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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
Fri Jan 01 2016
Journal Name
Journal Of The College Of Basic Education
Simultaneous Determination of Cephalexin and Cefixime by First and Second Derivative Ultraviolet Spectrophotometry
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A new spectrophotometric method for individual and simultaneous determination of cefixime and cephalexin depending on the first and second derivative mode techniques. The first and second derivative spectra of these compounds permitted individual and simultaneous determination of cefixime and cephalexin in concentration interval of (4– 24μg.ml-1 ) by measuring the amplitude of peak-to-base line, pea to peak at certain wavelengths and the area under peak at selected spectrum intervals. The methods showed reasonable precision and accuracy and have been applied to determine cefixime and cephalexin in two different pharmaceutical preparations.

Publication Date
Sun Jan 03 2016
Journal Name
Journal Of The College Of Basic Education
Simultaneous determination of cephalexin and cefixime by first and second derivative ultraviolet spectrophotometry
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Publication Date
Sun Jan 31 2016
Journal Name
International Journal Of Research In Humanities, Arts, And Literature
THE PROBLEMS FACING IRAQI CHILDREN IN LEARNING ENGLISH
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DBN Rashid, IMPAT: International Journal of Research in Humanities, Arts, and Literature, 2016 - Cited by 5

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Publication Date
Thu Aug 18 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Resource consumption accounting technique between traditional cost systems and contemporary cost management techniques in measuring the cost of products - A conceptual vision
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The contemporary business environment is witnessing increasing calls for modifications to the traditional cost system, and a trend towards adopting cost management techniques to provide appropriate financial and non-financial information for senior and executive departments, including the Resource Consumption Accounting (RCA) technique in question, which classifies costs into fixed and variable to support the decision-making process. Moreover, (RCA) combines two approaches to cost estimation, the first based on activity-based cost accounting (ABC) and the second on the German cost accounting method (GPK). The research aims to provide a conceptual vision for resource consumption accounting, after Considering it as an accounting te

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Publication Date
Wed Oct 07 2020
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Phylogenetic Tree Analysis of First Psychrobacter Sp. Strain From Blood of Iraqi Patient; A Case Report
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Publication Date
Wed Mar 01 2023
Journal Name
Iranian Journal Of Materials Science And Engineering
First-Principles Analysis of Cr-Doped SrTiO3 Perovskite as Optoelectronic Materials
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The influence of Cr3+ doping on the ground state properties of SrTiO3 perovskite was evaluated using GGA-PBE approximation. Computational modeling results infered an agreement with the previously published literature. The modification of electronic structure and optical properties due to Cr3+ introducing into SrTiO3 were investigated. Structural parameters assumed that Cr3+ doping alters the electronic structures of SrTiO3 by shifting the conduction band through lower energies for the Sr and Ti sites. Besides, results showed that the band gap was reduced by approximately 50% when presenting one Cr3+ atom into the SrTiO3 system and particularly positioned at Sr sites. Interestingly, substituting Ti site by Cr3+ led to eliminating the band ga

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Publication Date
Thu Aug 31 2023
Journal Name
Oncology And Radiotherapy
The role of breath holding technique on minimizing cardiac dose in left breast cancer irradiation in the adjuvant setting
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Publication Date
Tue Aug 01 2023
Journal Name
Baghdad Science Journal
First record of peregrine shrimp Metapenaeus stebbingi Nobili, 1904 (Crustacea, Decapoda: Penaeidae) in the Iraqi waters, North-West Arabian Gulf
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One male specimen of the species Metapenaeus stebbingi Nobili, 1904 was first recorded in November 2021 from the Iraqi territorial waters, Northwest of the Arabian Gulf. Therefore, the investigated shrimp species nominally corresponds to the original description of M. stebbing through the main diagnostic features. It must be adopted in the spread and expansion of species, a new record of the area, and a distinctive addition to the species of commercial shrimp within the Iraqi marine waters.

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Publication Date
Sat Aug 31 2019
Journal Name
Iraqi Journal Of Physics
The Effect of Laser And Thermal Treatment on the Hardness and Adhesion Force on the Cermet Coating By Thermal Spray Technique
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Ceramic coating compose from a ceramic mixture (MgO, Al2O3) and metall (Al-Ni) were produced by Thermal Spray Technique. The mixed ratio of used materials Al:Ni (50%) and 40% of Al2O3 and 10% MgO. This mixture was spray on a stainless steel substrate of type (316 L) by using thermal spray with flame method and at spraying distances (8, 12, 16 and 20) cm, then the prepared films were treated by laser and thermal treatment. After that performing a hardness and adhesion tests were eximined. The present study shows that the best value of the thermal treatment is 1000 ℃ for 30 mint; the optimum spray distance is 12 cm and most suitable laser is 500 mJ where the microscopic and mechanical character

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
Incidence of Injuries to Major Blood Vessels in the Lower Limb
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Background: Blood vessels injury is one of the most
common causes of medical emergencies that admitted to
hospitals and at the same time it regarded as one of the
most important causes of death. They may represent less
than 15% of all injuries; they deserve special attention
because of their severe complications.
Objective: The aim of the present study is to assess
anatomically the injures of major arteries and veins in the
lower limb with their management.
Methods: The present study extended from April 2006 to
February 2007, in which 65 patients with lower limb
vascular injury were examined in Emergency Department
and Forensic Medicine Department of Tikrit Teaching
Hospital in Salah-Aldin governora

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