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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
Mon Jan 01 2024
Journal Name
Baghdad Science Journal
Classification of Arabic Alphabets Using a Combination of a Convolutional Neural Network and the Morphological Gradient Method
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The field of Optical Character Recognition (OCR) is the process of converting an image of text into a machine-readable text format. The classification of Arabic manuscripts in general is part of this field. In recent years, the processing of Arabian image databases by deep learning architectures has experienced a remarkable development. However, this remains insufficient to satisfy the enormous wealth of Arabic manuscripts. In this research, a deep learning architecture is used to address the issue of classifying Arabic letters written by hand. The method based on a convolutional neural network (CNN) architecture as a self-extractor and classifier. Considering the nature of the dataset images (binary images), the contours of the alphabet

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Publication Date
Fri Jun 30 2017
Journal Name
Journal Of Madenat Al-elem University College
Study the toxic effect of the herbicide Gold topik (80EC) on survival and behavior of mosquito fish (Gambusia holbrooki Girard 1859)
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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Impact of Islamic Financial Inspection Thought on the Development of Inspection and comparing it with Positive Thought: Theoretical Comparative Study
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You Mohammed, you're prophet of God and I'm Gabriel)). With this heavenly call which Mohammed, the messenger of God (may God's mercies be on him), got and when he left Hiraa cave and after getting the aye ((read with your God's name)), a new period of mankind's history started. From that time, the greatest state was established. There was no public treasury and no public financial resources at that time. Abu Baker (God bless him) spent a lot of money to support the costs of the new mission. After Al-Hijra, the bases of establishing the Islamic state were available but it lacked administrative and financial organizing. Therefore the prophet was very keen to find Islamic system which ensures justice and availability of

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Social capital and the extent of its contribution to enhancing the management of excellence: An applied study at Azadi Hospital / Duhok
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The study aimed to reveal the role of social capital represented by its dimensions (structural, relational, and cognitive) in strengthening the management of excellence in Azadi Hospital / Duhok. In order to reach the goal of the study, the study variables were highlighted in theory through framing concepts and literary contributions for researchers in this field, In the field, the questionnaire was used as a basic tool to collect data from the individuals in the research sample who were represented by officials and individuals working from administrators and technicians, as (120) forms were distributed to the respondents, and (110) were retrieved from them in a way that is valid for analysis. Several statistical methods have bee

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Publication Date
Mon Dec 05 2022
Journal Name
Baghdad Science Journal
Synthesis, Identification, Theoretical Study, and Effect of the New Heterocyclic System from Ciprofloxacin Derivatives on the Activity of Some Liver Enzymes
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The target of this study was to synthesize several new Ciprofloxacin drug analogs by providing a nucleophilic substitution procedure that provides new functionality at the carboxylic group location. The analogs were synthesized, designed, and characterized by 1HNMR, and FTIR. The synthetic path began from the reaction of ciprofloxacin drug with morpholine to give compound[B], ciprofloxacin derivative was linked with a variety of primary and secondary amines to give compounds[B1-B9]. The above-mentioned prepared compounds [B3 and B5] were applied to liver enzymes, and the increase in the activity of these enzymes was observed. In addition, a theoretical study was conducted to study the energies and properties of the prepared co

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Publication Date
Sat Nov 22 2025
Journal Name
Adab Al Rafidayn
Measuring the quality of office services using (LibQUAL + ®): the central library of the University of Baghdad as a model
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Libraries, information centers, and everything related to organizing and preparing information need to be periodically re-evaluated in order to stand on the level of quality, which means improving the general reality of these institutions to ensure sufficient satisfaction from beneficiaries of the services provided. This is what was worked on in this research, as one of the most important quality standards in libraries and information centers, LibQUAL+®, was applied in one of the most important and oldest central university libraries, namely the Central Library of the University of Baghdad at its two locations, Al-Jadriya and Al-Waziriya. The sample of beneficiaries to whom the questionnaire was distributed reached 75 beneficiaries distrib

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Determination of the lot size using the Wagner-Whitin algorithm under the Constraint Theory / Case Study of Diyala Public Company
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         International companies are striving to reduce their costs and increase their profits, and these trends have produced many methods and techniques to achieve these goals. these methods is heuristic and the other Optimization.. The research includes an attempt to adapt some of these techniques in the Iraqi companies, and these techniques are to determine the optimal lot size using the algorithms Wagner-Whitin under the theory of constraints. The research adopted the case study methodology to objectively identify the problem of research, namely determining lot size optimal for each of the products of electronic measurement laboratory in Diyala and in light of the bottlenecks in w

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Publication Date
Fri Nov 15 2024
Journal Name
Iraqi Journal Of Science
Study of the Spectral Energy Distribution Model of the Protoplanetary Disk Geometric around the Brown Dwarf CFHT-BD-Tau 4
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The accretion circumstellar disk of young stars and the Brown dwarf plays an essential role in the formation and evaluation of the planet. Our main work in this paper is to investigate the geometrical shape model for the protoplanetary disk around one of the Brown Dwarfs. The photometric measurements for the brown dwarf CFHT-BD-Tau 4 were extracted from the Vizier archive. We used a numerical simulation to build a model of the spectral energy distribution of our target CFHT-BD-Tau 4. The spectral energy distribution model was fitted with observational data for the brown dwarf CFHT-BD-Tau 4. A transitional disk has been assumed around CFHT-BD-Tau 4. We obtained physical properties of the two disks and the size of the gap between them

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Publication Date
Sun Aug 24 2025
Journal Name
Basrah Journal Of Agricultural Sciences
Histological Study of the Stomach of the North African Catfish Clariasgariepinus (Burchell, 1822) (Siluriformes, Clariidae) from the Tigris River, Iraq
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This study investigates the stomach morphology and histochemistry of Clarias gariepinus. Grossly, the stomach is a J-shaped organ with three distinct regions: cardiac, fundic, and pyloric. Histologically, its wall comprises four layers: mucosa, submucosa, muscularis externa, and serosa. The mucosa exhibits broad longitudinal folds lined by high columnar cells with basal oval nuclei. These cells contain apical mucosubstances that react positively with Periodic Acid Schiff (PAS) stain and negatively with Alcian Blue (AB). Gastric pits result from mucosal invaginations. Glands are present in the fundic and cardiac regions but absent in the pyloric. Oxynticopeptic cells exclusively line the fundic glands. Enteroendocrine cells are distr

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Publication Date
Sun Aug 24 2025
Journal Name
Basrah Journal Of Agricultural Sciences
Histological Study of the Stomach of the North African Catfish Clariasgariepinus (Burchell, 1822) (Siluriformes, Clariidae) from the Tigris River, Iraq
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This study investigates the stomach morphology and histochemistry of Clarias gariepinus. Grossly, the stomach is a J-shaped organ with three distinct regions: cardiac, fundic, and pyloric. Histologically, its wall comprises four layers: mucosa, submucosa, muscularis externa, and serosa. The mucosa exhibits broad longitudinal folds lined by high columnar cells with basal oval nuclei. These cells contain apical mucosubstances that react positively with Periodic Acid Schiff (PAS) stain and negatively with Alcian Blue (AB). Gastric pits result from mucosal invaginations. Glands are present in the fundic and cardiac regions but absent in the pyloric. Oxynticopeptic cells exclusively line the fundic glands. Enteroendocrine cells are distr

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