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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
Tue Jul 01 2008
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Analysis of Data Obtained From Chromosomal Studies Performed During the Period from 2000-2007 A Retrospective Study
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Background: Generally, genetic disorders are a leading cause of spontaneous abortion, neonatal death, increased morbidity and mortality in children and adults as well. They a significant health care and psychosocial burden for the patient, the family, the healthcare system and the community as a whole. Chromosomal abnormalities occur much more frequently than is generally appreciated. It is estimated that approximately 1 of 200 newborn infants had some form of chromosomal abnormality. The figure is much higher in fetuses that do not survive to term. It is estimated that in 50% of first trimester abortions, the fetus has a chromosomal abnormality. Aim of the study: This study aims to shed some light on the results of chromosomal studies per

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Publication Date
Thu Dec 31 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
QUALITY EVALUATION OF THE INTERNAL METALLIC COATING FOR SOME FOODS THAT AVAILABLE IN THE LOCAL MARKETS: QUALITY EVALUATION OF THE INTERNAL METALLIC COATING FOR SOME FOODS THAT AVAILABLE IN THE LOCAL MARKETS
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The study aimed to estimate the content of lead and determine the quality of the internal coating of metal cans through electrical conductivity as well as to determine the accuracy of the information card for some types of canned food that available in local markets. The information card test showed that all of these samples contained the name of the food, trade mark, country origin, weight, and components, as was indicated by the company producing in all of them except for the C12 sample which was otherwise, and the batch number was mentioned in all samples except for the C3 and C17 which was not clear and not mentioned in the C21, and the validity period was observed (produce and fini

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Publication Date
Thu Sep 01 2016
Journal Name
Injury Prevention
The effectiveness of injury prevention program on reducing the incidence of lower limb injuries in adolescent male soccer players
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The highest incidence of injury is seen in adolescent playing pivoting sports such as soccer, basketball, and handball. Objective: To examine the effectiveness of a neuromuscular prevention program in reducing knee and ankle injuries in adolescent male soccer players.

Publication Date
Tue Jun 01 2021
Journal Name
Iraqi Journal Of Physics
Effect of Transition Metal Dopant on the Electrical Properties of ZnO-TiO2 Films Prepared by PLD Technique
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In this article, the influence of group nano transition metal oxides such as {(MnO2), (Fe2O3) and (CuO)} thin films on the (ZnO-TiO2) electric characteristics have been analyzed. The prepared films deposited on glass substrate laser Nd-YAG with wavelength (ℷ =1064 nm) ,energy of (800mJ) and number of shots (400). The density of the film was found to be (200 nm) at room temperature (RT) and annealing temperature (573K).Using DC Conductivity and Hall Effect, we obtained the electrical properties of the films. The DC Conductivity shows that that the activation energies decrease while the σRT at annealing temperature with different elements increases the formation of mixed oxides. The Hall effect, the elec

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Publication Date
Fri Oct 10 2025
Journal Name
Pharmakeftiki
Genetic polymorphisms and adverse effects that affect the natalizumab clinical response: a review
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The clinical response to natalizumab in patients with multiple sclerosis (MS) may be significantly influenced by genetic variation. Mutations in genes related to the drug’s mechanism of action or the pathological milieu of MS can contribute substantially to interindividual differences in treatment outcomes. This review aims to provide an overview of previous studies that have examined genetic polymorphisms associated with the clinical efficacy of natalizumab. A systematic literature search was conducted across the PubMed, Google Scholar, and ResearchGate databases using targeted keywords relevant to the subject matter. Several genetic loci were found to be linked to natalizumab responsiveness, including the integrin subunit alpha 4 (ITGA4

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Publication Date
Mon Dec 31 2012
Journal Name
College Of Islamic Sciences
The hadiths that al-Mazy cited in his book "Tuhfat al-Ashraf" from the Imam Ahmad Imam's collection and study
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This research seeks to attempt to reveal the intention of Al-Hafiz Al-Mazi from his market to hadiths from Imam Ahmad’s Musnad in his book “Masterpiece of Supervision in Knowing the Parties”, and researchers know that this book was classified by Al-Mazi to collect the parties to the six books: Sahih Al-Bukhari, Sahih Muslim, Sunan Abi Dawud, Jamea Al-Tirmidhi and Sunan Al-Nasa’i and Sunan Ibn Majah, in addition to some of the books ’authors’ books, and arranging them according to the Musnad, and it is not Musnad Ahmad from his condition, even if it is close to the arrangement of Mazi’s work, as he was a follower of that to the original owner Abu al-Qasim bin Asaker in his book “Supervising Knowledge of the Parties” in M

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of changing the exchange rate in bank loans : Applied research on a sample of Iraqi commercial banks
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Abstract

          The aim of the research is to measure the effect of changing the exchange rate on bank loans, and in order to achieve this goal, the (official exchange rate) was chosen as an independent variable and its effect was studied on the dependent variable, which is bank credit. Commercial Gulf, Baghdad, A Shore International for Investment (and the financial indicators (growth rate of loans) and the statistical program (Eviews 12) were used to measure the impact of the exchange rate change on the bank credit of banks, the research sample for the period 2012-2022, and the research reached a group Among the conclusions, the most important of which is that the

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Publication Date
Mon Dec 25 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Preparation and Evaluation of Ketoprofen Nanosuspension Using Solvent Evaporation Technique
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The effective surface area of drug particle is increased by a reduction in the particle size. Since dissolution takes place at the surface of the solute, the larger the surface area, the further rapid is the rate of drug dissolution. Ketoprofen     is class II type drug according to (Biopharmaceutics Classification System BCS) with low solubility and high permeability. The aim of this investigation was to increase the solubility and hence the dissolution rate by the preparation of ketoprofen     nanosuspension using solvent evaporation method. Materials like PVP K30, poloxamer 188, HPMC E5, HPMC E15, HPMC E50, Tween 80 were used as stabilizers in perpetration of differ

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Publication Date
Sun Oct 01 2017
Journal Name
Applied Energy
Hourly yield prediction of a double-slope solar still hybrid with rubber scrapers in low-latitude areas based on the particle swarm optimization technique
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Publication Date
Fri Oct 23 2020
Journal Name
Medico-legal Update
Role of Endoscopic Ultrasound Guided Fine Needle Aspirate for Evaluating Lesions in or Adjacent to Gastrointestinal Tract: A Single Tertiary Care Center Experience
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