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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 Jun 30 2012
Journal Name
Al-kindy College Medical Journal
The Detection of Silent Celiac Disease In patients With Type 1 Diabetes Mellitus by the use of Anti Tissue Transglutaminase Antibodies
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Objective: Detection the presumptive prevalence of
silent celiac disease in patients with type 1 diabetes
mellitus with determination of which gender more
likely to be affected.
Methods: One hundred twenty asymptomatic patients
[75 male , 45 female] with type 1 diabetes mellitus
with mean age ± SD of 11.25 ± 2.85 year where
included in the study . All subjects were serologically
screened for the presence of anti-tissue transglutaminase
IgA antibodies (anti-tTG antibodies) by Enzyme-
Linked Immunosorbent Assay (ELISA) & total IgA
was also measured for all using radial
immunodiffusion plate . Anti-tissue transglutaminase
IgG was selectively done for patients who were
expressing negative anti-

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Publication Date
Wed Nov 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Requirements for Developing the Technical Capabilities of Agricultural Extension Service Providers to Face the Effects of Climate Change in Baghdad Province
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Abstract<p>The aim of the research is to determine the requirements for developing the technical capabilities of the agricultural extension service providers to face the effects of climatic changes in Baghdad Governorate, to achieve the goal of the research and in order to obtain the respondents’ approval of the requirements (28) requirements were identified in the light of the literature and studies related to the subject and the opinions of specialists to develop the technical capabilities of the agricultural extension service providers distributed on two axes (the ability to know the effects of climate changes, the ability to know the practices to reduce the effects of climate changes). The</p> ... Show More
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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of The Mechanical Behavior Of Materials
Performance of concrete thrust block at several burial conditions under the influence of thrust forces generated in the water distribution networks
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Abstract<p>This study was prepared to investigate the performance and behavior of concrete thrust blocks supporting pipe fittings. In the water distribution networks, it is always necessary to change the path of the pipes at different degrees or to create new branches. In these regions, an unbalanced force called the thrust force is generated. In order to counter this force, these regions are supported with concrete blocks. In this article, the system components (soil, pipe with its bend and thrust blocks) have been numerically modeled and simulated by the ABAQUS CAE/2019 software program in order to study the behavior and stability of the thrust block with different burial conditions (several b</p> ... Show More
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Publication Date
Wed Apr 01 2020
Journal Name
Canadian Journal Of Physics
Influence of the variation in the Hubbard parameter (<i>U</i>) on activation energies of CeO<sub>2</sub>-catalysed reactions
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Accurate description of thermodynamic, structural, and electronic properties for bulk and surfaces of ceria (CeO2) necessitates the inclusion of the Hubbard parameter (U) in the density functional theory (DFT) calculations to precisely account for the strongly correlated 4f electrons. Such treatment is a daunting task when attempting to draw a potential energy surface for CeO2-catalyzed reaction. This is due to the inconsistent change in thermo-kinetics parameters of the reaction in reference to the variation in the U values. As an illustrative example, we investigate herein the discrepancy in activation and reaction energies for steps underlying the partial and full hydrogenation of acetyl

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Performance evaluation of the Iraq Stock Exchange market under the financial losses of terrorism for the years 2010-2015
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The Research topic seeks to analyze the "political risk and its component Terrorism Index," which consists of five indicators index, a number of terrorist operations, and the number of dead and wounded, and the size of the physical losses, based search sub-index analysis of material losses for the index terrorism and its impact on the indicators listed on the Iraq Stock Exchange Finance. As for the practical side, it has been use style gradient unrestricted and link the sample represented by ten banks listed on the Iraq Stock Exchange. was Statement the correlation and interaction of variables of the studySearch results produced that the volume of material losses is the most important indicator in the influential force and it explain a v

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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
Analyzing the Content of the Chemistry Book for the Fifth Grade of Preparatory School According to Imaginative Thinking Skills
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The aim of the research is to identify the imaginative thinking skills included in the content of the chemistry textbook for fifth-grade students in biological sciences at the preparatory stage, which is approved by the Ministry of Education, General Directorate of Curricula in the academic year 2020-2021. To achieve the objective of the study, the researcher depends on the previous studies in the field and content of imaginative thinking skills for preparing a list of skills that includes (3) essential skills and (11) sub-skills and (28) items related to all skills. The researcher adopted the analytical descriptive approach because of its appropriation of the goals of the research. Then the researcher analyzed the content of the book de

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Publication Date
Mon Jun 15 2020
Journal Name
Al-academy
The effect of the Iraqi marshes environment on the works of artist Mahoud Ahmed: محمود حسين عبد الرحمن حسين
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Scientific research on the environment of the Iraqi marshes, its beauty and its characteristics is considered one of the most important functions of Iraqi universities and scientific institutions, because of its great historical impact related to the identity of Iraq and the Iraqis and the basis of science and science, through which the first letter and the first human civilizations were established and in the same importance technical research is among the most important functions of departments Institutes and colleges of the arts, research centers and museums inside and outside Iraq. Also, research centers specialized in the natural environment of Iraq, including the marshes. Therefore, it is hoped that this research will develop the a

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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The Impact of Strategy 3-2-1 in acquiring Concepts of Sociology of fourth grade students: The Impact of Strategy 3-2-1 in acquiring Concepts of Sociology of fourth grade students
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Abstract

The current research aims to identify the impact of triangular bridging strategy in the acquisition of sociology of fourth-stage students. To achieve the research objective, the following null hypotheses were adopted: there are no statistically significant differences at a significance level (0, 05) between the average grades of the experimental group students who studied the triangular bridging strategy in acquiring concepts of sociology and average grades of the control group. The researcher has selected the fourth-stage students from Alexandronah School for girls that s related to the Directorate General of Baghdad the sample consisted of (87) students at litera

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Publication Date
Tue Mar 03 2020
Journal Name
Aip Conference Proceedings
Correlation study of (IL-17, IL-17RA) and some biochemical parameters with patients of Iraq colorectal cancer after and before taking a dose of chemotherapy
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Colorectal cancer CRC is the third most commonly diagnosed cancer in males and the second in female, so it is a common and life-threatening disease serum of 48 males and 40 females suffering from CRC disease as group one (G1) without taking a chemotherapy dose, the same patients group tow (G2) after taking the first chemotherapy dose, while group three (G3) whose patients in (G1) and (G2) after second taking a chemotherapy dose. and group four (G4) consist of (30 males and 30 females) healthy Iraqi control. Results showed a significant increase in IL-17, IL-17RA and CEA in G1, while there was a significant decrease in vitamin D concentration in G1 than other groups, also there was positive (+ ve) significant correlation between IL-17 and CE

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Different garlic forms: (lobster, mashed, crushed) and their effect on quality qualities And the molecular life of the fermented cucumber and flavor
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This study aimed to isolate and identifye the growth of microorganisms and
their effect on pickled cucumber and cabbage, the study also investigated the effect of
garlic (in the form of segments, chopped or crushed) on the mentioned pickled –food
features . Furthermore, a sense based comparison is made between vinegar-preserved
samples and vinegar-garlic preserved ones.
The following results have been obtained:
1- The isolation of staph. aureus alone from the samples and the study of its physical
and biochemical features.
2- The fresh garlic (segments, chopped and crushed) with concentration of 5%, 7.5%,
and 10% showed a damaging percentage of 100% to bacterial growth of staph. Aureus
after 24 hours of inc

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