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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
Wed Oct 01 2014
Journal Name
Al–bahith Al–a'alami
The electronic news bulletin of the ministry of higher education and scientific research: A study in the newspapers of: (AL-Taakhi, AL-Zaman, ALAdala,AL-Sabah and Baghdad) for period from 2nd October 2011 to 1st November 2011
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The research aims to know the reverberation of the the electronica news bulletin of the ministry of higher education and scientific research  in the newspapers of: (AL-Taakhi, AL-Zaman, ALAdala,AL-Sabah and Baghdad) for period from 2nd October 2011 to 1st November 2011 to explain its activity and advantage for the other newspapers and to show the importance which the newspapers showed for the study of the news subject in the bulletin, as well as,to show the proportional differences in which the newspapers interested in the subjects of the published news, and to reach to the results which lead us to good conclusions for the service of decision owner and open new horizons for the researchers to expanding in the s

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Publication Date
Fri Jan 01 2016
Journal Name
International Journal Of Surgery Case Reports
Myositis ossificans: A rare location in the foot. Report of a case and review of literature
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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi Journal Of Physics
A study of the effect of silica particles addition on some physical properties of PVC as a packaging material
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In this work, varying compositions of SiO2 micro filler were added
with the Polyvinyl Chloride (PVC) and samples have been prepared
using film casting technique. The results have been analyzed and
compared for PVC samples with (1 wt%, 3 wt%, 5 wt% and 10 wt%)
SiO2 micro filler. Mechanical characteristics such as tensile strength,
elongation at break and Young`s modulus were measured for all the
samples, where the tensile strength was increased from 8.39 Mpa for
purified PVC to 16 Mpa for 3% SiO2/PVC composite. Also, thermal
conductivity measurement values illustrated that composite materials
have a good thermal insulation at 10 wt. %, thermal conductivity was
decreased from 0.1684 W/m.

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Publication Date
Thu Sep 05 2024
Journal Name
Journal Of Ecohumanism
Early Warning System Means and Tools in the African Union and the Organization of American States: An Analytical Study
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Disasters, crises and wars are a serious and unforeseen threat. The capacity of the early warning system to monitor such crises is therefore crucial. The ability to make quick decisions in a short time is necessary to prevent crises from occurring. Here, the role and effectiveness of the early warning system emerges through its ability to monitor, record and analyze signals. It can also be evidenced by its ability to immediately convey these indicators to the concerned authorities to take measures that ensure these conflicts and disasters do not worsen. The system’s ability to detect disasters and crises, identify the crisis and its type, and use the scientific method and common sense to deal with it is something that contributes to findi

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Publication Date
Mon Dec 25 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Extraction, Identification and Isolation of B-sitosterol from Iraqi Wild Awsaj plant (Lycium barbarum) Using UAE (Probe and Bath) and two isolation technique (HPTLC and PHPLC): B-sitosterol in Iraqi Awsaj plant
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Awsaj (Lycium barbarum) is a plant belong to family Solanaceae serves as a good source of bioactive compounds like phytosterols which have many important biological activity. Literature survey available so far revealed that there was no studies about Iraqi wild Awsaj phytosterols especially B-sitosterol, there for the objective of this study was to examine the efficiency of ultrasound assisted extraction (probe and bath) as compared to the conventional (Soxhlet) extraction method for extraction of phytosterols especially B-sitosterol from fruits, leaves, stems and roots of Iraqi wild Awsaj plant. This goal was achieved by comparing the extraction mass yield, also by a quick and easy approach for identification and quantification of bioac

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Publication Date
Tue Mar 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Organizational Creativity in Enhancing Knowledge Management Processes: survey study for a sample of academic staff members at the Technical College of management / Baghdad)
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In many organizations, employees who have high mental skills are the main source of organizational creativity. When a firm does not put creativity as a goal, cannot stand solid against the competition. Nowadays, knowledge is the path to discover the innovation and creativity aspects, This can assist the firm to stand face to face with competition in the market. The importance of this research comes from detecting and knowing the relation between creativity and knowledge to know and detect the influence of organizational creativity on backing the management of knowledge and determine the final results. The problem of research is to trace the role of organizational creativity on knowledge management processes in order to enable the

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Publication Date
Mon Jan 01 2018
Journal Name
International Journal Of Science And Research (ijsr)
Optimal Economic Design of Diversion Structures during Construction of a Dam by Particle Swarm Optimization
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Diverting river flow during construction of a main dam involves the construction of cofferdams, and tunnels, channels or other temporary passages. Diversion channels are commonly used in wide valleys where the high flow makes tunnels or culverts uneconomic. The diversion works must form part of the overall project design since it will have a major impact on its cost, as well as on the design, construction program and overall cost of the permanent works. Construction costs contain of excavation, lining of the channel, and construction of upstream and downstream cofferdams. The optimization model was applied to obtain optimalchannel cross section, height of upstream cofferdam, and height of downstream cofferdamwith minimum construction cost

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Engineering
Optimal Economic Design of Diversion Structures during Construction of a Dam by Particle Swarm Optimization
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Publication Date
Thu Jun 01 2023
Journal Name
Baghdad Science Journal
Role of IL-37 and Dectin-1 during Toxoplasmosis
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Toxoplasmosis is a parasitic infection that triggers immune cells to produce cytokines and inflammatory mediators that are responsible for abnormal or aborted immune responses. This study highlights the evaluation of the Dectin-1 receptor and cytokine IL-37 in the serum of 80 patients who had miscarried in the first trimester and were infected with toxoplasmosis, as well as 40 pregnant women in the first trimester who had a successful pregnancy (control groups). The serum was first screened for the T. gondii IgM and IgG antibodies by an enzyme-linked immunosorbent assay (ELISA) and then the serum levels of IL-37 and Dectin-1 were determined. The results showed that the serum level of Dectin-1 was significantly increased in anti-

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
Vue sur la technique de point de vue dans le ROUGE ET LE NOIR de Stendhal
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It is axiomatical that the narrative prospective is profoundly significant to the writer who intends to commence his sketch of projected novel. It is the pillar of comprehensive absorbing as the writer should commit himself to circular his own concepts to the reader of his narrative characters.                                

   The dilemma of plot-perception is a twofold aspect; partly offers the question: what is the authors stand in regard to his characters? And: what is the aim of this theme? These correlative questions are inseparable since the reader who wishes

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