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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
Thu Jun 27 2024
Journal Name
Journal Of Optics
The influence of surfactant type on the formation of zinc oxide nanoparticles via liquid phase pulsed laser ablation technique
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To produce Zinc Oxide NanoParticles, ZnO-NPs, different methods can be used. However, the utilization of Liquid-Phase Pulsed Laser Ablation, LP-PLA, methodology of three distinct environment of aqueous using pure zinc plate will be one of the approaches for this job. Thus, in this work, concentrates on the influence of the results after employing some changes on the environment in other words, the influence of the NPs size and/or the NPs availability/appearance. Cetyltrimethylammonium Bromide, CTAB, is one of the three surfactants that have been used in the water-based solution. That is, the Sodium Dodecyl Sulfate, SDS, besides the Distilled Water, DW, the three surfactants will be ready when the molarity of the DW is around 10− 3 M. Th

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Federal and problematic relationship between the center and the region in Iraq
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The US invasion of Iraq in 2003 unleashed the repressed national aspirations of the Kurdish people. After the colonial powers, especially Britain, failed to establish a homeland of scattered Kurds in Iraq, Turkey, Syria and Iran, Iraq's Kurds managed to establish a semi-independent state in the north of the country Which lasted decades against the central authority in Baghdad in protest against what they call the forced integration of Kurds in the Iraqi state, and to obtain more rights and privileges as partners in this country. The federal region in the Kurdistan region of Iraq has become a reality, and it is eager not to strengthen its authority in return for the authority of the central government, but to annex other areas inhabited b

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Publication Date
Fri Jun 30 2023
Journal Name
Journal Of The College Of Education For Women
The Construction of the Iraqi Child in the UNICEF Reports during Covid19 Pandemic: A Critical Discourse Analysis
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The present paper aims at investigating the linguistic image portrayed by UNICEF reports on the Iraqi child from a critical discourse analysis perspective during Covid19 pandemic (2020). The paper attempts to fill a gap in research literature concerning the linguistic construction of the Iraqi child by the UNICEF reports during the critical health crisis of Covid19. Van  Leeuwen’s (2008) approach of social actor representation has been adopted for this purpose. From Van  Leeuwen’s approach, the category of determination (single determination and overdetermination) has been selected to be the main analytical tool for its high compatibility with the set of objectives put forward to figure out how such a globally effective and

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of Engineering
The Effective of Pressure and Sintering Temperature for Hardness Characteristics of Shape Memory Alloy by Using Taguchi Technique
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This paper presents the Taguchi approach for optimization of hardness for  shape memory alloy (Cu-Al-Ni) . The influence of  powder metallurgy parameters on hardness has been investigated. Taguchi technique and ANOVA were used for analysis. Nine experimental runs based on Taguchi’s L9 orthogonal array were performed (OA),for two parameters was study (Pressure and sintering temperature) for three different levels (300 ,500 and 700) MPa ,(700 ,800 and  900)oC respectively . Main effect, signal-to-noise (S/N) ratio was study, and analysis of variance (ANOVA) using  to investigate the micro-hardness characteristics of the shape memory alloy .after application the result of study shown the hei

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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
Sat Jun 26 2021
Journal Name
Journal Of The College Of Education For Women
Education and the Challenges of Globalization during the Corona Pandemic: A Field Study from Baghdad University Professors’ Point of View: ميسم ياسين عبيد
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study aims to examine education and the challenges of globalization in light of Corona pandemic. The examination involves surveying a randomly selected sample from the University of Baghdad’s professors, particularly from the colleges of Education for Women, Arts, and Sciences. The purpose of this examination is to learn about the dimensions of globalization, its effects on the educational process, and the importance of distance education during the spread of Corona virus quarantine. To achieve this, the researcher followed a descriptive and analytical approach by applying a questionnaire to a sample of 70 teachers who were randomly selected electronically. Results have shown that 78.6% emphasized the contribution of globalization duri

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Publication Date
Thu Nov 01 2018
Journal Name
Iop
Evaluating the part of historical center in Baghdad City
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Evaluating the part of historical center in Baghdad City

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Publication Date
Wed Jan 01 2020
Journal Name
Karbala Journal Of Physical Education Sciences
The effect of using a designed device to develop the technical performance of the descending landing skill facing with half a cycle on the parallel device of the technical men's
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The research included five sections containing the first section on the introduction of the research and its importance and was addressed to the importance of the game of gymnastic and skilled parallel effectiveness and the importance of learning, but the problem of research that there is a difference in learning this skill and difficulty in learning may be one of the most important reasons are fear and fear of falling and injury, And a lack of sense of the movement of the movement is one of the obstacles in the completion of the skill and the goal of research to design a device that helps in learning the skill of descending Almtor facing with half a cycle according to the typical locomotor track on the parallel device of the technical men'

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Publication Date
Fri Mar 01 2024
Journal Name
Annales Pharmaceutiques Françaises
Adopting video assignments as a tool to improve first-year pharmacy students class engagement
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Publication Date
Mon Apr 01 2013
Journal Name
Journal Of Drugs In Dermatology (jdd)
The Therapeutic Role of Isotretinoin in the Management of Behçet&#039;s Disease: A Single-Blinded, Controlled Therapeutic Study - JDDonline - Journal of Drugs in Dermatology
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AbstractOBJECTIVES: To evaluate the long-term remission efficacy and safety of isotretinoin in the treatment of Behcet's disease (BD). PATIENTS and METHODS: This single-blind, controlled therapeutic study was conducted in the Department of Dermatology and Venereology at Baghdad Teaching Hospital from February 2011 to January 2012. Thirty patients with BD were included in this work. Each patient received isotretinoin 20 mg orally once daily for 3 months. They were assessed at week 2 and then monthly depending on the Clinical Manifestation Index (CMI) and to record any side effects. At week 12, isotretinoin was stopped and patients were given placebo therapy in a form of glucose capsules for another 3 months. RESULTS: Thirty patients were tre

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