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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
Wed Sep 09 2020
Journal Name
International Journal Of Innovation, Creativity And Change
Estimation of the Effect of the Government Expenditure Growth Rate on the Rate of Inflation in the Iraqi Economy for the Period (1991- 2015)
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Government expenditure represents one of the controlling financial policies in the economic affairs and management of the economic cycle in order to achieve price stability, raise the rate of output growth and decrease the level of unemployment. The price stability represents one of the macroeconomic goals that all countries seek without exception, regardless of the economic philosophy adopted by each country; in addition to this is raising the productive capacity and reaching the actual output to the level of the expected output, that is, the level of output related to the natural unemployment rate or what is sometimes called the Non-inflationary unemployment rate. The restriction of government expenditure (G=T+∆B/iP+∆M/P) is

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Publication Date
Wed Dec 20 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Systemic Melatonin Supplementation as an Adjunct to Non-Surgical Periodontal Treatment in Obese Patients with Periodontitis
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Background: Obesity is considered an important risk factor for periodontal disease. It has been reported that reactive oxygen species linking both diseases, systemic melatonin supplementation as antioxidant therapy, was addressed as an adjuvant to scaling and root surface debridement (SRP) to enhance the treatment of periodontitis. Objective: To investigate the efficacy of systemic melatonin administration in periodontitis-obese patients as an adjuvant to scaling and root surface debridement (SRP). Methods: A randomized clinical trial was conducted at a dental-specialized center. Eighty subjects were included and allocated into group-I: twenty periodontium-healthy, normal-weight people; group-II: 30 obese patients with stage-III tre

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Publication Date
Thu Sep 01 2022
Journal Name
Iaes International Journal Of Robotics And Automation
Implementation of a complex fractional order proportional-integral-derivative controller for a first order plus dead time system
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This paper presents the implementation of a complex fractional order proportional integral derivative (CPID) and a real fractional order PID (RPID) controllers. The analysis and design of both controllers were carried out in a previous work done by the author, where the design specifications were classified into easy (case 1) and hard (case 2) design specifications. The main contribution of this paper is combining CRONE approximation and linear phase CRONE approximation to implement the CPID controller. The designed controllers-RPID and CPID-are implemented to control flowing water with low pressure circuit, which is a first order plus dead time system. Simulation results demonstrate that while the implemented RPID controller fails to stabi

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Publication Date
Tue Sep 10 2024
Journal Name
Iraoi Academic Scientific Journals
The Psychological and Physical Life Difficulties of Patients with nerve fascicle
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Publication Date
Wed Sep 27 2023
Journal Name
Journal Of Optics
Studying the responsivity and detectivity of GO/PSi/n-Si photo detector via drop casting technique
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Publication Date
Wed Sep 27 2023
Journal Name
Journal Of Optics
Studying the responsivity and detectivity of GO/PSi/n-Si photo detector via drop casting technique
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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Managing risk and its impact in the face of accidents and work injuries in industrial organizations
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The industrial sector of the important drivers of economic activity sectors due to having the capabilities and the potential to qualify biggest contribution to the economic development of the country, which requires the availability of a higher degree of safety in industrial organizations, and the preservation of the lives of employees and workers in emergency situations, and that all the work is not without its dangers, which produces in a year of uncertainty in the possible events get in the future, therefore, reduce the dangers that could be exposed to industrial organizations and management are at the heart of the strategic direction which works to stimulate thinking about the future and respond to the changes that occur in theextern

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Publication Date
Tue Jan 05 2016
Journal Name
Iraqi Journal Of Science
Local Study of blaCTX-M genes detection in Proteus spp. by using PCR technique
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n this study, 25 clinical isolates of Proteus spp. were collected from urine, wounds and burns specimens from different hospitals in Baghdad city, all isolates were identified by using different bacteriological media, biochemical assays and Vitek-2 system. It was found that 15 (60%) isolates were identifies as Proteus mirabilis and 10 (40 %) isolates were Proteus vulgaris. The susceptibility of P. mirabilis and P. vulgaris isolates towards cefotaxime was (66.6 %) and (44.4 %) respectively; while the susceptibility of P. mirabilis and P. vulgaris isolates towards ceftazidime was (20%). Extended spectrum β-lactamses producing Proteus was (30.7 %). DNA of 10 isolates of P. mirabilis and 4 isolates of P. vulgaris were extracted and de

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Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
The challenges facing the Insurance sector in Iraq Analytical study in Iraqi insurance companies (National insurance company as model)
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Most of World nations are striving to provide the necessary needs to protect their economic properties assets against natural or abnormal disasters that may be inflicted on such property and the means that used by such countries to reduce the damages is insurance, whereas insurance as a system that collects and distributes different risks into the group thus  to achieve a social symbiosis between individuals. The system works to transfer the risks from the individual to the group and then distributes the losses to all members of the group.

According to the importance of the insurance sector and the need to develop it as well as working on improving its performance, this search aims to identify the ac

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Publication Date
Mon Sep 30 2024
Journal Name
Modern Sport
The Effect of Skill Exercises According to the Concentration Technique of Lateral Thinking on Motor Accuracy and Learning the Diving Stop Attack for Students in the Epee Weapon
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لمعرفة مدى تأثير تمرينات مهارية وفق تقنية تركيز للتفكير الجاني على الدقة الحركة وتعلم هجمة الإيقاف  بالغطس للطلاب في سلاح الشيش استخدمت الباحثتان المنهج التجريبي على عينة من طلاب المرحلة الثالثة بكلية التربية البدنية وعلوم الرياضة –جامعة ديالى والتي بلغت (30) طالباً موزعين على مجموعتين التجريبية والضابطة وبعد إكمال اجراءات البحث وتطبيق الاختبارات القبلية وتنفيذ التمرينات والاختبار البعدي ومعالجة الب

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