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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
Fri Jun 05 2015
Journal Name
International Journal Of Science And Research
The Effect of Growth Medium and Nodes Number on the Acclimatization Success of Tissue Propagated Potatoes Seedlings Solanum tuberasum
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The experiment was conducted at the period from 20th Dec. 2015 to 30th Mar. 2016 to know the effect of growth medium and nodes number on the acclimatization success of tissue propagated potatoes seedlings (Burrin class) and study some plant physiological properties. The first experiment involved testing growth media: loam, peat moss, and perlite with different portions (1:1) to plant tissue propagated potato tubers, while the second experiment involved testing the nodes number where 9, 8, 7, 6, and 5 plant nodes were chosen. Results of the first experiment showed the superiority of the culture media of peat moss + perlite to other culture media by giving the higher values of shoot system studied properties: plant height, branches number, le

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Economics And Finance Studies
THE EFFECTS OF NEGATIVE AUDIT AND AUDIT ENVIRONMENT ON THE INTERNAL AUDITOR PERFORMANCE: MEDIATING ROLE OF AUDITING PROCESS INDEPENDENCE
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Publication Date
Fri Dec 01 2023
Journal Name
Case Studies In Construction Materials
Appraising the synergistic use of recycled asphalt pavement and recycled concrete aggregate for the production of sustainable asphalt concrete
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Material obtained from the demolition of concrete structures and milling of flexible pavements has the highest potential for recyclability. This study aimed to evaluate the performance of hot mix asphalt with the concurrent use of recycled asphalt pavement (RAP) and recycled concrete aggregate (RCA). Contents of RAP and RCA were varied from 0% to 50% by fixing the total recycling materials percentage to 50%. Penetration grade 40/50 virgin binder and waste engine oil (WEO) as rejuvenator were used in the present study. A series of tests, such as Scanning electron microscopy (SEM), Marshall stability, indirect tensile strength test, IDEAL CT, uniaxial compression test, and resilient modulus test, were carried out to assess the performance of

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Alloys And Compounds
Probing the effects of thermal treatment on the electronic structure and mechanical properties of Ti-doped ITO thin films
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Publication Date
Fri Jun 11 2021
Journal Name
Journal Of Baghdad College Of Dentistry
The influence of different root canal irrigants on the push-out bond strength of AH plus and Bioceramic sealers
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Background: The bond strength of endodontic sealers with dentin is a very important property for maintaining the integrity and seal of the root canal filling. The aim of this study was to evaluate and compare the effect of various irrigants (QMix, 17% EDTA and 2.5% NaOCl) on the push-out bond strength of AH plus and Bioceramic sealers. Materials and methods: Forty eight freshly extracted maxillary first molars human teeth with striaght palatal root were used in the study. The collected samples were randomly divided into three groups of equal sample size (n=16), according to the final irrigation regimen as follows: Group (1): QMix 2 in 1, Group (2): 17% ethylenediaminetetraacetic acid, Group (3): 2.5% sodium hypochloride. All samples were

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Publication Date
Sun Jun 01 2008
Journal Name
Baghdad Science Journal
The role of annealing temperature on the optical energy gap and Urbach energy of Se:2%Sb thin films
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The optical energy gap(Eopt) and the width of the tails of localized states in the band gap (?E) for Se:2%Sb thin films prepared by thermal co-evaporation method as a function of annealing temperature are studied in the photon energy range ( 1 to 5.4)eV.Se2%Sb film was found to be indirect transition with energy gap of (1.973,2.077, 2.096, 2.17) eV at annealing temperature (295,370,445,520)K respectively. The Eopt and ?E of Se:2%Sb films as a function of annealing temperature showed an increase in Eopt and a decrease in ?E with increasing the annealing temperature. This behavior may be related to structural defects and dangling bonds.

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Publication Date
Mon Dec 20 2021
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
MORPHOLOGY AND MOLECULAR IDENTIFICATION OF THE LARVAL STAGE OF TWO SPECIES FROM THE GENUS CHRYSOBOTHRIS ESCHSCHOLTZ, 1829 (COLEOPTERA, BUPRESTIDAE)
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The genus of Chrysobothris Eschscholtz, 1829 is one of the most diverse and widespread genera of the family Buprestidae of some 700 described species distributed throughout the world. In Iraq, particularly in the Kurdistan region, about 4 species had been recorded so far, many of these species are sympatric, share larval host plants, and are difficult to reliably separate morphologically. The current study investigates species limits and relationships among the recognized species occurring within the Erbil Province; mitochondrial cytochrome C oxidase (COX I) molecular analysis confirmed the monophyly of two Chrysobothris species, Ch. affinis (Fabricius, 1794) and Ch. chrysostigma (Linnaeus, 1758). Implications of the resultant larval mor

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Publication Date
Sat Dec 01 2018
Journal Name
مجلة علوم التربية الرياضية
Identifying the standard levels of the most physical abilities and mobility of football players among ages (14-15) years
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Football is a game derived from the integration of football and tennis skills and some of the laws of volleyball and yard measurements, and since it is a newly created game must be studied and cover all aspects related to them to reach them to the highest levels. It is known that each game or sports activity should have Physical capabilities and motor skills, which is important to determine the level of technical performance where the abilities of the game contribute to mastering skills. The significance of the research in determining the standard levels of physical and motor abilities of the football players to help young professionals and the sponsors to increase the efficiency of these capabilities and thus raise the level of per

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation the effect of burning investment and black sand materials on the surface roughness of acrylic resin denture base
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Objective: The aim of this study was to evaluate the effect of pumice, burning investment material
and black sand on the surface roughness of heat cure acrylic resin.
Methodology: Sixty specimens were prepared from pink heat cure acrylic resin, the specimens
where grouped into; 20 specimens which polished with pumice and water (control group); 20
specimens which polished with investment material (after burning it) and water; and 20 specimens
which polished with black sand and water. The average surface roughness of specimens after
polishing procedure had been determined by profilometer (surface roughness tester).
Results: Through the application of ANOVA and LSD tests, the result of this study showed that there
wa

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Publication Date
Thu Jun 20 2019
Journal Name
Baghdad Science Journal
The Influence of Rewards on Games Flow, Challenge, and Its Effects Towards the Engagement of Malaysian Digital Traditional Games
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Games engagement has become one of the main concerns in game industry. Early study revealed that Malaysian digital traditional games are suffering with the same issue due to several factors. One of it is the lack of the game itself. Although many Malaysian traditional games have been digitized, none of them has incorporated rewards despite its importance in games engagement. Realizing the importance of rewards in games engagement, one of Malaysian traditional Congkak has been chosen to be enhanced by incorporating rewards. Experiments have been conducted among 50 gamers among the Millennials. Prior interview, game demo and human test are conducted. Experiments focused on the influence of rewards on games flow, games challenge, and its ef

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