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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
Sat Dec 01 2012
Journal Name
Iraqi Journal Of Physics
Study of the electronic structure of indium gallium phosphide In0.5Ga0.5P nanocrystals
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The electronic structure of zinc blend indium gallium phosphide In0.5Ga0.5P nanocrystals which have dimension (2-2.8 nm) is investigated using the density functional theory coupled with large unit cell (LUC) for the different size core (8 ,16,54,64) atoms respectively. The investigated properties include total energy, energy gap, conduction band, valence band, cohesive energy, ionicity and density of state etc. as a function of core size and lattice constant. Results show the shape effect of increasing the core size and lattice constant on these electronic properties

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Publication Date
Tue Sep 01 2009
Journal Name
Al-khwarizmi Engineering Journal
Study Effect of Dezincification on the Fatigue Properties of Brass Alloy
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This research includes a study of dezincification by corrosion from brass alloys in three types of media, which are acidic solution, basic and slat solution in different percentages. The study show the higher dezincification occurs in basic solution which decrease the fatigue properties where the fatigue properties are inversely proportional with dezincification.

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Publication Date
Mon Sep 30 2002
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The New Synthesis of Potassium-Exchange Zeolite A
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Publication Date
Wed May 12 2021
Journal Name
Journal Of Biotechnology Research Center
A review of the Common Food-borne Viruses
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Publication Date
Wed Jan 01 2020
Journal Name
Italian Journal Of Pure And Applied Mathematics
The non-zero divisor graph of a ring
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Publication Date
Sun Mar 06 2016
Journal Name
Baghdad Science Journal
A Note on the Perturbation of arithmetic expressions
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In this paper we present the theoretical foundation of forward error analysis of numerical algorithms under;• Approximations in "built-in" functions.• Rounding errors in arithmetic floating-point operations.• Perturbations of data.The error analysis is based on linearization method. The fundamental tools of the forward error analysis are system of linear absolute and relative a prior and a posteriori error equations and associated condition numbers constituting optimal of possible cumulative round – off errors. The condition numbers enable simple general, quantitative bounds definitions of numerical stability. The theoretical results have been applied a Gaussian elimination, and have proved to be very effective means of both a prior

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Publication Date
Thu Jan 01 2015
Journal Name
Aip Conference Proceedings
Performance measurements of single server fuzzy queues with unreliable server using left and right method
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The fuzzy assignment models (FAMs) have been explored by various literature to access classical values, which are more precise in our real-life accomplishment. The novelty of this paper contributed positively to a unique application of pentagonal fuzzy numbers for the evaluation of FAMs. The new method namely Pascal's triangle graded mean (PT-GM) has presented a new algorithm in accessing the critical path to solve the assignment problems (AP) based on the fuzzy objective function of minimising total cost. The results obtained have been compared to the existing methods such as, the centroid formula (CF) and centroid formula integration (CFI). It has been demonstrated that operational efficiency of this conducted method is exquisitely develo

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Publication Date
Sun Dec 01 2019
Journal Name
Al- Mohtaref Journal
Impact of The Use of Electronic Concept Mapping Strategy in Learning and Retaining Some of The Skills of The Ground-Moving Carpet in Women's Artistic Gymnastics
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The study aimed to identify the use of the electronic concept maps method in learning some of the skills of the floor exercises in the artistic gymnastics for third graders ,as well as to identify the best group between the two research groups (experimental And the officer to learn and retain some of the skills of the floor exercises in the artistic gymnastics of the research subject , and the experimental method was used and included the sample research on students of the collage of Physical Education and Sports Sciences/University of Baghdad, third grade, and has selected (10) Students for each group of The experimental and controlling groups randomly by lottery and after the completion of the period of implementation of the experiment wh

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Environmental Science And Development
Estimation of the Concentrations of Some Pollutants Resulting from the Use of Arabian Bakhour and Their Effect in Patients with Asthma in the City of Baghdad
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This research focus on studying 3 types of Bakhour in the markets of Baghdad city and assessing their impact on the quality of life for asthmatic whom used Bakhour at their houses through investigating particles physical properties, also estimating the levels of heavy metals (Cd, Cu, Mn, Pb and Zn), Particulate Matter PM2.5, PM10, Total Volatile Organic Compounds (TVOC) and formaldehyde (HCHO). The quality of life for asthmatic patients whom use Bakhour was assessing by Mini Asthma Quality of Life Questionnaire. The results indicated that shapes of Bakhour particles were irregular or spherical. Burning process generated the higher percent of PM ˂1μm. Type 2 Bakhour showed the highest percent of <1μm which was 73%.The amount of

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Theoretical Study of the Effect of Permeability Tensor upon Drainage of Soils
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the influence of permeability tensor upon drainage of anisotropic soils under ponded water and steady recharge (rainfall) is theoretically investigated. Tensorial permeability has led to the formulation of mixed type partial differential equations. Since there is no analytical solution to this problem, the formulation is therefore solved numerically by the method of finite elements. The finite element formulation is implemented into a computer model which can be applied to any problem of seepage under steady state
conditions. Two different example problems representing two different flow conditions under full anisotropy have been studied. Results of the model for the isotropic case were checked against exact mathematical solutions de

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