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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 May 13 2015
Journal Name
International Journal Of Current Microbiology And Applied Sciences
First Record of Hairy Rove Beetle, Creophilus maxillosus (Linnaeus, 1758)(Coleoptera; Staphylinidae) for Iraq
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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The most important challenges facing the Iraqi economyAnd ways to address them
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Facing the Iraqi economy, a number of economic challenges that threaten the future of Iraq and the security of economic, political and social, such as poverty, unemployment, inflation and the dilapidated infrastructure and rising production costs and administrative and financial corruption, environmental pollution, water problems and the deterioration of agricultural and industrial production, etc., and over the seriousness of these challenges, they are intertwined and overlapping and growing worse, without the corresponding adoption of state strategies that will develop appropriate solutions and appropriate to resolve those challenges because of concern the subject of security and terrorism, which requires the development of an

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Publication Date
Sat Jan 01 2022
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science (ijeecs)
A new smart approach of an efficient energy consumption management by using a machine-learning technique
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Many consumers of electric power have excesses in their electric power consumptions that exceed the permissible limit by the electrical power distribution stations, and then we proposed a validation approach that works intelligently by applying machine learning (ML) technology to teach electrical consumers how to properly consume without wasting energy expended. The validation approach is one of a large combination of intelligent processes related to energy consumption which is called the efficient energy consumption management (EECM) approaches, and it connected with the internet of things (IoT) technology to be linked to Google Firebase Cloud where a utility center used to check whether the consumption of the efficient energy is s

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Publication Date
Wed Oct 01 2025
Journal Name
Studies In Big Data
Employing AI Tools to Achieve Integration Between the Target Costing Technique, SDG, and Their Role in Improving Administrative Decisions
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Publication Date
Sun Jan 01 2023
Journal Name
Rawal Medical Journal
Efficacy of lumbar interlaminar epidural steroid injections for lumbar spinal stenosis: A prospective study
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Objective: To study the effect of epidural spinal injection over one year in case of spinal stenosis. Methodology: This prospective study included 566 patients with spinal stenosis seen at Al-Kindy Teaching and Al-Sader, Hospitals who were treated by local epidural steroid injection. They were followed up for at least five subsequent visits after seven days, one month, three months, six months, and one year to assess efficacy. Result: Mean age of patients was 49.5 years, with a predominance of females (65%). L4/L5 was the most involved level in the spinal stenosis (70%). Grade II stenosis accounted for (45.4%) of cases. The pairwise comparison revealed that there was significant decrease in proportions of patients with pain in day

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The impact of leadership styles in the crisis management center the Strategic planning - Field research in the Headquarters Ministry of electricity
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Abstract

The current research aims to testing the impact of leadership styles (autocratic, democratic) in crises management (Making decision response, communications and information flows, Mobilization of resources) through strategic planning (Mission, objectives, and environmental analysis, and strategic choice) among managers of the Iraqi Ministry of electricity. Questionnaire has been adopted as a tool in data and information relating to research, as it had prepared on the basis of number of scales and finished using the included Likert quintet, which  has been subjected to standards of validity and reliability and distributed to a sample consisting of (96) managers at the three departments of Min

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Publication Date
Sun Dec 01 2013
Journal Name
Alustath
"The Common Humanity That is in Us All": Earnest Gaines's (A Lesson before Dying)
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Gaines's A Lesson Before Dying (1993) is about more than the challenges associated with being blacking an Eurocentric society. Though Gaines positions the story within the context of the African American experience, its central theme investigates what it means to be human. The Afro-American writer Ernest Gaines consistently writes about people who face the problems of being denied humanity, dignity, and self-worth. The article illustrates one man's struggle to gain recognition of his humanity in the court (as his attorney insists on calling him a hog for a crime he did not commit) and how this recognition will initiate a change in the community.

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Publication Date
Mon Jul 01 1996
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
NOTES ON CHRYSOMYA BEZZIANA VILLENEUVE (DIPTERA, CALLIPHORIDAE) FIRST RECORD FROM IRAQ
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The Old World Screwworm Fly Chrysomya bezziana is a new insect pest on cattles and other domestic recor¬ded for the first from Iraq. It was first observed in cow's vagina in September of 1996 in Shaikh Hammed (Tarmiya), near Baghdad city. Chrysomya bezziana Villeneuve is well known as one of the most important insect pests of livestock. Its larvae infest living tissues by causing myiasis. In a wide range of worm-blooded host species (Spradbery and Vanningham, 1980; Spradbery and Kirk. 1992). It is widely dist¬ributed species over an extensive area of tropical and subtropical Africa, the Arabian Gulf countries, Iran. Indian subcontinent. South-East Asia. Indonesia, and as far east as Papua New Guinea (Zurapt, 1965; Djalayer et al. 1978;

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Publication Date
Tue May 01 2018
Journal Name
Journal Of Craniofacial Surgery
Single Session Facial Lipostructure by Using Autologous Fat Mixed With Platelet-Rich Fibrin Injected by Using Facial Autologous Muscular Injection Technique
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Aim:

This study was designed to evaluate the role of single session autologous facial fat grafting in correcting facial asymmetries after mixing it with platelet-rich fibrin (PRF) and injecting them into rich vascular facial muscular plane.

Materials and Methods:

Fifteen patients (12 females and 3 males) with age ranging from 18 years to 40 years were included in this study and followed up during 6 months, all the patients were treated in the Al-Shaheed Ghazi Al-Hariri for specialized surgeries hospital (Medical City, Baghdad, Iraq).

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Monitoring of Defects Concentration in Deformed Aluminum Using Doppler Broadening Technique
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Doppler broadening of the 511 keV positron annihilation ??? ? was used to estimate the concentration of defects ?? different deformation levels of pure alnminum samples. These samples were compressed at room temperature to 15, 22, 28, 38,40, and 75 % thickness reduction. The two-state ^sitron-trapping model has been employed. 'I he s and w lineshape parameters were measured using high-resolution gamma spectrometer with high pure germanium detector of 2.1 keV resolution at 1.33 MeV of 60Co. The change of defects concentration (Co) with the deformation level (e) is found to obey an empirical formula of the form Cd - A £ B where A and ? are positive constants that depend mainly on the deformation procedure and the temperature at which the def

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