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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 Jun 11 2017
Journal Name
Al-academy
Directorial Vision Between The Closed And Open In The Iraqi Theater Space
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This research deals with the concept of space in the theatrical performance and how the director works between two different spaces, the closed space and the open space. The question was how to use space according to the director's vision in the presentation. The problem of the research was whether the director of the Iraqi filmmaker could see the variable in the architectural space Or the place or space within the exhibition between open and closed, through the formation of the vision of the external components of intellectual and aesthetic and aesthetic, and impact on the relationship between the actor and the recipient to produce a new aesthetic space, and then the purpose of research and importance and limits and terminology The seco

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Publication Date
Thu Jan 01 2015
Journal Name
International Journal Of Scientific Research In Knowledge
The Impact of Teenage Pregnancy on Maternal, Fetal and Neonatal Outcomes
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Adolescent pregnancy is common health problem still found in both developed and developing countries; as adolescent may have early sexual practice or early marriage. Adolescent mothers face substantially higher maternal and perinatal morbidity and mortality than adult women. This is a randomized prospective clinical study conducted at Al-Elwiya Maternity Teaching Hospital, Baghdad, Iraq. The objective of this work is to assess the adverse maternal, fetal and neonatal outcomes in early and late teenage pregnant mothers. Study sample consisted of 220 primigravid women with a singleton, cephalic, viable fetus and no congenital abnormality that gave birth at Al-Elwiya Maternity Teaching Hospital, Baghdad, Iraq. The 1stgroup: early teenage (46 w

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Christian Taghlib tribe in the first century A.H: The Christian Taghlib tribe in the first century A.H
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Abstract:
Taghlib tribe had an important part in the history of the first century of
hijra. She managed to get the best social, economic and political basis in the
Arab- Islamic state. In this basis Taghlib was the best Dhimies in the Islamic
state. This tribe refused to be among the people of the book, and to be from
the people of dhima. That tribe refused to pay the Jizya and Khraj, but
accepted to pay double Sadaqa in stead of Jizya and Khraj, so in that case
many Muslims become angry.
Although their Christianity was naïve and simple, Taghlib hold it until the
end of the third century A.H. Taghlib did so because her people wanted to
keep their good relation with the Byzantine. Taghlib thought that the

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Publication Date
Sun Mar 06 2016
Journal Name
Baghdad Science Journal
The Impact of Operating System on Bandwidth in Open VPN Technology
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The internet is a basic source of information for many specialities and uses. Such information includes sensitive data whose retrieval has been one of the basic functions of the internet. In order to protect the information from falling into the hands of an intruder, a VPN has been established. Through VPN, data privacy and security can be provided. Two main technologies of VPN are to be discussed; IPSec and Open VPN. The complexity of IPSec makes the OpenVPN the best due to the latter’s portability and flexibility to use in many operating systems. In the LAN, VPN can be implemented through Open VPN to establish a double privacy layer(privacy inside privacy). The specific subnet will be used in this paper. The key and certificate will

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Publication Date
Sun Feb 04 2018
Journal Name
Journal Of The College Of Education For Women
Phrenic nerve paralysis during cryoballoon ablation for atrial fibrillation: A comparison between the first- and second-generation balloon
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The present study deals with the effect of teaching speaking Strategies (SS) on EFL Iraqi College students. The use of speaking strategies not only solves learners’ communication problems, but also enhances the learner’s interaction in target language, and improves their oral proficiency .The aim of the study is to find out the effect of teaching SS used by EFL College students .The learner of the first stage is population of the study at the Department of English, College of Education /Ibn-Rushd .The sample consists of (60) students distributed on experimental group(A) as well as control group(B) each group contains (30) students . In order to achieve the aim of the study, questionnaire has been constructed to be taught on the experime

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Publication Date
Thu Sep 01 2022
Journal Name
Journal Of Stomatology
The effectiveness of limited flap design in surgical removal of fully impacted lower third molars: a comparative clinical study
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Publication Date
Tue Oct 01 2019
Journal Name
Ceramics International
A first-principles study of the electronic, structural, and optical properties of CrN and Mo:CrN clusters
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Publication Date
Thu May 05 2016
Journal Name
Global Journal Of Engineering Science And Researches
EVALUATE THE RATE OF CONTAMINATION SOILS BY COPPER USING NEURAL NETWORK TECHNIQUE
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The aim of this paper is to design suitable neural network (ANN) as an alternative accurate tool to evaluate concentration of Copper in contaminated soils. First, sixteen (4x4) soil samples were harvested from a phytoremediated contaminated site located in Baghdad city in Iraq. Second, a series of measurements were performed on the soil samples. Third, design an ANN and its performance was evaluated using a test data set and then applied to estimate the concentration of Copper. The performance of the ANN technique was compared with the traditional laboratory inspecting using the training and test data sets. The results of this study show that the ANN technique trained on experimental measurements can be successfully applied to the rapid est

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Publication Date
Mon Aug 31 2020
Journal Name
Bmc Oral Health
The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study
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Abstract<sec><title>Background

The purpose of this study was to evaluate the anesthetic effectiveness of a buccal infiltration technique combined with local massage (using 2% lidocaine) in the extraction of mandibular premolars to be utilized as an alternative to the conventional inferior alveolar nerve block.

Methods

Patients eligible included any subject with a clinical indication for tooth extraction of the mandibular 1st or 2nd premolars. All patients were anesthetized buccally by local infiltration technique followed by an external pressure applied for 1 min directly over the injection area. In each case, another local

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Publication Date
Tue Jan 01 2013
Journal Name
International Journal Of Contemporary Mathematical Sciences
Equivalent between the Criterion and the Three Open Set's Conditions in Disk-Cyclicity
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A vector in a separable infinite dimensional Hilbert space is called disk-cyclic for bounded operator if the orbit α : 0, α∈;|∝| 1is dense in. The useful tool used to discover codisk-cyclic operation is called the disk-cyclic Criterion. In this paper we will show that some equivalent conditions of the

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