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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 Jun 07 2023
Journal Name
Journal Of The Turkish-german Gynecological Association
Maternal and neonatal outcomes in adolescent pregnant women with one prior Cesarean section in Baghdad
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Publication Date
Sun Feb 05 2023
Journal Name
مجلة تكريت للعلوم الادارية والاقتصادية
The role of strategic auditing of human resources management in crystallizing organizational capabilities: A prospective study at the University of Baghdad
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دور التدقيق الاستراتيجي لإدارة الموارد البشرية في بلورة القدرات التنظيمية دراسة استطلاعية في رئاسة جامعة بغداد

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Publication Date
Sun May 12 2019
Journal Name
Al-khwarizmi Engineering Journal
Motion Control of Three Links Robot Manipulator (Open Chain) with Spherical Wrist
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Robot manipulator is a multi-input multi-output system with high complex nonlinear dynamics, requiring an advanced controller in order to track a specific trajectory. In this work, forward and inverse kinematics are presented based on Denavit Hartenberg notation to convert the end effector planned path from cartesian space to joint space and vice versa where a cubic spline interpolation is used for trajectory segments to ensure the continuity in velocity and acceleration.  Also, the derived mathematical dynamic model is based on Eular Lagrange energy method to contain the effect of friction and disturbance torques beside the inertia and Coriolis effect. Two types of controller are applied ; the nonlinear computed torque control (CTC

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Publication Date
Fri Aug 18 2023
Journal Name
Journal Of Research In Medical And Dental Science
Morphologic Evaluation of the Permanent Mandibular First Molar within an Iraqi Population Using Cone Beam Computed Tomography (Retrospective Study)
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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Using Project Management Maturity Model to Evaluate Construction Sector -Organizations. Case Study at the Department of buildings - Karkh first
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The education sector suffers from many problems, including the scarcity of schools that can absorb the increasing number of students in light of the increasing population growth rate, as some regions suffer from a lack of opening of new schools or the expansion of existing schools to increase their capacity so that attention is required. The research sought to identify the level of maturity of project management at the research site (Building Department in Al-Karkh I/ Ministry of Education) Being responsible for educational projects and their implementation and to know that, the ten areas of the knowledge guide to project management PMBOK have been adopted according to the PM3 model (one of the models of maturity

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Publication Date
Fri Jun 02 2023
Journal Name
Bandaoti Guangdian/semiconductor Optoelectronics
NMUSING AN INNOVATIVE DEVICE TO IMPROVE THE EFFICIENCY OF THE ANTERIOR QUADRICEPS MUSCLE OF THE INJURED KNEE JOINT AFTER SURGICAL INTERVENTION OF THE ANTERIOR CRUCIATE LIGAMENT IN ADVANCED SOCCER PLAYERS
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This study aimed to manufacture an innovative device that enables the player to walk after the operation and improves the functional efficiency through the improvement in the range of motion as well as the improvement in the size of the muscles working on the knee joint. The research, the study population consisted of players with severing the anterior cruciate ligament of the advanced soccer players, and the number of the research sample was (5) injured for the control sample and (5) for the experimental sample in Abu Ghraib Hospital and some rehabilitation centers for a period of six months, and the pre-tests were conducted after two weeks of The cruciate ligament surgery was performed, and the innovative device was used for the e

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Publication Date
Wed Sep 08 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Obstacles facing the application of electronic banking An exploratory: study of the opinions of a sample of bank employees operating in the city of Nasiriyah
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Electronic banking plays a prominent role in providing the best banking services and upgrading the banking sector for the better, so this study aimed to shed light on the most prominent obstacles that prevent the application of electronic banking in banks operating in the city of Nasiriyah, and in order to achieve this goal the researcher used the descriptive analytical approach And through a questionnaire form that was distributed to a group of employees, numbering (60) employees in the upper, middle and operational departments in a number of branches of private banks operating in the city of Nasiriyah, namely (the Iraqi Trade Bank, the Gulf Commercial Bank, the Bank of Baghdad, the Union Bank of Iraq), which represented The stu

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Publication Date
Sun Mar 04 2018
Journal Name
Baghdad Science Journal
Using Texture Analysis Image Processing Technique to Study the Effect of Microwave Plasma on the Living Tissue
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The present study is a hybrid method of studying the effect of plasma on the living tissue by using the image processing technique. This research explains the effect of microwave plasma on the DNA cell using the comet score application, texture analysis image processing and the effect of microwave plasma on the liver using texture analysis image processing. The study was applied on the mice cells. The exposure to the plasma is done by dividing the mice for four groups, each group includes four mice (control group, 20, 50, 90 second exposure to microwave plasma). The exposure to microwave plasma was done with voltage 175v and gas flow on 2 with room temperature; the statistical features are obtained from the comet score images and the textur

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Engineering
Optimized Zero and First Order Design of Micro Geodetic Networks
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Precision is one of the main elements that control the quality of a geodetic network, which defines as the measure of the network efficiency in propagation of random errors. This research aims to solve ZOD and FOD problems for a geodetic network using Rosenbrock Method to optimize the geodetic networks by using MATLAB programming language, to find the optimal design of geodetic network with high precision. ZOD problem was applied to a case study network consists of 19 points and 58 designed distances with a priori deviation equal to 5mm, to determine the best points in the network to consider as control points. The results showed that P55 and P73 having the minimum ellipse of error and considered as control points. FOD problem was applie

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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Selection of the initial value of the time series generating the first-order self-regression model in simulation modeAnd their impact on the accuracy of the model
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In this paper, compared eight methods for generating the initial value and the impact of these methods to estimate the parameter of a autoregressive model, as was the use of three of the most popular methods to estimate the model and the most commonly used by researchers MLL method, Barg method  and the least squares method and that using the method of simulation model  first order autoregressive through the design of a number of simulation experiments and the different sizes of the samples.

                  

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