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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
Mon Jan 01 2024
Journal Name
Aip Conference Proceedings
Priority study of welding parameters affecting the rate of molten metal precipitation and hardness
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Publication Date
Thu Jul 01 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
A proposed encryption technique of different texts using circular link lists
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Publication Date
Sun Nov 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Pump-Probe Technique to Study of the All-Optical Switching Properties of Copper Phthalocyanine Thin Film prepared via Pulsed laser deposition
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Abstract<p>Z-scan has been utilized for studying the non-linear properties and optical limiting behaviors of the dye Copper Phthalocyanine thin films. The refractive index is negative, which indicates a self-defocusing behavior and non-linear absorption coefficient (<italic>β</italic>) of CuPc is a positive sign is a result of RSA. The optical switching behaviors of dye have been researched with the use of the method of the pump-probe with 9ns Q-Switched Nd: YAG laser at pump beam equal to 532 nm and a probe beam equal to 630nm Diode laser. The thin films of copper Phthalocyanine also reflect a significant limiting of the optical power of CW laser with an adequate threshold of the opt</p> ... Show More
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Publication Date
Thu Jan 30 2020
Journal Name
Journal Of Engineering
  Positional Accuracy Assessment for Updating Authoritative Geospatial Datasets Based on Open Source Data and Remotely Sensed Images
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OpenStreetMap (OSM) represents the most common example of online volunteered mapping applications. Most of these platforms are open source spatial data collected by non-experts volunteers using different data collection methods. OSM project aims to provide a free digital map for all the world. The heterogeneity in data collection methods made OSM project databases accuracy is unreliable and must be dealt with caution for any engineering application. This study aims to assess the horizontal positional accuracy of three spatial data sources are OSM road network database, high-resolution Satellite Image (SI), and high-resolution Aerial Photo (AP) of Baghdad city with respect to an analogue formal road network dataset obtain

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Publication Date
Thu Jun 17 2021
Journal Name
Revista Iberoamericana De PsicologÍa Del Ejercicio Y El Deporte
THE EFFECT OF USING THE ELECTRONIC PARTICIPATORY LEARNING STRATEGY ACCORDING TO THE WEB PROGRAMS IN LEARNING SOME BASIC SKILLS OF BASKETBALL FOR FIRST-GRADE INTERMEDIATE SCHOOL STUDENTS ACCORDING TO THE CURRICULAR COURSE
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The research aims to identify the impact of using the electronic participatory learning strategy according to internet programs in learning some basic basketball skills for middle first graders according to the curricular course, and the sample of research was selected in the deliberate way of students The first stage of intermediate school.As for the problem of research, the researchers said that there is a weakness in the levels of school students in terms of teaching basketball skills, which prompted the researchers to create appropriate solutions by using a participatory learning strategy.The researchers imposed statistically significant differences between pre and post-test tests, in favor of the post tests individually and in favor of

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Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
Forbidden Montage and the transition Technique in one-snapshot Movies 1917 Film- A model: محمد عبد الجبار كاظم-عذراء محمد حسن
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  Starting from the term (forbidden montage) initiated by the French critic (Andre Bazin) as a method of processing the movies that depend on (mise en scene) achieved by the action of the camera and its ability to photograph and employ the depth of the field, in addition to the possibility of free movement without interruption in the filming environment in order to avoid montage as much as possible (the montage that distorts focus and distracts attention and moves away from realism, which is the most important theoretical pillar of Bazin in photography). The pursuit was behind a cinema that depicts its topics in one integrated snapshot with all its details thus approximating reality without any interference of montage. Our study sta

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Publication Date
Sun Sep 15 2024
Journal Name
Iraqi Journal Of Pharmaceutical Sciences
Novel Candidate Single Nucleotide Polymorphisms of ERCC2 Gene that Influence Colorectal Cancer Susceptibility
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Colorectal cancer (CRC) is the most common gastrointestinal malignancy and one of the top ten common cancers worldwide with approximately 2 million cases. There are multiple risk factors that could lead to CRC emergence; of which are genetic polymorphisms. Excision repair cross-complementing group 2 (ERCC2) gene encodes for ERCC2 enzyme which plays a crucial role in maintaining genomic integrity by removing DNA adducts. Several studies suggested that there could be a link between genetic polymorphisms of ERCC2 gene and the risk of CRC development. Hence the present study aims to validate the relationship between the following ERCC2 single nucleotide polymorphisms (rs13181, rs149943175, rs530662943, and rs1799790) and CRC susceptibility. A t

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Prothrombin Time role in Head Injury & Intracranial Hematomas, A prospective Study of 325 cases
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Objective: Aimed to asses the role of PT estimation in early diagnosis and predicting the extent and the outcome of head injury with ICerH and/ or Contusion
Method :PT was measured by Digiclot 818
Group –1: One hundred consecutive head injured patients admitted at Neurosurgical and Al Ramadi teaching hospitals were initially estimated for prothrombin time and subsequently scanned
Group-2 : Two hundred twenty five consecutive non scanned head injured patients admitted to Neurosurgical and Al Ramadi teaching hospitals were estimated with prothrombin time at the time of insult and subsequently for the next two weeks Al – Kindy Col Med J 2012; Vol. 8 No. 1 P: 54
Clinical and neurological evaluation (GCS) score in addition to

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Publication Date
Mon Jan 27 2020
Journal Name
Medico-legal Update
Indications and Adverse Outcomes of Emergency Lower Segment Cesarean Section at 1St and 2Nd Stages of Labor at Al-Elwiya Maternity Teaching Hospital
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Publication Date
Fri Jan 11 2019
Journal Name
Iraqi Journal Of Physics
Control the deposition uniformity using ring cathode by DC discharge technique
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Simulation of direct current (DC) discharge plasma using
COMSOL Multiphysics software were used to study the uniformity
of deposition on anode from DC discharge sputtering using ring and
disc cathodes, then applied it experimentally to make comparison
between film thickness distribution with simulation results. Both
simulation and experimental results shows that the deposition using
copper ring cathode is more uniformity than disc cathode

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