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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
Tue Dec 16 2008
Journal Name
Journal Of Planner And Development
Evaluation of the efficiency of the regional transport network of the district center of Mahmudiya
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The Study aims at evaluating the efficiency of the regional transportation net in Al-mahmoodiya Qadaa center. The bus station of the Qadaa center is suffering from heavy traffic jam, which is due to the ongoing movement of the adjacent provinces, particularly the small cities. They vary in the degree of their link by the regional transportation net that links the province with the centers of big cities. That affects the traffic flow of the civilians of these cities and their daily activities in hierarchical way To achieve the purpose of the study, a questionnaire has been constructed to collect data through selecting a random sample including the passengers who are coming to the bus station in Al-Mahmoodiya center to know the flo

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Form that is a Proposed of Procedures for Auditing the Technical Reserves of General Insurances Branches in the Insurance Activity : applied research
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The research aims to identify the theoretical framework of technical reserves in the insurance activity and the role of the auditor in verifying the integrity of the estimates of technical provisions (technical reserves) for the branches of general insurance in insurance companies based on the relevant international auditing standards, as a proposed audit program has been prepared in accordance with international auditing standards that enable the auditor to express a sound opinion on the fairness of the financial statements of these companies , The research has reached many conclusions, the most important of which is the existence of deficiencies in the audit procedures of insurance companies, as the audit program of those companies did

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Publication Date
Wed Aug 03 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the currency sale window in the stability of the dinar exchange rate and its reflection on inflation
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The: currency Auction is one of the monetary policy tools created after 2003, in order to keep pace with the changes that the monetary and financial policies will witness from financial openness and expectations of high levels of liquidity after international economic restrictions. It is necessary to re-evaluate the work of the currency Auction from time to time and observation its efficiency in adjustment the exchange rate And its reflection on the general level of prices as one of the objectives of its inception, and during the analytical aspect, it was confirmed that the currency Auction for selling the currency had a major role in adjustment the exchange rate and controlling inflation levels, due to the market’s dependence

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Publication Date
Tue Sep 03 2019
Journal Name
Rawal Medical Journal
Evaluation of Radial Nerve Injury Associated with Closed Humeral Shaft Fracture by Early Pre-operative Ultrasonic Evaluation and Correlation with Surgical Exploration
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Traumatic radial nerve injury in humeral shaft fracture is the most common traumatic nerve injury in long-bone fracture, with overall prevalence 2-18%, ranging from traction to complete transection. Spontaneous recovery may reach 88%. The aim of the study is to assess the sensitivity & specificity of the ultrasound to detect the radial nerve injury and to see if this can be used as a diagnostic test. This is a prospective study on 17 adult patients with a closed fracture of the humeral shaft, dividing into two groups, the first group of 7 patients had signs and symptoms of radial nerve palsy at presentation and the second group of 10 patients had intact radial nerve function was considered as a control group. All these patients had at leas

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Attitude of the University of Baghdad Students towards the Mixed and Single-Sex Learning
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The study aims at finding out:
1. The students' attitude towards the mixed learning at the university.
2. The statistically significant differences in attitude towards the mixed learning at the university according to the specialization variable.
3. The statistically significant differences in attitude towards the mixed learning at the university according to the gender variable.
The researcher has constructed a scale for measuring the students' attitude towards the mixed learning at the university.
After assuring its validity and reliability, the scale has been given to a sample of (100) students. The sample is selected randomly from (4) colleges of the university of Baghdad, (2) for scientific specialization and (2)for h

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Publication Date
Mon May 01 2023
Journal Name
Journal Of Engineering
Parametric Analysis of Surface Roughness and Metal Removal Rate during Electrical Discharge Machining of O1 Tool Steel
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This work studies the impact of input machining parameters of Electrical Discharge Machining (EDM) on the machining process performance. Tool steel O1 was selected as the workpiece material, copper as the electrode material, and kerosene as the dielectric medium. Experimental runs have been carried out with a Design of Experiment (DOE) technique. Twenty tests are accomplished with the current range of (18 to 24 Ampere), a pulse duration range of (150 to 200 µs), and a pulse-off time range of (25 to 75 µs). Based upon the experimental study's output results, the EDM parameter's effect (voltage of power supply, discharge current, pulse duration, and pulse pause interval) on the responses of the process represented by sur

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Publication Date
Wed Jun 30 2010
Journal Name
Al-kindy College Medical Journal
Electron Microscopic Study of the Effects of Preeclampsia on the Placental Endothelial Cells Ultra Structures during Pregnancy
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Background: Preeclampsia occurs in 3-5% of
pregnancies and is a major cause (12-20 %) of
maternal mortality in developed countries. It is the
leading cause of preterm birth and intra-uterine
growth restrictions (IUGR).
Objective: The study was designed to determine and
demonstrate the ultra structural changes of
endothelial cells in placenta of women suffering from
hypertensive disease.
Patients & Methods: Placental samples were
obtained from two groups of pregnant women
groups (preeclamptic and normal pregnant women).
The specimens were fixed in 2.5% gluteraldehyde
and preceded for electron microscopic examination.
Results: Placenta of women with preeclampsia has
shown marked degenerative

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Publication Date
Mon Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
Fabrication and Characterization of Tri Metal Oxides by Chemical Spray Pyrolysis Technique as a Gas Sensor
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In this research tri metal oxides were fabricated by simple chemical spray pyrolysis technique from (Sn(NO3)2.20 H2O, Zn(NO3)2.6 H2O, Cd(NO3)2.4 H2O) salts at concentration 0.1M with mixing weight ratio 50:50 were fabricated on silicon substrate n-type (111). (with & without the presence of grooves by the following diemensions (20μm width, 7.5μm depth) with thickness was about ( 0.1 ±0.05 µm) using water soluble as precursors at a substrate temperature 550 ºC±5, with spray distance (15 cm) and their gas sensing properties toward H2S gas at different concentrations (10,50,100,500 ppmv) in air were investigated at room te

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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
Mon Oct 01 2018
Journal Name
2018 International Conference On Advanced Science And Engineering (icoase)
Performance of BCH and RS Codes in MIMO System Using MPFEC Diversity Technique
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