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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
Wed Apr 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Multi-level model of the factors that affect the escalation of dust in Iraq
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In this research The study of Multi-level  model (partial pooling model) we consider The partial pooling model which is one Multi-level  models and one of  the Most important models and extensive use and application in the analysis of the data .This Model characterized by the fact that the treatments take hierarchical or structural Form, in this partial pooling models, Full Maximum likelihood FML was used to estimated parameters of partial pooling models (fixed and random ), comparison between the preference of these Models, The application was on the Suspended Dust data in Iraq, The data were for four and a half years .Eight stations were selected randomly  among the stations in Iraq. We use Akaik′s Informa

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Publication Date
Sat Oct 14 2023
Journal Name
Environmental Monitoring And Assessment
The technique of arsenic elimination from contaminated soil with enhanced conditions by electro-kinetic remediation
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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
Fast lightweight encryption device based on LFSR technique for increasing the speed of LED performance
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LED is an ultra-lightweight block cipher that is mainly used in devices with limited resources. Currently, the software and hardware structure of this cipher utilize a complex logic operation to generate a sequence of random numbers called round constant and this causes the algorithm to slow down and record low throughput. To improve the speed and throughput of the original algorithm, the Fast Lightweight Encryption Device (FLED) has been proposed in this paper. The key size of the currently existing LED algorithm is in 64-bit & 128-bit but this article focused mainly on the 64-bit key (block size=64-bit). In the proposed FLED design, complex operations have been replaced by LFSR left feedback technology to make the algorithm perform more e

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Publication Date
Sun May 01 2016
Journal Name
Journal Of Multidisciplinary Engineering Science Studies
The Thickness Effects Characterization Properties Of Copper Oxide Thin Films Prepared By Thermal Evaporation Technique
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In This paper, CuO thin films having different thickness (250, 300 , 350 and 400) nm were deposited on glass substrates by thermal vacuum evaporator. The thermal oxidation of this evaporated film was done in heated glass at temperature (300 in air at one hour. The study of X-ray diffraction investigated all the exhibit polycrystalline nature with monoclinic crystal structure include uniformly grains. Thin film’s internal structure topographical and optical properties. Furthermore, the crystallization directions of CuO (35.54 , 38.70 ) can be clearly observed through an X-ray diffraction analysis XRD, Atomic Force Microscope AFM (topographic image) showed that the surface Characteristics , thin films crystals grew with increases in either

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Publication Date
Sat Dec 02 2017
Journal Name
Al-khwarizmi Engineering Journal
e Timoshenko Three-Beams Technique To Estimate The Main Elastic Moduli Of Orthotropic Homogeneous Materials
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 A New developed technique to estimate the necessary six elastic constants of homogeneous laminate of special orthotropic properties are presented in this paper for the first time. The new approach utilizes the elasto-static deflection behavior of composite cantilever beam employing the famous theory of Timoshenko. Three extracted strips of the composite plate are tested for measuring the bending deflection at two locations. Each strip is associated to a preferred principal axis and the deflection is measured in two orthogonal planes of the beam domain. A total of five trails of testing is accomplished and the numerical results of the stiffness coefficients are evaluated correctly under the contribution of the macromechanic

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Effectiveness of Indicators of Financial Discipline in Strengthening the Exchange Rate, with a Special Reference to Iraq
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Controlling public expenditures is one of the main objectives of the public budget. The public budget often suffers from a deficit, whether in developed or developing countries, because expenditures are usually greater than the revenues generated. This requires the existence of financial rules that are adhered to by the government, which in turn leads to discipline. Fiscal policy leads to a reduction in the obligations incumbent on the government.  Adhering to the financial rules would correct the course of fiscal policy in Iraq, with the need to direct oil revenues in the years of financial abundance when global oil prices rise to sovereign funds similar to other rentier countries, which contributes to maintaining the stabi

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Publication Date
Wed Nov 01 2023
Journal Name
Clinical Epidemiology And Global Health
The association of interleukin-10 single nucleotide polymorphisms (rs1800871) and serum levels in Iraqi patients with celiac disease: A case-control study
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Publication Date
Mon Jan 01 2024
Journal Name
Organization, Technology And Management In Construction: An International Journal
The factors that affect constructability in Iraq
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Abstract<p>Applying the constructability concept in the construction industry has proven many benefits in different projects; however, this concept still lacks usage in Iraq. Therefore, it is important to encourage usage of the constructability concept in the construction industry in Iraq. The main purpose of this study is to investigate the factors that affect constructability in Iraq and then classify them according to their importance. A total of 37 factors were collected from an intensive literature review, and they were classified under the sub and main categories. A survey was undertaken in two sessions with open questionnaire and close questionnaire. The results were analysed and the mean</p> ... Show More
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Publication Date
Wed Aug 03 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The adequacy of foreign reserves and their role in the stability of the exchange rate of the Iraqi dinar
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Many countries are very important in their interest not only in diversifying foreign reserves, but in determining and planning their volume in accordance with the goals set, namely facing potential external shocks, as the research aims to determine the extent of the strength of foreign reserves in the possession of the Central Bank in relation to every influential variable in the Iraqi economy. , in order to determine the minimum level of reserves that requires reconsideration of the exchange rate, as the research adopted the inductive analytical method in analyzing real (Quantitative data) for the research variables in the years of study, as the research adopted a set of analytical indicators approved by the International Moneta

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Suspicion in the truth that the satisfaction of the student in the criticism of the speech of the poet and the writer to I bin Al-Atheer
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Suspicion in the truth that the satisfaction of the student in the criticism of the speech of the poet and the writer to I bin Al-Atheer

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