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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 Jun 01 2022
Journal Name
Iraqi Journal Of Physics
Theoretical Investigations of Electronic and Optical Properties of Vanadium Doped Wurtzite Zinc Oxide from First Principle Calculation Method
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In this study lattice parameters, band structure, and optical characteristics of pure and V-doped ZnO are examined by employing (USP) and (GGA) with the assistance of First-principles calculation (FPC) derived from (DFT). The measurements are performed in the supercell geometry that were optimized. GGA+U, the geometrical structures of all models, are utilized to compute the amount of energy after optimizing all parameters in the models. The volume of the doped system grows as the content of the dopant V is increased. Pure and V-doped ZnO are investigated for band structure and energy bandgaps using the Monkhorst–Pack scheme's k-point sampling techniques in the Brillouin zone (G-A-H-K-G-M-L-H). In the presence of high V content, the ban

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Publication Date
Sat Oct 01 2011
Journal Name
Journal Of Engineering
INTERACTION EFFECTS OF HYDRODYNAMICALLY FULLY DEVELOPED PRIMARY FLOW AND SECONDARY FLOW IN THE THERMAL ENTRANCE REGION OF ANNULAR DUCT
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Experiments have been conducted to study the local and average heat transfer by mixed
convection for hydrodynamically fully developed, thermally developing and fully developed
laminar upward air flow in an inclined annulus with adiabatic inner cast iron tube and uniform
heated outer aluminum tube with an aspect ratio ( Ω = 0.72) and (L/Dh≈40) for both calming and
test sections). A wide range of Reynolds number from 859 to 2024 has been covered, and heat
flux has been varied from 159 W/m2 to 812 W/m2 (these values of heat flux and Reynolds
number gave Richardson number range from 0.03 to 0.٣٨), with angles of annulus inclination
φ =0o (horizontal position), φ =60o (inclined position), and φ =90o (vertical posi

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Publication Date
Fri Feb 10 2023
Journal Name
Journal Of Applied Mathematics
The Dynamics of a Delayed Ecoepidemiological Model with Nonlinear Incidence Rate
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In this paper, the general framework for calculating the stability of equilibria, Hopf bifurcation of a delayed prey-predator system with an SI type of disease in the prey population, is investigated. The impact of the incubation period delay on disease transmission utilizing a nonlinear incidence rate was taken into account. For the purpose of explaining the predation process, a modified Holling type II functional response was used. First, the existence, uniform boundedness, and positivity of the solutions of the considered model system, along with the behavior of equilibria and the existence of Hopf bifurcation, are studied. The critical values of the delay parameter for which stability switches and the nature of the Hopf bifurcat

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Publication Date
Thu Jun 20 2019
Journal Name
Baghdad Science Journal
A Comparative Analysis of the Zernike Moments for Single Object Retrieval
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Zernike Moments has been popularly used in many shape-based image retrieval studies due to its powerful shape representation. However its strength and weaknesses have not been clearly highlighted in the previous studies. Thus, its powerful shape representation could not be fully utilized. In this paper, a method to fully capture the shape representation properties of Zernike Moments is implemented and tested on a single object for binary and grey level images. The proposed method works by determining the boundary of the shape object and then resizing the object shape to the boundary of the image. Three case studies were made. Case 1 is the Zernike Moments implementation on the original shape object image. In Case 2, the centroid of the s

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Engineering
Identificatio n Of Key Factors Affecting Waste Management In Life Cycle Of The Construction Project By Using Delphi Technique
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The problem of generated waste as a result of the implementation of construction projects, has  been aggravated recently because of construction activity experienced by the world, especially Iraq, which is going through a period of reconstruction, where construction waste represents (20-40%) of the total generated waste and has a negative effect on the environment and economic side of the project. In addition, the rate of consumpted  amounts of natural resources are estimated to be about 40% in the construction industry, so it became necessary to reduce waste and to be manage well. This study aims to identify the key factors affecting waste management through the various phases of the project, and this is accom

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Publication Date
Fri Mar 01 2024
Journal Name
Baghdad Science Journal
The Association between Single Nucleotide Polymorphisms rs1042522 and rs1642785 in the TP53 gene and Acute Myeloid leukemia in a sample of the Baghdad/ Iraq population
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Acute myeloid leukemia (AML) represents the most prevalent type of acute leukemia in adults and is responsible for approximately 80% of all cases. The tumor suppressor gene (TP53) is a gene that has been frequently studied in cancer, and mutations in this gene account for about 50% of human cancers. This study aims to evaluate the correlation between two single nucleotide polymorphisms (SNPs) in the gene: rs1042522 and rs1642785, and a group of Iraqi patients suffering from pre-diagnostic acute myeloid leukemia (AML). Blood samples were collected from sixty patients (26 males and 34 females) and sixty controls (26 males and 34 females); these subjects were matched in gender, age, and ethnicity. Genomic DNA has been extracted fro

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Publication Date
Wed Mar 15 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Biodiversity and Genetic Relationships to the Species for the genus Gladiolus L. (Iridaceae) Wild Growing in Iraq Using RAPD-PCR Technique
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This study observed the genetic diversity and relationships among 4 species belonging to genus Gladiolus L. , by using the Random  Amplified Polymorphic DNA (RAPD) technique , the study  includes extraction of genomic DNA from the dray leaves by using commercial kit . 4 random primers  used the produced of many polymorphic bands among the 4 species , it was also possible to fined the DNA fingerprint of all studied species.Through the appearance of a number of bands that were unique to each species.Genetic distances ranged from 0.10 to 0.86, and used cluster  analysis were performed to construct dendrogram.Cluster analysis grouped the 4 species Into tow main clusters depending on their ancestor and their morphological

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Publication Date
Mon Jan 01 2018
Journal Name
Ndt &amp; E International
Porosity evaluation of in-service thermal barrier coated turbine blades using a microwave nondestructive technique
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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Simole matimatical technique in leaser cavity design and manufacturing
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In this research design was treated gap laser mathematically and practically Bashaddam model Raasi simple and new and we have found that there is a good match in the practical and theoretical results

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Engineering Science And Technology
Evaluating water quality index of al Hammar Marsh, south of Iraq with the application of GIS technique
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