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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
Thu Jun 24 2021
Journal Name
Ibero-american Journal Of Exercise And Sports Psychology
The effect of an educational curriculum based on metacognitive skills in teaching some offensive skills on the specialized school of basketball in Baghdad governorate
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The educational process depends on the means of conveying information from the teacher to the learner. Whenever appropriate, this means the learning process takes place better, faster, and with less effort, and the problem of research lies. The players lack learning in the meta-knowledge curriculum in basketball offensive skills than offensive skills. The aim of the research is to identify the effect of training exercises for educational numbers based on metacognitive skills in teaching some offensive skills with basketball. As for the research assignment, there are statistically significant differences between the results of the pre and post tests for the experimental group and in favor of the post tests. The experimental approach was used

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Publication Date
Fri Oct 01 2010
Journal Name
Analytica Chimica Acta
A reversed phase high performance liquid chromatography method for the determination of fumonisins B1 and B2 in food and feed using monolithic column and positive confirmation by liquid chromatography/tandem mass spectrometry
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The development of a reversed phase high performance liquid chromatography fluorescence method for the determination of the mycotoxins fumonisin B1 and fumonisin B2 by using silica-based monolithic column is described. The samples were first extracted using acetonitrile:water (50:50, v/v) and purified by using a C18 solid phase extraction-based clean-up column. Then, pre-column derivatization for the analyte using ortho-phthaldialdehyde in the presence of 2-mercaptoethanol was carried out. The developed method involved optimization of mobile phase composition using methanol and phosphate buffer, injection volume, temperature and flow rate. The liquid chromatographic separation was performed using a reversed phase Chromolith® RP-18e column

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Publication Date
Wed Jul 01 2020
Journal Name
Plant Archives
a study about some biological aspects of invasive molly fish “poecilia latipinna” (lesueur, 1821) in southern iraq
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Publication Date
Mon Sep 01 2025
Journal Name
International Journal Of Renewable Energy Research
A Comparative Study of Optimal Fuzzy Logic Controllers for Blade Pitch Angle in Horizontal-axis Wind Turbines
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The blade pitch angle (BPA) in wind turbine (WT) is controlled to maximize output power generation above the rated wind speed (WS). In this paper, four types of controllers are suggested and compared for BPA controller in WT: PID controller (PIDC), type-1 fuzzy logic controller (T1-FLC), type-2 fuzzy logic controller (T2-FLC), and hybrid fuzzy-PID controller (FPIDC). The Mamdani and Sugeno fuzzy inference systems (FIS) have been compared to find the best inference system used in FLC. Genetic algorithm (GA) and Particle swarm optimization algorithm (PSO) are used to find the optimal tuning of the PID parameter. The results of500-kw horizontal-axis wind turbine show that PIDC based on PSO can reduced 2.81% in summation error of power

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Publication Date
Mon Jan 01 2018
Journal Name
Pakistan Journal Of Medical & Health Sciences
Prevalence of Peripheral Arterial Disease in End Stage Renal Disease Patients Undergoing Hemodialysis: A Cross-Sectional Study
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The chronic renal disease is a principle common medical dilemma in Iraq. Peripheral arterial disease (PAD) is a prevalent infirmity in the hemodialysis people. The aim of present study was to estimate the prevalence of PAD in subjects with end-stage renal disease (ESRD). This cross-sectional study was done between January 2016 and May 2017 on ESRD subjects regularly attending renal dialysis unit in Al-Kindy teaching hospital in Baghdad, Iraq. PAD was diagnosed on the base of the ankle-brachial index (ABI) measured by using a hand-held Doppler ultrasound. Subjects with ABI ≤0.9 were supposed positive for PAD. A total of 150 ESRD cases were analyzed. The mean age of the subject was 49.52±15 years. Majority of them were males 87(58%). Most

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Publication Date
Mon Mar 31 2025
Journal Name
The Iraqi Geological Journal
Evaluation of Machine Learning Techniques for Missing Well Log Data in Buzurgan Oil Field: A Case Study
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The investigation of machine learning techniques for addressing missing well-log data has garnered considerable interest recently, especially as the oil and gas sector pursues novel approaches to improve data interpretation and reservoir characterization. Conversely, for wells that have been in operation for several years, conventional measurement techniques frequently encounter challenges related to availability, including the lack of well-log data, cost considerations, and precision issues. This study's objective is to enhance reservoir characterization by automating well-log creation using machine-learning techniques. Among the methods are multi-resolution graph-based clustering and the similarity threshold method. By using cutti

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Publication Date
Tue Aug 16 2022
Journal Name
Heat Transfer
Experimental study on thermo‐hydraulic performance of metal foam twisted tape in a double pipe heat exchanger
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Abstract<p>A recent study compared experimentally the hydraulic and thermal activity of twisted tape inserts for two types, metal foam twisted tape (MFTT) and traditional twisted tape (TTT), in a double pipe heat exchanger. The investigation goal of the innovatively designed MFTT is to enhance the heat transfer process, which provides a higher thermal enhancement factor over those of TTT under the same conditions. Heat transfer activity in terms of Nusselt number (<italic>Nu</italic>) and Nusselt number ratio (<italic>Nu</italic>/<italic>Nu</italic><sub>o</sub>) as the heat exchanger equipped with the proposed MFTT and TTT inserts with various tape‐twist ratios (<i></i></p> ... Show More
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Publication Date
Thu Jan 01 2015
Journal Name
Agriculture And Agricultural Science Procedia
The Influence of the Water Quality on the Droplet Spectrum Produced by Agricultural Nozzles
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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
(Effect of the Critical Sussecc Factors in the Sustainable Competitive advantage ) "Descriptive analytical studay in Al Mu'tasim General Contracting Company.
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      The  objective   of this  research is to analyze the relationship between the  Factors  of critical success and sustainable competitive advantage, and I have tested Search Company Mu'tasim General Contracting, through applied on a sample of (90) manager, engineer and project manager, spread over sections and the company's projects surveyed. has been selected sector construction industry as one of the sectors vital and important that play a major role in the advancement of Iraq's infrastructure under the current circumstances, which epresent a set of Projects are Mu'tasim General Contracting construction  imple

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Publication Date
Sun Jan 22 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of international Accounting Standard No (21) in reducing tax obstacles : applied research in the General Authority for Taxes .
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               The research aimed to shed light on the impact of international Accounting Standard No (21) on tax obstacles represented by (tax evasion, double taxation) The financial statements of a group of banks operating in the private sector were relied upon to know the impact of the standard on tax obstacles, as well as knowing the amount of amounts, The researcher relied on the method of financial analysis of that data, which was obtained from the website of the Securities Commission, and conducted personal interviews with a number of university professors, chartered accountants, financial experts, banks, and the General Authority for Taxes to benefit from their

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