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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
Organization, Technology And Management In Construction: An International Journal
The factors that affect constructability in Iraq
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Abstract<p>Applying the constructability concept in the construction industry has proven many benefits in different projects; however, this concept still lacks usage in Iraq. Therefore, it is important to encourage usage of the constructability concept in the construction industry in Iraq. The main purpose of this study is to investigate the factors that affect constructability in Iraq and then classify them according to their importance. A total of 37 factors were collected from an intensive literature review, and they were classified under the sub and main categories. A survey was undertaken in two sessions with open questionnaire and close questionnaire. The results were analysed and the mean</p> ... Show More
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Publication Date
Fri Feb 10 2023
Journal Name
Journal Of Applied Mathematics
The Dynamics of a Delayed Ecoepidemiological Model with Nonlinear Incidence Rate
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In this paper, the general framework for calculating the stability of equilibria, Hopf bifurcation of a delayed prey-predator system with an SI type of disease in the prey population, is investigated. The impact of the incubation period delay on disease transmission utilizing a nonlinear incidence rate was taken into account. For the purpose of explaining the predation process, a modified Holling type II functional response was used. First, the existence, uniform boundedness, and positivity of the solutions of the considered model system, along with the behavior of equilibria and the existence of Hopf bifurcation, are studied. The critical values of the delay parameter for which stability switches and the nature of the Hopf bifurcat

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Publication Date
Fri Jun 03 2016
Journal Name
Al-kindy College Medical Journal
Patellar Fracture Fixation by Cerclage and Tension Band Wiring Technique versus Kirschner wires and Tension Band Wiring Technique
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Background:Fractures of patella constitute 1% of all fractures. Various techniques have been described for internal fixation of patella fractures. Superiority of one technique over the other has long been debated. Objective:We reviewed a series of seventy patients with transverse or comminuted fractures of patella treated with cerclage and tension band wiring technique to assess if it had any advantages over k. wires and tension band wiring technique. Type of the study:Retrospective study.Methods; Seventy patients with displaced patella fracture, with a mean age of 47 years (range 13-75) were divided into two groups :group A 36 patients were treated with cerclageand tensi

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Publication Date
Sat Dec 31 2016
Journal Name
Al-kindy College Medical Journal
Patellar Fracture Fixation by Cerclage and Tension Band Wiring Technique versus Kirschner wires and Tension Band Wiring Technique
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Background: Fractures of patella constitute 1% of all fractures. Various techniques have been described for internal fixation of patella fractures. Superiority of one technique over the other has long been debated. Objective: We reviewed a series of seventy patients with transverse or comminuted fractures of patella treated with cerclage and tension band wiring technique to assess if it had any advantages over k. wires and tension band wiring technique. Type of the study: Retrospective study. Methods; Seventy patients with displaced patella fracture, with a mean age of 47 years (range 13-75) were divided into two groups :group A 36 patients were treated with cerclage and tension bands technique ,and group B 34 patients were fixed by 2 K.

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Publication Date
Thu Jun 10 2021
Journal Name
Journal Of Kufa−physics
The Structural and Optical Properties of Cobalt dioxide (CoO2 )Thin Films deposited via (SCSP) Technique for photovoltaic applications
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Publication Date
Sat May 02 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&#39;s
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AS Salman, SK Hameed…, Karbala Journal of Physical Education Sciences, 2020

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Publication Date
Sun Mar 02 2008
Journal Name
Baghdad Science Journal
Determination Of Micro Amount Of Spironolactone In Some Of Pharmaceutical Preparate By Using a Molecular Luminescence Technique.
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The present study include a new developed method of analysis for determination of drug Spironolaction (SP) in some Pharmaceuticals by Spectrofluorometric method. Spironolaction was determined under optimal experimental condition that follows :- The excitation spectrum was (l=351 nm), the emmetion spectrum was (l=518 nm), pH=1, the suitable temperature for reaction 60oC and the optimal time less than (3) minute. The analysis and rang statistical data was:-Linear dynamic rang (1-10) ?g.ml-1, the detection limit (D.L = 0.023 ?g.ml-1), Molar absorptivity (? = 29875 liter mole-1 cm-1), Relative standard deviation (%RSD = 0.78), (%Erel = 3.3) and recovery (Rec = 96.6) percentage. Determination of Spironolactone was accomplished by two methods

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Publication Date
Tue Nov 13 2012
Journal Name
Wireless Personal Communications
Design and Implementation of a Scalable RFID-Based Attendance System with an Intelligent Scheduling Technique
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Publication Date
Sun May 24 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Establishment of the possible association between the presence of Helicobacter pylori in the saliva and gastric biopsy by using polymerase chain reaction technique in association with oral manifestation of peptic ulcer disease
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Background: Helicobacter pylori are important gastrointestinal pathogen associated with gastritis, peptic ulcers, and an increased risk of gastric carcinoma. There are several popular methods for detection of H. pylori (invasive and non-invasive methods) each having its own advantages, disadvantages, and limitations, and by using PCR technique the ability to detect H. pylori in saliva samples offers a potential for an alternative test for detection of this microorganism. Materials and methods: The study sample consists of fifty participants of both genders, who undergo Oesophageo-gastrodudenoscopy at the Gastroenterology Department of Al-Kindy Teaching Hospital Baghdad/ Iraq, during five months period from January 2014 to May 2014. They we

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Engineering
Experimental Study of Optimum Chilled Water Distribution Configuration in Air Conditioning Terminal Unit Using RSM Technique
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The distribution of chilled water flow rate in terminal unit is an important factor used to evaluate the performance of central air conditioning unit. A prototype of A/C unit has been made, which contains three terminal units with a complete set of accessories (3-way valve, 2-way valve, and sensors) to study the effect of the main parameters, such as total water flow rate and chilled water supply temperature with variable valve opening. In this work, 40 tests were carried out. These tests were in two groups, 20 test for 3-way valve case and 20 test for 2-way valve case. These tests were performed at three levels of valve opening, total water flow rate and water supply temperature according to the design matrices establis

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