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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 Aug 01 2020
Journal Name
Surgical Neurology International
Unilateral absence of the internal carotid artery associated with anterior communicating artery aneurysms: Systematic review and a proposed management algorithm
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Background:

Absence or hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly that is mostly unilateral and highly associated with other intracranial vascular anomalies, of which saccular aneurysm is the most common. Blood flow to the circulation of the affected side is maintained by collateral pathways, some of which include the anterior communicating artery (Acom) as part of their anatomy. Therefore, temporary clipping during microsurgery on Acom aneurysms in patients with unilateral ICA anomalies could jeopardize these collaterals and place the patient at risk of ischemic damage. In this paper, we review the literature on cases with a unilaterally absent ICA associa

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Publication Date
Mon Nov 01 2021
Journal Name
Applied Thermal Engineering
Investigation on the combustion and performance characteristics of a DI free piston linear generator engine fuelled with CNG-CO2 blend
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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Impact of Cognitive Behavior Program Based on Meichenbaum Theory in Reducing the Negative Emotional Sensitivity among the Intermediate Stage Students
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The aim of this research is to construct a cognitive behavior program based on the theory of Meichenbaum in reducing the emotional sensitivity among Intermediate school students. To achieve the aims of the research, two hypotheses were formulated and the experimental design with equal groups was chosen. The population of research and its sample are determined. The test of negative emotional sensitivity, which is constructed by the researcher, was adopted. The test contains (20) items proved validity and reliability as a reliable test by presenting it to a group of arbitrators and experts in education and psychology. An educational program is constructed based on the theory of Meichenbaum. The test was applied to a sample of (60) second i

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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
factors determining pricing strategies in Iraqi business market – on analytic study in a number of industrial sector companies
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Pricing has an important position among the elements of marketing mixture (4ps) as it represents revenues that in turn represent one of the important  pillars' for resources affecting on organizations sustainability and development , and the failure in determining prices and their strategies has a dangerous effect on the organizations reality and future as a whole . from this point,  this is what from the focus of the research problem,which centered on how to get companies to critical price that satisfies customers and achieve corporate objectives.                          

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Publication Date
Tue Oct 02 2018
Journal Name
Iraqi Journal Of Physics
Study the effect of thermal annealing on some physical properties of thin Cu2SiO3 films prepared by pulsed laser deposition
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The Cu2SiO3 composite has been prepared from the binary compounds (Cu2O, and SiO2) with high purity by solid state reaction. The Cu2SiO3 thin films were deposited at room temperature on glass and Si substrates with thickness 400 nm by pulsed laser deposition method. X-ray analysis showed that the powder of Cu2SiO3 has a polycrystalline structure with monoclinic phase and preferred orientation along (111) direction at 2θ around 38.670o which related to CuO phase. While as deposited and annealed Cu2SiO3 films have amorphous structure. The morphological study revealed that the grains have granular and elliptical shape, with average diameter of 163.63 nm. The electrical properties which represent Hall effect were investigated. Hall coeffici

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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Requirements of Achieving Sustainable Competitive Advantage under Framework of Constructing Green Strategy for Business Organizations ( perceptual analytical study)
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The aim of this research is to know how business organizations achieve competitive advantage ,and make it sustainable through constructing a green strategy ( friend to environment) which is reflected on sustaining their competitive advantages .The problem of this study is presented through trying to answer many thoughtful questions, the most important of them are: 

1-Can business organizations today make green strategies supporting their competitive advantage?

2-Is there a framework or mechanism could be depended on by business organizations to manage strategic risks of losing their competit

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Publication Date
Mon Apr 01 2024
Journal Name
Iraqi Journal Of Oil And Gas Research (ijogr)
Comparative study of electrochemical oxidation system hybrid with photocatalytic system for the treatment of Al-Najaf petroleum refinery wastewater
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Publication Date
Thu Feb 12 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Early and delayed effect of 2% chlorhexidine on the shear bond strength of composite restorative material to dentin using a total etch adhesive
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Background: Lack of durability of the bond of the dental adhesive systems to tooth structure is one of the most important problems in tooth colored restorative work. This in vitro study was performed to evaluate the effect of 2% chlorhexidine gluconate(CHX) on dentin bond strength by using total etch adhesive system at twenty-four hours and three months of water storage. Material and methods:A flat dentin surface was prepared for forty sound human maxillary premolar teeth which were acid etched with 36% phosphoric acid gel after being divided randomly into four groups of ten teeth each according to storage time and CHX application, theCHX was applied for 60 seconds before adhesive application for groups I and III which were tested after twe

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Publication Date
Thu Feb 12 2026
Journal Name
Journal Of Baghdad College Of Dentistry
A Comparative Evaluation of the Centering Ability and Canal Transportation of Simulated S-Shaped Canals Instrumented with Different Nickel –Titanium Rotary Systems
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Background: The purpose of this study was to evaluate and compare centering ability and canal transportation of simulated S-shaped canals instrumented with four different types of rotary nickel-titanium systems. Materials and Methods: Forty simulated S-shaped canals in resin blocks were divided into four groups of ten each and were instrumented to an apical size 25 by different instrumentation technique using ProTaper Universal files (group A), ProTaperNext (group B), Reciproc (group C) and WaveOne (group D).Centering ability and canal transportation was measured at (11) measuring points from D0 to D10 bysuperimposion of the pre- and post-operative images obtained by using digital camera in standardized manner. An assessment of the canals

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Publication Date
Sun Oct 07 2012
Journal Name
Journal Of Educational And Psychological Researches
The Role of School in Promoting Intellectual Security of Students in Qurayyat Governorate
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The current study aimed to reveal the role of the high school (boys) in the Governorate of Qurayyat (KSA) in promoting intellectual security of students, and whether there were differences in the estimates of the study sample due to the variables; the current position, academic qualification, teaching specialization and years of experience. This study was conducted by applying the analytical descriptive method, and used questionnaire as a tool for data collection. The survey consisted of (44) ite

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