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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 2016
Journal Name
Journal Of Economics And Administrative Sciences
Assessing the financial performance of the Chambers of the municipalities of Babylon , Karbala ,applied research comparative ((Search unsheathed))
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Abstract
             Shorten the research problem that there is no system or model to evaluate the financial performance of the departments of municipalities where it is not possible for a person or institution both to know or to know their success in terms of the financial work of failure and where it is now than those without assessing the financial performed, authorized to be and necessities FATF is the financial performance assessment, which is the work unfinished aspects without Hence the work came in this study to study and diagnose and analyze financial data in a sample of municipal departments in order to develop a model to assess the financ

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Publication Date
Fri Dec 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Effect of Vertical Boom Position of the Greenhouse Sprayer on the Penetration of Spray to the Eggplants Canopy
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Abstract<p>The research objective focuses on spraying the leaves of the plant from the top and bottom through a spraying machine designed and made of aluminum with a movable arm equipped with a nozzle holder divided into three parts and each piece contains a nozzle of the type (Flat Fan 120-C3) as the machine was tried in a greenhouse with a study of the effect of changing the positions of the upper and lower piece of the tube carrying the nozzles to four levels (A1, A2, A3, A4) and the effect of pressure change on two levels (2,4) bar and studying the effect of the previous factors on some of the characteristics of the study, Spray quality on adaxial of leaf, Spray quality on the abaxial surfac</p> ... Show More
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Publication Date
Mon May 04 2020
Journal Name
Biochemical And Cellular Archives
MOLECULAR AND HEMATOLOGICAL STUDY OF TOXOPLASMA GONDII IN HORSES
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Publication Date
Sat Jan 01 2022
Journal Name
Annals Of Forest Research
Histological and histochemical study of stomach in neonatal Cats
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AN Salih, LO Hamza, Ann. For. Res, 2022 - Cited by 2

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Publication Date
Sun Feb 15 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An evaluation of an Iraqi phosphate-bonded investment and a commercial type on the marginal fit of ceramometalcopings using three different investing and burnout techniques
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Background: The accuracy of fitness of any dental casting is imperative for the success of any prosthodontic treatment. From the time that dental casting was first introduced, efforts have been made to produce more accurate and better fitted castings with minimal marginal discrepancy. The aim of this in vitro study was to evaluate the effects of three different investing and burnout techniques on the vertical marginal discrepancies ofceramometalcopings invested with two types of phosphate- bonded investments. Materials and methods: Sixty wax patterns were fabricated on a standardized prepared brass die representing an upper central incisor by the aid of a custom-made split mold. Three different investing and burnout techniques were applied

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Publication Date
Mon Jun 10 2024
Journal Name
Humanities And Social Sciences Communications
The mediating role of accounting information systems in small and medium enterprise strategies and organizational performance in Iraq
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Abstract<p>This paper examined accounting information systems (AIS) as a mediator between small and medium-sized enterprises (SMEs) strategies, including (finance source, administrative innovation, organizational culture, developing capabilities levels of SMEs, information source, development of business managers, and technological innovation) and organizational performance. In this quantitative study, 450 self-administered questionnaires were distributed to the managers and owners of SMEs using purposive sampling. Data were analyzed using the structural equation modeling (SEM) method via SmartPLS3 Software. The study offers empirical findings on the importance of AIS as a mediator, considers various factors, a</p> ... Show More
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Publication Date
Wed Dec 01 2010
Journal Name
Iraqi Journal Of Physics
Study of electron energy distribution function and transport parameters for CF4, Ar gases mixture discharge by using the solution of Boltzmann equation-Part II
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The Boltzmann transport equation is solved by using two- terms approximation for pure gases and mixtures. This method of solution is used to calculate the electron energy distribution function and electric transport parameters were evaluated in the range of E/N varying from . 172152110./510.VcmENVcm
The electron energy distribution function of CF4 gas is nearly Maxwellian at (1,2)Td, and when E/N increase the distribution function is non Maxwellian. Also, the mixtures are have different energy values depending on transport energy between electron and molecule through the collisions. Behavior of electrons transport parameters is nearly from the experimental results in references. The drift velocity of electron in carbon tetraflouride i

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Publication Date
Thu Apr 01 2021
Journal Name
Computer Methods And Programs In Biomedicine
A hybrid approach based on multiple Eigenvalues selection (MES) for the automated grading of a brain tumor using MRI
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Publication Date
Sat Apr 01 2023
Journal Name
Baghdad Science Journal
Synthesis, Spectroscopy of New Lanthanide Complexes with Schiff Base Derived From (4-Antipyrinecarboxaldehyde with Ethylene Di-Amine) and Study the Bioactivity
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The study involved preparing a new compound by combining Schiff bases generated from compounds for antipyrine, including lanthanide ions (lanthanum, neodymium, erbium, gadolinium, and dysprosium). The preparation of the ligand from condensation reactions (4-antipyrinecarboxaldehyde with ethylene di-amine) at room temperature, and was characterization using spectroscopic and analytical studies ( FT-IR, UV-visible spectra, 1H-NMR, mass spectrometry, (C.H.N.O), thermogravimetric analysis (TGA), in addition to the magnetic susceptibility and conductivity measurement of the synthesis complexes, among the results we obtained from the tests, we showed that the ligand behaves with the (triple Valence) lanthanide ions, the multidentate

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Publication Date
Sun Sep 15 2024
Journal Name
Advanced Journal Of Chemistry, Section A
Synthesis, Characterization and Study the Liquid Crystalline Properties of Some New Bent Compounds Derived from Diethylpyrimidine-2,4,6(1H,3H,5H)-Trione
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This article includes designed and synthesized for bent-shaped liquid crystal molecules starting from 5,5-diethylpyrimidine-2,4,6(1H,3H,5H)-trione and two moles of chloroacetylchloride in N, N-dimethyl formamide (DMF) and triethylamine (TEA) to product compound [I] ,then reacted the later compound with two moles of 4-hydroxybenzonitrile to yield nitrile compound [II]. Likewise, reaction 5,5-diethylpyrimidine-2,4,6(1H,3H,5H)-trione and two moles of ethylchloroacetate with fused sodium acetate in ethanol to create an ester compound [III], and then the later compound was reacted with two moles of hydrazine hydrate in ethanol to obtained hydrazide acid compound [IV]. After that, the compound [IV] reacted with two moles of ethyl acetoacetate in

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