extent of the social worker’s use of group discussion technique in professional practice with school activity groups in Tubas Governorate schools
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This study aimed at identifying the extent to which the social worker used the techniques of group discussion in the professional practice with the groups of school activity in the schools of Tubas governorate in light of some variables (gender, years of experience, academic qualification). The analytical descriptive method was used due to its suitability for the objectives of the study.  A questionnaire was designed to collect data that included (30) items, distributed in three areas .The validity and reliability of the tool were verified and then distributed to the study sample.

 

The results of the study showed that the highest averages were in the discussion stage domain, where the pre-discussion stage was m

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Publication Date
Wed Sep 27 2023
Journal Name
Journal Of Optics
Studying the responsivity and detectivity of GO/PSi/n-Si photo detector via drop casting technique
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Publication Date
Wed Sep 27 2023
Journal Name
Journal Of Optics
Studying the responsivity and detectivity of GO/PSi/n-Si photo detector via drop casting technique
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Publication Date
Mon Jan 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Difficulties in the application of modern trends in physics in middle schools of the province of Baghdad, from the perspective of teachers of physics
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     The goal of current research is to identify the difficulties in the application of modern physics in the middle schools of the province of Baghdad schools from the perspective of teachers of physics trends, sample search of (127) teachers, Karkh Third Directorate, and use Researcher questionnaire data collection tool after applying it to teachers who have experience (5) years and more after confirmation of the validity and reliability of the scale (the tool) researcher has used the averages for the purpose of interpreting the results. the results showed that the difficulties have been in the order following: (difficulties related educational environment of modern trends of teaching, curriculum-related dif

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Degree of Difficulties in Learning Mathematics for the Fifth and Sixth Grades from the Teachers' Point of View and Their Suggestions for Addressing Them
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The current study aimed to identify the difficulties faced by the student in mathematics and possible proposals to address these difficulties. The study used a descriptive method also used the questionnaire to collect data and information were applied to a sample of (163) male and female teachers. The results of the study found that the degree of difficulties in learning mathematics for the fifth and sixth grades is high for some paragraphs and intermediate for other paragraphs, included the student's field. The results also revealed that there were no statistically significant differences at the level of significance (α = 0.05) between the responses of the members of the study sample from male and female teachers to the degree of diffi

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Publication Date
Sun Dec 28 2025
Journal Name
Journal Of Studies And Researches Of Sport Education
The most important obstacles facing girls’ clubs in Iraq
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SummaryThe most important obstacles facing girls’ clubs in IraqLamia Hassan Al-Diwan - Fatima Abdel Maleh - Nahida Hamed Thank youResearch SummaryIn the introduction and the importance of the research: We talked about women entering endurance events and relying on the principle of more training will achieve better results in the future. Based on the concepts that call for the equality of men with women in all aspects of sporting and competitive activity and as a result of the decline in women’s participation in sports clubs that include men, we came to The idea of ​​establishing clubs for Iraqi girls in 1992, with a club in every governorate, and the Iraqi National Olympic Committee adopted this idea, the goal of which is to develop

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Publication Date
Fri Dec 01 2017
Journal Name
Mustansiriya Medical Journal
Assessment of Antimicrobial Sensitivity of Bacterial Pathogens Isolated from Post-Cesarean Surgical Site Infection of Patients in Al-Elwiyah Maternity Hospital
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