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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
Fri Jan 01 2021
Journal Name
Plant Archives
STUDY OF THE EFFECT OF SPEED, DEPTH OF THE CULTIVATION AND THE NUMBER OF TIMES THE SPRING – LOADED CULTIVATOR PASSES ON SOME TECHNICAL PARAMETERS OF THE CULTIVATOR AND ON WEED CONTROL
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Publication Date
Fri Jan 15 2021
Journal Name
Plant Archives
STUDY OF THE EFFECT OF SPEED, DEPTH OF THE CULTIVATION AND THE NUMBER OF TIMES THE SPRING – LOADED CULTIVATOR PASSES ON SOME TECHNICAL PARAMETERS OF THE CULTIVATOR AND ON WEED CONTRO
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Publication Date
Mon Mar 02 2026
Journal Name
Journal Of Physical Education
A comparative analysis , for some Elkinmetekih variables , in the performance of the skill (Nick shot the front reverse ) , between the players of the Iraqi team and the Egyptian , for young people in squash
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Publication Date
Tue Jun 30 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
EVALUATION OF SPORTS AWARENESS AMONG WOMEN AT THE UNIVERSITY OF BAGHDAD FOR THE PERIOD 2011-2016 AND STUDY THE FACTORS AFFECTING THEIR PARTICIPATION IN SPORTS ACTIVITIES: EVALUATION OF SPORTS AWARENESS AMONG WOMEN AT THE UNIVERSITY OF BAGHDAD FOR THE PERIOD 2011-2016 AND STUDY THE FACTORS AFFECTING THEIR PARTICIPATION IN SPORTS ACTIVITIES
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The exercise of activities and sports are of great importance to public health and to maintain the ideal health weight as well as the psychological and mental comfort of humans. The aim of this study is to determine the contribution and participation of educated females in physical activities at the University of Baghdad hall for the years 2011-2016, and to show the factors that influence women's contribution to physical activities at the university by selecting 100 students of males and 100 females' students randomly. During the questioning questions and statistical analysis of the questioning to find out the reasons for the discouraging contribution of the women to the various physical activities and try to find solutions and r

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Publication Date
Sun Jan 01 2006
Journal Name
Diala Journal For Application Research
Study and calculation of the effects of excessive stress temperatures on the buoyant convection of clouds.
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Recent developments in two main phases of cumulus cloud studies are discussed; first the relations between the clouds and their energy sources in the subcloud layer and second, the interaction between the clouds and their environment in the cloud layer. Under the first heading, the various originating impulses for cumulus formation are mentionitd. and how the character of this impulse affects the spacing, scale and temperature structure of the clouds. The possible origins of trade cumuli are considered.

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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
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
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
Wed Dec 30 2009
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Mixed convection in an Horizontal Rectangular Duct Including interior Circular Core with Time periodic Boundary Condition
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Numerical Investigation was done for steady state laminar mixed convection and thermally and hydrodynamic fully developed flow through horizontal rectangular duct including circular core with two cases of time periodic boundary condition, first case  on the rectangular wall while keeping core wall constant and other on both the rectangular duct and core walls. The used governing equations are continuity momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function and the Body Fitted Coordinates (B.F.C.) methods. The Finite Difference approach with the Line Successive Over Relaxation (LSOR) method is used to obtain all the computational results the (B.F.C.) method is used to generate th

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Publication Date
Sun Mar 06 2016
Journal Name
Baghdad Science Journal
Isolation and Purification of a Cyclooxygenase-2 from the Blood of a Patient Suffering from Rheumatoid Arthritis and Studying the Effect of Natural Products of the Soapwort on the Activity of Purified Enzyme
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In this paper to isolate and study the properties of the cyclooxygenase-2 (EC: 1.14.99.1) enzyme in the blood of a patient suffering from rheumatoid arthritis and study the effect of natural products of the Soapwort on the activity of purified enzyme. The study involves taking 30 ml of blood from an adult woman 40 years old, who suffers from rheumatoid arthritis disease for 13 years. Serum is separated and subjected to a series of purification processes including: precipitation by ammonium sulfate, filtration by centrifugation radiator, dialysis in presence of ammonium bicarbonate, separation using the technology of ion exchange, lipholization and then estimating approximate molecular weight of the enzyme using gel filtration techni

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