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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 Jan 01 2023
Journal Name
Journal Of Engineering
State-of-the-Art in Data Integrity and Privacy-Preserving in Cloud Computing
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Cloud computing (CC) is a fast-growing technology that offers computers, networking, and storage services that can be accessed and used over the internet. Cloud services save users money because they are pay-per-use, and they save time because they are on-demand and elastic, a unique aspect of cloud computing. However, several security issues must be addressed before users store data in the cloud. Because the user will have no direct control over the data that has been outsourced to the cloud, particularly personal and sensitive data (health, finance, military, etc.), and will not know where the data is stored, the user must ensure that the cloud stores and maintains the outsourced data appropriately. The study's primary goals are to mak

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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The reality and dilemmas of higher education in IraqAnalytical vision in knowledge economies
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The subject of education, and since time immemorial, gripe the attention of the religious, intellectual, political, social and economic elites. This attention not only in Iraq, but in different countries in the world. There is a close correlation between the educational level of the societies and the edginess of its rising and advancement in all fields.

In order to achieve the research objectives, the research has   been divided into three sections: section I include the historical, scientific, humanitarian evolution of education, starting from the first economic revolution (The Agricultural revolution) through the second economic revolution (The Industrial Revolution) and till the Third Economi

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Publication Date
Wed Sep 14 2022
Journal Name
Lecture Notes In Civil Engineering
Effect of Nozzle Condition and Type in the Spray Quality in Wheat Plants
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Publication Date
Tue Sep 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Private investment and its role in the process of economic reform in Iraq
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بعد ثورة تموز عام 1958في العراق, لم يكن يسمح للقطاع الخاص بأن تكون له استثمارات كبيرة في القطاعات الاقتصادية. وذلك بسبب الإيديولوجيات التي كانت تؤطر الفكر السياسي. حيث كان النهج الاشتراكي هو الغالب في إدارة الأنشطة الاقتصادية. إذ قامت الدولة بتأميم معظم الاستثمارات الخاصة الكبيرة ،لاس

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Publication Date
Sun Mar 14 2021
Journal Name
Aestimum
The role of fiscal and monetary policy in stimulating Circular Economy in Iraq
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The issue of the Circular Economy is not a new issue to several countries, especially the developed ones. Here in Iraq it is considered newly introduced, despite the few attempts to establish projects that concern recycling most of them were doomed to fail, due to two main reasons: the first one is the financial and administrative corruption widespread in all departments of the country, the second one is the priorities of public spending. It is well known that Iraq was subjected to two major attacks, the ISIS entry attack in 2014 to Iraq. ISIS occupied about a third of Iraqi lands which resulted in a collapse in oil prices, as Iraq depends almost entirely on oil revenues in its budget which is the second attack. This made the Iraqi governme

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
Studying the Changes in Solar Radiation and Their Influence on Temperature Trend in Iraq for a Whole Century
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Most studies indicated that the values ​​of atmospheric variables have changed from their general rates due to pollution or global warming etc. Hence, the research indicates the changes of direct solar radiation values ​​over a whole century i.e. from 1900 to 2000 depending on registered data for four cities, namely (Mosul - Baghdad - Rutba - Basra. Moreover, attemptsto correlate the direct solar radiation with the temperature values have been ​​recorded over that period. The results showed that there is a decreasing pattern of radiation quantities over time throughout the study period, where the value of direct radiation over the city of Baghdad 5550 w/m2 was recorded in the year 1900, but this ratio decreased cle

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Publication Date
Tue Dec 11 2018
Journal Name
Baghdad Science Journal
Study of Cytotoxic Effect of Aqueous Extract Fenugreek(Trigonella Foenum Graecum L.S) Seeds and The New Complexes of Rh (?) and Pd (?) on Cancer Cell Lines
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The effect of the aqueous extract of fenugreek seeds (Trigonella Foenum Graecum L.), Rhodium complex (?) with formula [RhL2CLH2O].1 1/2 ETOH and palladium (?) [pdl2].2ETOH,where L=2-hydroxy phenyl piperonalidine was studied on two cancer cell lines. The first cell line was intestine cancer of female albino mice (L20B), the second one was Rhabdomysarcomas (RD)cell line in human. The activity of the new complexes and the aqueous extract was compared to the well-known anticancer drug (cis-platin) by utilizing the in vitro system. The cell lines were treated with four concentrations of cis-platin 31.25,62.5,125 and 250 ?g/ml for 72 hour exposure time. The same concentrations were used with extract and the new complexes. This study showed that t

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Publication Date
Sun Jan 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
השואה והשלכותיה על אהרון אפלפלד - עיון בשלושה סיפורים קצרים עוזר למורה – עלי מוחמד רשיד The Holocaust and its impact on Aharon Bielefeld - A Study in Three Short Stories
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מטרת המחקר הזה היא לבדוק את שלושה סיפורים קצרים מהקובץ הראשון של אהרון אפלפלד , שנחשב ההצהרה הרשמית על היותו סופר השואה הראשון בישראל , המשותף לשלושת הסיפורים הוא הנימה של הגיבורים היוצאים למסע פיזי ונפשי לגלות את אשר אירע להם , מגמתו של המחקר היא לבדוק את הצורה המיוחדת שבה אפיין אפלפלד את גיבוריו שמעידים על כך , כי השואה היא החוויה המרה והקשה בקרב היהודים והשלכותיה נשארה טמונה בקרבם גם אחרי המלחמה ואחרי שנים

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Publication Date
Tue Sep 01 2009
Journal Name
Al-khwarizmi Engineering Journal
Low Cost Heart Rate Monitor Using Led-Led Sensor
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A high sensitivity, low power and low cost sensor has been developed for photoplethysmography (PPG) measurement. The PPG principle was applied to follow the dilatation and contraction of skin blood vessels during the cardiac cycle. A standard light emitting diodes (LEDs) has been used as a light emitter and detector, and in order to reduce the space, cost and power, the classical analogue-to-digital converters (ADCs) replaced by the pulse-based signal conversion techniques. A general purpose microcontroller has been used for the implementation of measurement protocol. The proposed approach leads to better spectral sensitivity, increased resolution, reduction in cost, dimensions and power consumption. The basic sensing configuration prese

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Publication Date
Sat Jan 01 2022
Journal Name
Proceeding Of The 1st International Conference On Advanced Research In Pure And Applied Science (icarpas2021): Third Annual Conference Of Al-muthanna University/college Of Science
Interleukin 2−330 single nucleotide polymorphism association with type 1 diabetes in Iraqi patients
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Type 1 diabetes (T1D) is an autoimmune disease with chronic nature resulting from a combination of both factors genetic and environmental. The genetic contributors of T1D among Iraqis are unexplored enough. The study aimed to shed a light on the contribution between genetic variation of interleukin2 (IL2) gene to T1D as a risk influencer in a sample of Iraqi patients. The association between IL2−330 polymorphism (rs2069762) was investigated in 322 Iraqis (78 T1D patients and 244 volunteers as controls). Genotyping for the haplotypes using polymerase chain reaction test – specific sequence primer (PCR-SSP) for (GG, GT, and TT) genotypes corresponding to (G and T) alleles were performed. A significant association revealed a decreased freq

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