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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
Sat Jan 05 2019
Journal Name
Iraqi Journal Of Physics
Study of nuclear structure for carbon isotopes using local scale transformation technique in shell model
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This work is devoted to study the properties of the ground states such as the root-mean square ( ) proton, charge, neutron and matter radii, nuclear density distributions and elastic electron scattering charge form factors for Carbon Isotopes (9C, 12C, 13C, 15C, 16C, 17C, 19C and 22C). The calculations are based on two approaches; the first is by applying the transformed harmonic-oscillator (THO) wavefunctions in local scale transformation (LST) to all nuclear subshells for only 9C, 12C, 13C and 22C. In the second approach, the 9C, 15C, 16C, 17C and 19C isotopes are studied by dividing the whole nuclear system into two parts; the first is the compact core part and the second is the halo part. The core and halo parts are studied using the

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Publication Date
Sun Jun 30 2024
Journal Name
Modern Sport
The effect of an educational curriculum using virtual reality glasses in improving some kinetic abilities and learning freestyle swimming for first-year primary school students
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هدفت الدراسة الى الاهتمام واستغلال ماهو جديد من تقنيات واجهزة حديثة في تعليم السباحة الحرة عن طريق توجيه الاطفال على تطوير مداركهم واستيعابهم بالتطور التكنولوجي الذي يتناوله العالم ،قامت الباحثتان باعداد منهج تعليمي باستخدام نظارة الواقع الافتراضي وذالك بتوفير بيئة مشابهة للبيئة الحقيقية تحاكي مدارك عقول الاطفال في عالم افتراضي لتتكون صورة كاملة عن مهارات السباحة الحرة ،ومن هنا اتت المشكلة نتيجة تعل

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Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Engineering
Historical Paths and the Growth of Baghdad Old Center
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Urban growth of cities is connected with three related problems, the first one, is the deterioration of the center, which is a mark for historical origin. The second is the emergence of city edge, which contradicts by the center. The third one is the rapid semi urbanism of the edge. Literature review showed that Baghdad historical center (Old Rusafa and Karkh) had grown in four morphological stages, during which main paths had been changed from those which were perpendicular to the river front to those parallel to it. Research problem is that “there is a knowledge gap about the direction and origin of paths within Baghdad old center, after its growth”. The first research hypothesis is, “the direction of paths within old Baghdad cen

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Publication Date
Thu Jan 01 2015
Journal Name
The Iraqi Postgraduate Medical Journal
Aesthetic results of superomedial pedicle technique in reduction mammaplasty
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ABSTRACT: BACKGROUND: Breast reduction for mammary hypertrophy is a highly effective procedure with high degree of patient satisfaction. There are many methods of breast reduction which involve removal of excess tissue with reshaping of overlying skin while maintaining a viable nipple areolar complex. OBJECTIVE: The purpose of this study is to evaluate the use of the superomedial technique as an effective method for reduction mammoplasty. PATIENTS AND METHODS: A total of 30 patients underwent reduction mammoplasty by utilizing superomedial pedicle technique between 2010 and 2013. Those patients were evaluated postoperatively in terms of their aesthetic and functional satisfaction, viability of nipple – areolar complex and nipple sensory p

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Publication Date
Sat Dec 28 2024
Journal Name
Journal Of Physical Education
The Effect of a Psychological Counseling Program to reduce irrational ideas and the causal attribution of the coaches of the gymnasium sports care center
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The research aimed to prepare a psychological counseling program for the coaches of the Sports Care Center in the gymnasium, and to learn about the impact of the psychological counseling program in reducing irrational ideas and causal attribution of the coaches of the Sports Talent Care Center in the gymnasium, to assume that there are statistically significant differences between the results of the tribal and posttests of the research group Experimental in the scale of irrational ideas, and there are statistically significant differences between the results of the tribal and posttests of the experimental research group in the scale of the causal attribution scale, The experimental approach was adopted by designing one experimental

