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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 Oct 23 2025
Journal Name
Baghdad Science Journal
Continuous Flow Injection-Turbidimetric Analysis for Determination of Cobalt (II) Ion in Alloys Using a Microcell with Irradiation Sources at 0–180° Using a Single Solar Cell as a Detector
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A cost-effective and efficient detector was created to conduct thorough turbidimetric measurements by reaction of Co (II) ion with calcium ferro cyanide to form bright green particulate, using the method of continuous flow injection analysis, the use of NAG-5SX1-1D-SSP Analyzer in determining cobalt (II) ion in a test for the validity of the new design. The NAG-5SX1-1D-SSP Analyzer is composed of five irradiation sources of white snow leds having the diameter of 10 mm with one solar cell of 55 mm length, 13.5 mm width. Using a selector switch to select the optimum voltage to be used which was 2.7 VDC. Under conditions of optimization, cobalt (II) ion was determined at 0.005–20 mmol. L–1(n = 23) while linearity dynamic range 0.005–7 mm

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Role of the Arab oil to the achievement of Economic security in the Arab: The Role of the Arab oil to the achievement of Economic security in the Arab
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Abstract:
This research aims to the importance of oil in achieving economic
security in the Arab. Oil is not an ordinary subject and returns it significance to
the followings:
1. The importance of skipping a source of energy.
2. The importance of oil as raw material for petrochemical industry.
3. The importance of the oil sector as an area of foreign investment
4. The importance of oil in the marketing activities, transport, insurance
and various services
In addition to the importance of oil in general and the Arab oil has
additional strategic advantages such as geographic location, And the
magnitude of reserves and production of heavy investment costs are relatively
simple, And the ability to meet the

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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The accuracy of cone-beam computed tomography in the evaluation of boney support of teeth among patients with a unilateral cleft of lip and palate among IraqiPopulation
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Background: To evaluate the bony supports of the teeth adjacent to the area of cleft in patient with unilateral cleft lip and palate and to compare these measurements with the measurements of the same teeth in non-cleft side by using CBCT. Materials and methods: The CBCT scans of 30 patients having cleft lip( unilateral) and palate(unilateral), were analyzed and the measurements of the alveolar bony support for teeth that are adjacent to the cleft area were measured with those teeth located on opposite side (non- clef) side. For each tooth, the measurements will taken for the distance between the( cementoenamel junction) (CEJ) and the bony crest (AC) at the( buccal area) was measured and the thickness of the buccal plate At zero, one, tw

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Achieve breastfeeding book and theft book To the end of the door cut the way of the manuscript Sailing Forum for Sheikh Ibrahim bin Mohammed Halabi (T: 659 H): Study and achieve
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Achieve breastfeeding book and theft book
To the end of the door cut the way of the manuscript
Sailing Forum for Sheikh Ibrahim bin Mohammed Halabi
(T: 659 H)

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Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The impact of strategic approach in the effectiveness of small and medium Enterprises in Iraq
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The purpose of this research highlight the achievement of the effectiveness of small and medium enterprises dimensions and conformable to analyze the relationship between business strategies and human resources management strategies , and launched search of a dilemma thought provoking fundamental questions revolve around the search is the lack of appropriate strategies in these enterprises to help them continuity and permanence in business and markets , as these enterprises lack the human resources management strategies appropriate , as well as business strategies that make them withstand the changes in the market environment is changing and volatile . It was to

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Publication Date
Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
The role of electrolytes and inflammatory biomarkers in the development of febrile seizure in children
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Publication Date
Mon May 27 2019
Journal Name
Al-khwarizmi Engineering Journal
Prediction of Process Parameters That Affecting on Surface Roughness in Multi-Point Forming Process Using ANOVA Algorithm
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Multipoint forming process is an engineering concept which means that the working surface of the punch and die is produced as hemispherical ends of individual active elements (called pins), where each pin can be independently, vertically displaced using a geometrically reconfigurable die. Several different products can be made without changing tools saved precious production time. Also, the manufacturing of very expensive rigid dies is reduced, and a lot of expenses are saved. But the most important aspects of using such types of equipment are the flexibility of the tooling. This paper presents an experimental investigation of the effect of three main parameters which are blank holder, rubber thickness and forming speed th

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Publication Date
Fri Mar 01 2024
Journal Name
Medicine Advances
Quality of life, adherence and knowledge of epileptic patients and the impact of a pharmacist‐led educational intervention: A review
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Around 65 million individuals suffer from epilepsy worldwide, and when it is not properly treated, it is linked to higher rates of physical harm and mortality. Due to the requirement for long‐term therapy and the side effects of many medications, medication compliance is a significant issue. The purpose of this review was to summarize the findings of previous studies examining the quality of life (QOL), adherence, patient education, and medication knowledge, as well as the impact of a pharmacist‐led educational intervention. Additionally, to find out if these studies benefit epileptic patients, to find the appropriate method used to help them in all aspects of their lives, and to use these in future studies. A systematic and comprehensi

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Removal of Nickel and Cadmium Ions from Wastewater by Sorptive Flotation: Single and Binary systems
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The removal of heavy metal ions from wastewater by sorptive flotation using Amberlite IR120 as a resin, and flotation column, was investigated. A combined two-stage process is proposed as an alternative of the heavy metals removal from aqueous solutions. The first stage is the sorption of heavy metals onto Amberlite IR120 followed by dispersed-air flotation. The sorption of metal ions on the resin, depending on contact time, pH, resin dosage, and initial metal concentration was studied in batch method .Various parameters such as pH, air flow rate, and surfactant concentration were investigated in the flotation stage. Sodium lauryl sulfate (SLS) and Hexadecyltrimethyl ammonium bromide (HTAB) were used as anionic and cationic surfactant re

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Publication Date
Thu Jan 30 2020
Journal Name
Journal Of Engineering
Comparison of Single and Group Bored Piles Settlement Based on Field Test and Theoretical Methods
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 Bored piles settlement behavior under vertical loaded is the main factor that affects the design requirements of single or group of piles in soft soils. The estimation of bored pile settlement is a complicated problem because it depends upon many factors which may include ground conditions, validation of bored pile design method through testing and validation of theoretical or numerical prediction of the settlement value. In this study, a prototype single and bored pile group model of arrangement (1*1, 1*2 and 2*2) for total length to diameter ratios (L/D) is 13.33 and clear spacing three times of diameter, subjected to vertical axial loads. The bored piles model used for the test was 2000

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