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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 Sep 01 2016
Journal Name
Arabian Journal Of Geosciences
Assessment of interconnection between surface water and groundwater in Sawa Lake area, southern Iraq, using stable isotope technique
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Publication Date
Wed Jul 01 2015
Journal Name
Advanced Powder Technology
Characterization of nano-silica prepared from local silica sand and its application in cement mortar using optimization technique
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Publication Date
Thu Dec 20 2018
Journal Name
Frontiers In Immunology
Resveratrol Attenuates Allergic Asthma and Associated Inflammation in the Lungs Through Regulation of miRNA-34a That Targets FoxP3 in Mice
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Asthma is a chronic inflammatory disease of airways mediated by T-helper 2 (Th2) cells involving complex signaling pathways. Although resveratrol has previously been shown to attenuate allergic asthma, the role of miRNA in this process has not been studied. We investigated the effect of resveratrol on ovalbumin-induced experimental allergic asthma in mice. To that end, BALB/c mice were immunized with ovalbumin (OVA) intraperitoneally followed by oral gavage of vehicle (OVA-veh) or resveratrol (100 mg/kg body) (OVA-res). On day 7, the experimental groups received intranasal challenge of OVA followed by 7 days of additional oral gavage of vehicle or resveratrol. At day 15, all mice were euthanized and bronchioalveolar fluid (BALF), se

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Publication Date
Thu Feb 01 2024
Journal Name
Baghdad Science Journal
A New Green Approach of CFIA Technique for Direct Assay with a High Throughput of Sulfamethoxazole Drugs Using Condensation Reaction with NQS Agent
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A new design of manifold flow injection (FI) coupling with a merging zone technique was studied for sulfamethoxazole determination spectrophotometrically. The semiautomated FI method has many advantages such as being fast, simple, highly accurate, economical with high throughput . The suggested method based on the production of the orange- colored compound of SMZ with (NQS)1,2-Naphthoquinone-4-Sulphonic acid Sodium salt in alkaline media NaOH at λmax 496nm.The linearity range of sulfamethoxazole was  3-100  μg. mL-1, with (LOD) was 0.593 μg. mL-1 and the RSD% is about 1.25 and the recovery is 100.73%. All various physical and chemical parameters that have an effect on the stability and development of

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Publication Date
Mon Sep 30 2019
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Removal of-Copper Ions-from Aqueous Solution Using Liquid-Surfactant-Membrane Technique
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Extraction of copper (Cu) from aqueous solution utilizing Liquid Membrane technology (LM) is more effective than precipitation method that forms sludge and must be disposed of in landfills. In this work, we have formulated a liquid surfactant membrane (LSM) that uses kerosene oil as the main diluent of LSM to remove copper ions from the aqueous waste solution through di- (2-ethylhexyl) phosphoric acid - D2EHPA- as a carrier. This technique displays several advantages including one-stage extraction and stripping process, simple operation, low energy requirement, and. In this study, the LSM process was used to transport Cu (II) ions from the feed phase to the stripping phase, which was prepared, using H2SO4. For LSM p

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Engineering
Strengthening of Reinforced Concrete T- Section Beams Using External Post-Tensioning Technique
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This research is carried out to investigate the externally post-tensioning technique for strengthening RC beams. In this research, four T-section  RC beams having the same dimensions and material properties were casted and tested up to failure by applying two mid-third concentrated loads. Three of these beams are strengthened by using external tendons, while the remaining beam is kept without strengthening as a control beam. Two external strands of 12 mm diameter were fixed at each side of the web of the strengthened beams and located at depth of 200 mm from top fiber of the section (dps). So that the depth of strands to overall depth of the section ratio (dps

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Publication Date
Mon Jan 28 2013
Journal Name
Spie Proceedings
Enhancement of security for free space optics based on reconfigurable chaotic technique
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Free Space Optical (FSO) technology offers highly directional, high bandwidth communication channels. This technology can provide fiber-like data rate over short distances. In order to improve security associated with data transmission in FSO networks, a secure communication method based on chaotic technique is presented. In this paper, we have turned our focus on a specific class of piece wise linear one-dimensional chaotic maps. Simulation results indicate that this approach has the advantage of possessing excellent correlation property. In this paper we examine the security vulnerabilities of single FSO links and propose a solution to this problem by implementing the chaotic signal generator “reconfigurable tent map”. As synchronizat

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Publication Date
Sat Dec 31 2016
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Experimental Investigation of Mass Transfer for Copper Reduction by Weight Difference Technique
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An experimental analysis was included to study and investigate the mass transport behavior of cupric ions reduction as the main reaction in the presence of 0.5M H2SO4 by weight difference technique (WDT). The experiments were carried out by electrochemical cell with a rotating cylinder electrode as cathode. The impacts of different operating conditions on mass transfer coefficient were analyzed such as rotation speeds 100-500 rpm, electrolyte temperatures 30-60 , and cupric ions concentration 250-750 ppm. The order of copper reduction reaction was investigated and it shows a first order reaction behavior. The mass transfer coefficient for the described system was correlated with the aid of dimensionless groups as fo

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Publication Date
Tue Oct 30 2018
Journal Name
Iraqi Journal Of Physics
Optical properties of ZnO/MgF2 bilayer thin films prepared by PVD technique
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Zinc Oxide (ZnO) is considered as one of the best materials already used as a window layer in solar cells due to its antireflective capability. The ZnO/MgF2 bilayer thin film is more efficient as antireflective coating. In this work, ZnO and ZnO/MgF2 thin films were deposited on glass substrate using pulsed laser deposition and thermal evaporation deposition methods. The optical measurements indicated that ZnO thin layer has an energy gap of (3.02 eV) while ZnO/MgF2 bilayer gives rise to an increase in the energy gap. ZnO/MgF2 bilayer shows a high energy gap (3.77 eV) with low reflectance (1.1-10 %) and refractive index (1.9) leading to high transmittance, this bilayer could be a good candidate optical material to improve the performance

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Publication Date
Sun Apr 30 2017
Journal Name
Ibn Al-haitham Jour. For Pure & Appl. Sci.
Solution of High Order Ordinary Boundary Value Problems Using Semi-Analytic Technique
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The aim of this paper is to present a method for solving high order ordinary differential equations with two point's boundary condition, we propose semi-analytic technique using two-point oscillatory interpolation to construct polynomial solution. The original problem is concerned using two-point oscillatory interpolation with the fit equal numbers of derivatives at the end points of an interval [0 , 1] . Also, many examples are presented to demonstrate the applicability, accuracy and efficiency of the method by comparing with conventional methods.

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