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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 Dec 31 2020
Journal Name
Pollution Research Journal
ANALYSIS OF THE HYDRAULIC CHARACTERISTICS OF AL MAHAWIL STREAM USING HECRAS: A FIELD STUDY
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A water resources management for earthen canal/stream is introduced through creating a combination procedure between a field study and the scientific analytical concepts that distinguish the hydraulic problems on this type of stream with using the facilities that are available in HECRAS software; aiming to point the solutions of these problems. Al Mahawil stream is an earthen canal which is subjected to periodic changes in cross sections due to scour, deposition, and incorrect periodic dredging processes due to growth of the Ceratophyllum plants and weeds on the bed and banks of the stream; which affect the characteristics of the flow. This research aims to present a strategy of water resources management through a field study that conducte

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Publication Date
Wed May 31 2017
Journal Name
Journal Of Engineering
A Study of Parameters Affecting the Solvent Extraction-Flocculation Process of Used Lubricating Oil
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The aim of this study was to investigate the effect of operating variables on, the percentage of removed sludge (PSR) obtained during re-refining of 15W-40 Al-Durra spent lubricant by solvent extraction-flocculation treatment method. Binary solvents were used such as, Heavy Naphtha (H.N.): MEK (N:MEK), H.N. : n-Butanol (N:n-But), and H.N. : Iso-Butanol (N:Iso:But). The studied variables were mixing speed (300-900, rpm), mixing time (15-60, min), and operating  temperature (2540, oC). This study showed that the studied operating variables have effects where, increasing the mixing time up to 45 min for H.N.: MEK, H.N.: n-Butanol  and 30 min for H.N.: Iso-Butanol increased the PSR, after that percentage was decreased; increasing t

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Publication Date
Mon Jun 06 2022
Journal Name
International Journal Of Health Sciences
effect of a training curriculum for the development of some functional variables and the level of achievement in the effectiveness of air rifle shooting
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There are significant differences between the pre and post-tests in favor of the post-test in the tests) stroke volume (S.V), cardiac thrust (C.O.P), left ventricular volume, maximum oxygen consumption Vo2max), which indicates the effect of the proposed training approach.There are significant differences between the pre and post-tests in favor of the post-test in the achievement level test with air rifle shooting for young female shooters, which indicates the effect of the proposed training curriculum.There are no significant differences between the pre and post-tests in the tests (heart rate (HR) before exercise, heart rate (HR) after exercise, systolic blood pressure rate before exercise, systolic blood pressure rate after exercis

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of The Mechanical Behavior Of Materials
Experimental and numerical study of the bulb's location effect on the behavior of under-reamed pile in expansive soil
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Abstract<p>In this experimental and numerical analysis, three varieties of under-reamed piles comprising one bulb were used. The location of the bulb changes from pile to pile, as it is found at the bottom, center, and top of the pile, respectively. <italic>PLAXES 3D</italic> was used to conduct the research. In expansive soil, the under-reamed piles were 350 mm long, with the pile tip in dense sandy soil. The experiment was carried out in both saturated and unsaturated circumstances. The influence of the bulb location on the pile's bearing capacity for vertical and lateral loads, as well as the amount of swelling pressure and upward movement owing to swelling, was investigated. The re</p> ... Show More
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Publication Date
Tue Mar 15 2022
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of Resin Infiltration and Microabrasion on the Microhardness of the Artificial White Spot Lesions (An in Vitro Study)
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Publication Date
Tue Mar 15 2022
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of Resin Infiltration and Microabrasion on the Microhardness of the Artificial White Spot Lesions (An in Vitro Study)
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Background: White spot lesion is the first visible sign of dental caries that is characterized by demineralized lesion underneath an intact surface. Several studies demonstrated that they could be treated using noninvasive techniques like the use of fluoride or casein phospho-peptide and amorphous calcium phosphate. Improvement in aesthetic outcomes by covering the demineralized enamel is one of the advantages of the use of resin infiltration and opal-ustre microabrasion, which are two new techniques that had been used for treatment of white spot lesion. The purpose of this study was to evaluate the impact of resin infiltration and microabrasion in the microhardness of the artificial white spot lesions at various depths. Material and method

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of internal marketing in achieving customer satisfaction An exploratory study of a sample of private bank managers in Baghdad
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This study examined the effect of elements of internal marketing activities on customer satisfaction through an exploratory study of banking services in the city of Baghdad, if the research problem crystallized by asking a group of questions, the most important (is there a correlation and impact between the dimensions of internal marketing and customer satisfaction, this study aims to determine The effect of internal communication, training and internal market research on customer satisfaction, represented by the quality of service, loyalty and market share, and embodied the objective of this study to identify the level of availability of internal marketing activities and programs in the research banks, data were collected using

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Publication Date
Thu Dec 15 2022
Journal Name
Al Kut Journal Of Economics And Administrative Sciences
The relationship of demographic diversity to institutional effectiveness An analytical study of a sample of workers in public organizations in Iraq
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Diversity has become one of the required phenomena to be available within public organizations, in light of the changes taking place in the global and international environment and in various fields. Therefore, it was imperative to study the impact of this phenomenon in various institutions, especially public ones, in most developing countries, including Iraq. The current research aims to analyze the relationship between The demographic diversity and institutional effectiveness of a sample of workers in public institutions included (500) respondents. The questionnaires were distributed to them randomly. Diversity is considered an independent variable and institutional effectiveness a dependent variable. The researcher used interview tools a

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Publication Date
Thu Sep 01 2016
Journal Name
Journal Of Engineering
Improvement of Traffic Movement for Roads Network in Al-Kadhimiya City Center
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Numerous regions in the city of Baghdad experience the congestion and traffic problems. Due to the religious and economic significance, Al-Kadhimiya city (inside the metropolitan range of Baghdad) was chosen as study area. The data gathering stage was separated into two branches: the questionnaire method which is utilized to estimate the traffic volumes for the chosen roads and field data collection method which included video recording and manual counting for the volumes entering the selected signal intersections. The stage of analysis and evaluation for the seventeen urban roads, one highway, and three intersections was performed by HCS-2000 software.The presented work plots a system for assessing the level of service

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Publication Date
Wed Oct 01 2014
Journal Name
Al–bahith Al–a'alami
TV and educating university youth about the challenges of cultural identity in Iraq Field study of a sample of students at University of Baghdad
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The TV plays an active role in building the general culture of the recipients, which calls for emphasizing its contemporary mission in rebuilding the values that support the development and modernization of diverse societies. Such importance is necessary to explore the challenges facing the cultural invasion, The space opening, which had its cultural returns to the societies, produced a space for alternative values and antagonisms in the cultures and traditions of these societies in the midst of a psychological / social conflict behind a clash with the peculiarities of Muslim societies. Cultural Adtha.
From these points of view, and because the universities are an important stage to announce the demands of the advocates of change and

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