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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 Aug 15 2023
Journal Name
Al-academy
Formal questioning and its representations in the design of contemporary residential rooms for children with autism
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The formal investigation of the interior spaces of the residential bedrooms for children with autism is one of the basic tasks that should be known by the interior designer. Achieving an atmosphere compatible with his health condition, which contributes to generating a sense of spatial intimacy through the design dimension provided by the interior designer and his tireless endeavor to meet the needs of the child in an internal environment that achieves the functional dimension and spiritual approaches that enhance the child’s sense of spatial belonging and contribute to improving his mood and this positively reflects on his behavior and social integration. The current research has reached the most important design criteria that must be

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Publication Date
Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
The impact of JAK2V617F allelic burden on clinical and laboratory parameters in patients with myeloproliferative neoplasms
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Publication Date
Sun Sep 06 2015
Journal Name
Baghdad Science Journal
The age-specific fecundity life tables of Planococcus citri Risso and important predators attack in Baghdad
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Reproduction potential and age –specific fecundity of the Mealybug Planococcus citri Risso were studied in the laboratories of Biological control research unit,college of Agriculture –Baghdad university at 25± 2Cº and 60-70% R.H.with 16 light:8 dark photo period.The results showed that the survival ratio began to decline at the 38th day, the average female age was 20 days ,while the average age was 8 days at the first reproduction . Net reproduction rate ( Ro ) was 58.59 female female generation which prove that the population of the mealybug was of the unstable kind , intrinsic rate of increase (rm) was 0.118 femalefemale and the average length period of generation ( T ) was 34.30 days . Many local predators attack the mealybug

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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Al-nahrain University
Histopathological Studies of the Liver and Kidney in Mice Fed on Smut Wheat Infected with Tilletia
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The current study was designed to investigate the effect of Tilletia smut spores on histopathological changes in liver and kidney in mice. Twenty animals were divided into two equal groups, 10 mice each, control group fed on normal diet and the treated groups were fed on a mixture of 50% normal diet with 50% wheat infected with Tilletia for 30 days. Histopathological sections taken from liver and kidney treated with Tilletia revealed several alterations. The changes in liver included, multiple granulomatous lesions, area of coagulation necrosis, vacuolar degeneration in the cytoplasm of hepatocytes, proliferation of hepatocytes with formation of pseudolobull which initiates for procancer. Whereas in the kidney, the changes included

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Publication Date
Fri Sep 03 2021
Journal Name
Tropical Journal Of Natural Product Research
Hematological and Histopathological Changes in the Spleen of Male Albino Rats (Rattus norvegicus) Treated with Meloxicam
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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
Focus groups strategy and its impact on the achievement of primary school students in art education
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Art education is one among the fundamental subjects for elementary school students, because it contributes to assembling learners’ personalities and developing their technical skills. For this reason, this research comes, which aims to understand the effect of the task groups’ strategy in developing the performance of elementary school students in art education. to realize the goal of the research, the researcher put the subsequent hypotheses:
-There is not any statistically significant difference at the amount (5%) between the typical many students between the experimental group that studied consistent with the strategy of task groups and therefore the control group that studied in keeping with the same old method that they obt

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Adoption of the International Financial Reporting Standard IFRS11 Constraints and Remedies (Application in Basra Gas Company)
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The aim of this study is to highlight on the concept of joint arrangements and projects in accordance with IFRS 11, in addition, the study also focuses on accounting standards and IFRSs which are relevant to this standard.  With a description of the legislative and accounting challenges in the Iraqi environment facing the application of IFRS 11, as well as studying the reality of accounting in such economic activity of companies operating in this sector.

In order to achieve the study objectives, the researcher conducted a comparative analysis between IFRS 11 (Joint Arrangements) and the Iraqi Unified Accounting System, In the second step, IFRS 11 is applied to the Basrah Gas Company's (research sampl

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Publication Date
Tue May 16 2023
Journal Name
Political Sciences Journal
Peaceful coexistence between social components and its impact on political stability in the province of Nineveh
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The issue of peaceful coexistence between societies is the topic of the hour, as it is one of the important issues in this era, especially in days when conflicts and conflicts abound, and even wars in the name of religion, gender, race, language, and the like. The world, so that single-mindedness and adherence to one opinion and intolerance to it became the method of dialogue in our world today, as writing in the field of peaceful coexistence, peace-building, tolerance, pluralism, and acceptance of the other is one of the new fields of knowledge in Iraq in general and in Nineveh Governorate in particular, as peaceful coexistence is one of the basic needs And necessary for the presence of individuals in societies, and it requires the achi

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Publication Date
Thu Feb 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluation of the Construction, Build, Operate and Transfer (B.O.T): Applied Research in Southern Cement State Company
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   Form of investment in infrastructure important factor to drive economic growth in any country, with the dwindling ability of governments to provide the necessary funds for such investments, emerged as a rising trend for private sector involvement in public projects and infrastructure, and one of these trends is the build-operate-transfer system (BOT), which commonly used in various developed and developing countries as one of the tools used in the implementation of these investments, as the private sector under this system design, finance, build and operate the project, and are re-administration of the state after a certain period under a contractual agreement between the parties of the contract. As this system provides majo

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Publication Date
Tue Jun 01 2021
Journal Name
Baghdad Science Journal
The Energy Spectra and Heat Capacity of GaAs Gaussian Quantum Dot in an External Magnetic Field
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In this paper, a theoretical study of the energy spectra and the heat capacity of one electron quantum dot with Gaussian Confinement in an external magnetic field are presented. Using the exact diagonalization technique, the Hamiltonian of the Gaussian Quantum Dot (GQD) including the electron spin is solved. All the elements in the energy matrix are found in closed form. The eigenenergies of the electron were displayed as a function of magnetic field, Gaussian confinement potential depth and quantum dot size. Explanations to the behavior of the quantum dot heat capacity curve, as a function of external applied magnetic field and temperature, are presented.

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