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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
Sun Jan 01 2012
Journal Name
Iraqi Journal Of Science
REMOTE SENSING MONITORING OF CHANGES IN SOIL POLLUTION A CASE STUDY IN A REGION IN BAGHDAD, IRAQ
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One of the main environmental problems which affect extensively the areas in the world is soil salinity. Traditional data collection methods are neither enough for considering this important environmental problem nor accurate for soil studies. Remote sensing data could overcome most of these problems. Although satellite images are commonly used for these studies, however there are still needs to find the best calibration between the data and real situations in each specified area. Landsat satellite (TM & ETM+) images have been analyzed to study soil pollution (Exacerbation of salinity in the soil without the use of abandoned agricultural for a long time) at west of Baghdad city of Iraqi country for the years 1990, 2001 & 2007. All of the th

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Publication Date
Sat Mar 31 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
A Comparison between the Product-Refill and the Equalization Oxygen Pressure Swing Adsorption Processes
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This work presents a design for a pressure swing adsorption process (PSA) to separate oxygen from air with approximately 95% purity, suitable for different numbers of columns and arrangements. The product refill PSA process was found to perform 33% better (weight of zeolite required or productivity) than the pressure equalization process. The design is based on the adsorption equilibrium of a binary mixture of O2 and N2 for two of the most commonly used adsorbents, 5A & 13X, and extension from a single column approach. Zeolite 13X was found to perform 6% better than zeolite 5A. The most effective variables were determined to be the adsorption step time and the operational pressure. Increasing the adsorption step

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Publication Date
Sun Jan 01 2023
Journal Name
Isvs E-journal
Preserving the Past and Building the Future: A Sustainable Urban Plan for Mosul, Iraq
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Preserving the Past and Building the Future: A Sustainable Urban Plan for Mosul, Iraq

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Publication Date
Mon Nov 24 2025
Journal Name
Journal Of Administration And Economics
Using the Maximum Likelihood Method with a Suggested Weight to Estimate the Effect of Some Pollutants on the Tigris River- City of Kut
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The aim of this research is to use robust technique by trimming, as the analysis of maximum likelihood (ML) often fails in the case of outliers in the studied phenomenon. Where the (MLE) will lose its advantages because of the bad influence caused by the Outliers. In order to address this problem, new statistical methods have been developed so as not to be affected by the outliers. These methods have robustness or resistance. Therefore, maximum trimmed likelihood: (MTL) is a good alternative to achieve more results. Acceptability and analogies, but weights can be used to increase the efficiency of the resulting capacities and to increase the strength of the estimate using the maximum weighted trimmed likelihood (MWTL). In order to perform t

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Publication Date
Tue Dec 01 2020
Journal Name
Baghdad Science Journal
Seasonal variation and correlation between the physical, chemical and microbiological parameters of Nile water in selected area in Egypt (Case study): physical, chemical and microbiological parameters of Nile water
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Fresh water resources in terms of water quality is a crucial issue worldwide. In Egypt, the Nile River is the main source of fresh water in the country and monitoring its water quality is a major task on governments and research levels. In the present case study, the physical, chemical and algal distribution in Nile River was monitored over two seasons (winter and summer) in 2019. The aims of the study were to check the seasonal variation among the different water parameters and also to check the correlations between those parameters. Water samples were collected from the Nile in Cairo governorate in EGYPT. The different physiochemical and microbiological properties in water samples were assessed. The studied parameters were included: te

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
The Relations Of Design And The Role Of It Making The Idea For Fashion Design
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Publication Date
Thu Oct 31 2013
Journal Name
Al-khwarizmi Engineering Journal
Influence of the Applied Potential and Temperature on the Electrode position of the Lead Dioxide
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The excellent specifications of electrodes coated with lead dioxide material make it of great importance in the industry. So it was suggested this study, which includes electrodeposition of lead dioxide on graphite substrate, knowing that the electrodeposition of lead dioxide on graphite studied earlier in different ways.

In this work the deposition process for lead dioxide conducted using electrolytic solution containing lead nitrate concentration 0.72 M with the addition of some other material to the solution, such as copper nitrate, nickel nitrate, sodium fluoride and cetyl trimethyl ammonium bromide, but only in very small concentrations. As for the operating conditions, the effect of change potential and temperature as well

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Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
Value system and its impact on the morals of the public job of the individual
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         Values ​​are penetrating or interfering in the lives of individuals and groups and are connected to them in the sense of life itself, because they are closely linked to the motives of behavior, hopes and goals, and can be said that values ​​are everything. The concept of values ​​is one of the concepts that have received the attention of researchers from different disciplines. This has resulted in a kind of confusion and variation in use from one specialization to the other, and uses multiple uses within one specialization. Therefore, there is no uniform definition of values ​​because they relate to individuals. Individuals differ in many things, such as perception,

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Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
The moral dimension of generating and destroying value Through the implementation of the Balanced Scorecard
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يسعى المجتمع من خلال الوحدات الإقتصادية إلى الوصول إلى تحقيق أفضل الإنجازات التي لا تتمثل بالسلع والخدمات حسب وإنما بما يتحقق من مردود لكافة الاطراف المعنية بالوحدات الإقتصادية على ان لايتم ذلك على حساب قيم المجتمع وأخلاقياته وآدابه العامة. وعليه تصبح الوحدات الإقتصادية مسرحاً لصراعات قوى متعددة كل منها له قيمه الأخلاقية سواء كان فرداً أومجموعة افراد أو وحدة إقتصادية أو أي جهة أُخرى، وبحكم مسؤولياته

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
The preoccupations of the compressive references and their impact on the formations of postmodern art
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The artistic process operates whether in general in all arts or specifically in one type of arts or one of the genres of arts types on the preoccupations of the pressing artistic references as the founder of the artistic work in the material formulations on the one hand and on the other hand as a translator to understand the artistic achievement in general and plastic art in particular and for the importance The researcher chose the title of her research tagged (the preoccupations of the pressing reference and its impact on the formations of postmodern arts).
The first chapter of the methodological framework deals with the problem of research, importance, objective, limits, and then terminology and its definition, and then the secon

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