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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 Nov 10 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Prevalence of Anxiety and Depression Among the Iraqi Repatriated Prisoners of the Iran-Iraq War, 1980-1988
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Objective: To find out the prevalence of anxiety and depression among Iraqi repatriated prisoners of Iran-Iraq war
(IRPOWs), and the relationship with some variables.
Methodology: A descriptive study was carried out from Oct. 18th, 2009 through Jan. 10th, 2010. A Snowball
sampling as a non-probability sampling technique was used to recruit 92 repatriates who had visited Ministry of
Human Rights. An instrument was constructed for this purpose. The constructed instrument consisted of six
demographic characteristics, and fourteen items to measure the level of anxiety and depression in prisoners of
war (POWs). Data were collected with using the constructed instrument and the process of the interview as means
for data col

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Publication Date
Fri Mar 28 2008
Journal Name
Ama, Agricultural Mechanization In Asia, Africa & Latin America
The Effect of Two Type of Plows With Four Speeds on the Field Capacity and Bulk Density
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Publication Date
Mon Aug 01 2022
Journal Name
Optik
Assessing the optoelectronic performance of d-orbital doped cubic HfO2: The case of W, Nb, and Mo
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This contribution provides an atomistic understanding into the impact of W, Nb, and Mo co-substitution at Hf-site of cubic HfO2 lattice to produce Hf1−xTMxO2 system at x = 25%. The calculations have been performed under the framework of density functional theory supported by Habbured parameter (DFT+U). Structural analysis demonstrates that the recorded lattice constants is in good coherence with the previously published results. For the lattice parameters, contraction by 1.33% comparing with the host system has been reported. Furthermore, the doping effect of TM on the band gap leads to its reduction in the resulting Hf0.75TM0.25O2 configurations. The partial density of states (PDOS) indicate that hybridization through localized electroni

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Publication Date
Mon Feb 01 2021
Journal Name
Journal Of Research In Medical And Dental Science
The Effect of Adding Poloxamer Surfactant on the Penetration Depth of NaOCl and NaOH into Dentinal Tubules
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Objectives: The purpose of this in vitro study was to compare the effect of adding poloxamer surfactant to irrigant solutions on the penetration de..

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Publication Date
Sun Jan 13 2019
Journal Name
Iraqi Journal Of Physics
The effect of short range correlation on the inelastic C2 and C4 form factors of 18O nucleus
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The effect of short range correlations on the inelastic Coulomb form factors for excited +2 states (1.982, 3.919, 5.250 and 8.210MeV) and +4 states (3.553, 7.114, 8.960 and 10.310 MeV) in O18 is analyzed. This effect (which depends on the correlation parameterβ) is inserted into the ground state charge density distribution through the Jastrow type correlation function. The single particle harmonic oscillator wave function is used with an oscillator size parameter .b The parameters β and b are adjusted for each excited state separately so as to reproduce the experimental root mean square charge radius of .18O The nucleusO18 is considered as an inert core of C12 with two protons and four neutrons distributed over 212521211sdp−− activ

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Molecular Liquids
The development of new homogenous and heterogeneous catalytic processes for the treatment of low grade palm oil
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Low grade crude palm oil (LGCPO) presents as an attractive option as feedstock for biodiesel production due to its low cost and non-competition with food resources. Typically, LGCPO contains high contents of free fatty acids (FFA), rendering it impossible in direct trans-esterification processes due to the saponification reaction. Esterification is the typical pre-treatment process to reduce the FFA content and to produce fatty acid methyl ester (FAME). The pre-treatment of LGCPO using two different acid catalysts, such as titanium oxysulphate sulphuric acid complex hydrate (TiOSH) and 5-sulfosalicylic acid dihydrate (5-SOCAH) was investigated for the first time in this study. The optimum conditions for the homogenous catalyst (5-SOCAH) wer

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Publication Date
Mon Mar 25 2024
Journal Name
Heritage And Sustainable Development
Job burnout and its relationship to achieving competitive superiority among the employees of the University of Baghdad
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This research focuses on the epidemic of Job burnout and seeks to achieve sustainable preeminence among the employees of the University of Baghdad. It also identifies the meaning of the differences between the two genders of males and females according to the variables, and it also does the correlation between the two variables. First, the two researchers developed a test of job burnout that incorporates 18 items, which has been proven to be statistically fit. Moreover, they developed a competitive superiority measure consisting of 22 items in it, and its psychometric properties confirm their fit. The two tools were applied to a sample of 120 employees who were randomly selected from six colleges at the University of Baghdad, alongside univ

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Engineering
The Effects of Different Water Types on the Dissolution, Physical Appearance, and Compressive Strength of Gypsum Rock
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Dissolution of gypsum rock in water is significant, which may result in hydrocarbon reservoir formation and evaporate deposits. However, the complexity of the gypsum dissolution process is still of interest because of its uncleanness that requires more critical analysis. The objectives of this experimental study are emphasis on the dissolution characteristics of gypsum rock under room temperature and by various types of water; namely: deionized, tap, fresh, acidic, well, and normal rainwatre. In addition, the influences of dissolution on gypsum rock's mechanical and physical characteristics. Gypsum rock was obtained from Agjalar area, in the southwest of Sulaymaniyah city, Northern Iraq. Experimental results show that we

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Publication Date
Sat Jan 04 2014
Journal Name
Journal Of Materials And Chemical Engineering
The Effect of Atomic Percentage Selenium Content on the Permittivity and Polarizability of Ge1-xSex thin films
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Generally the a.c. conductivity shows a power law in frequency s  ()  where the exponent s ≤ 1. As the frequency goes to zero the conductivity become frequency independent. The a.c. conductivity was studied for the Ge1-xSex thin films to see how the selenium contents affect the permittivity and the permeability for the Ge1-x Sex. The thin films prepared by thermal evaporation at room temperature and under vacuum (~2 x10-5toor) using Edward coating unit model 306A. From the relation between ln conductivity and ln w, the effect of selenium contents in Ge1-x Sex thin films on the exponent value, the relaxation time and the maximum barrier height. An algebric fitting method for circles and circular arcs was used to find the permit

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Publication Date
Sat Feb 21 2026
Journal Name
Lark Journal For Philosophy , Linguistics And Social Sciences
The Possibility of Religious Reform: Is there any real accountability for the roots of extremism and terrorism?
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