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Publication Date
Mon Mar 27 2023
Journal Name
Iranian Journal Of Materials Science And Engineering
First-Principles Analysis of Cr-Doped SrTiO 3 Perovskite as Optoelectronic Materials
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The influence of Cr3+ doping on the ground state properties of SrTiO 3 perovskite was evaluated using GGA-PBE approximation. Computational modeling results infered an agreement with the previously published literature. The modification of electronic structure and optical properties due to Cr3+ introducing into SrTiO 3 were investigated. Structural parameters assumed that Cr3+ doping alters the electronic structures of SrTiO 3 by shifting the conduction band through lower energies for the Sr and Ti sites. Besides, results showed that the band gap was reduced by approximately 50% when presenting one Cr3+ atom into the SrTiO 3 system and particularly positioned at Sr sites. Interestingly, substituting Ti site by Cr3+ led to eliminating the ban

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Publication Date
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
Complications of Ponseti Technique in Treatment of Idiopathic Club Foot
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Background: Clubfoot, or talipes equinovarus, is a congenital deformity that consist of; supination and adduction of the forefoot and midfoot; equinus of hindfoot and varus. It was found that more than 100,000 babies are born each year with congenital clubfoot

Objectives: The purpose of this study was to investigate the complications of  ponseti method for treatment of children with idiopathic club foot.

Subjects and Methods: 50 children with 74 clubfeet were managed by Ponseti method from May 2019 to July 2020 in Al-Wasity teaching hospital with primary correction of the deformity followed sometimes by elongation of Achilles tendon then the pati

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Publication Date
Thu Jan 06 2022
Journal Name
Chemical Papers
A solvent collection technique using dispersive liquid–liquid microextraction coupled with spectrophotometry for the trace determination of folic acid in pure, dosage forms and flaxseed
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A simple, rapid and environmentally friendly dispersive liquid–liquid microextraction method-based spectrophotometric method for the trace determination of folic acid has been developed. The proposed method is based on the formation of a deep yellow product via reaction of folic acid and 1,2-naphthoquine-4-sulfonate at pH = 9. The formed complex was extracted using a mixture of chloroform and ethanol. Then, the tiny organic droplets were measured at λ = 520 nm. At the optimum conditions, linearity was ranged from 0.05 to 1.5 μg/mL for the standard and samples, with a linear correlation coefficient of 0.9996. The detection limits were 0.02, 0.027, 0.03, 0.02 and 0.04 μg/mL for standard, tablet (5 mg), tablet (1 mg), syrup and fl

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Publication Date
Thu Sep 01 2005
Journal Name
Journal Of Sport Sciences
Comparison study in some kinematics variables in (100) meter butterfly swimming to first and second ranking in world swimming championship Espana 2003
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The aim of study was making comparison in some kinematics variables in (100) meter butterfly swimming to first and second ranking in championship 2003 Espana, so noticed there is no such like this study in our country in comparison study for international champions therefore not specific and scientific discovering to these advanced levels, also the researchers depend on group of kinematics variables when the comparison making and it was included (50 meter the first, 50 meter the second, the differences between the first (50) meter and the second , more over basic variables in (100) meter butterfly , after having the results and treat it statistically the researchers reaches to two conclusions which was: • Success the first rank in startin

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Publication Date
Sun Mar 02 2008
Journal Name
Baghdad Science Journal
A study of analysis and comparison to the low nutrient density foods that more normality for children age (3 –5 years)
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Through the early childhood and after the ablactating the child learns acquired food habbits that might studying with him throughout his life. Here the parents role arises: teaching the child the sound food habits and hygienic styles and whatever beneficial to the health and with the sufficient quantities for the body. In this way the experiences the child learns at home will be of great help in his future life in choosing the suitable food after becoming more dependent in making his decisions and choices away from his parents. The results in this study showed that the averages of the children’s consumption of the high energy foods in comparison with the other highest consumption average , after that comes the con sumption of soft drills

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