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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 May 01 2018
Journal Name
Journal Of Craniofacial Surgery
Single Session Facial Lipostructure by Using Autologous Fat Mixed With Platelet-Rich Fibrin Injected by Using Facial Autologous Muscular Injection Technique
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Aim:

This study was designed to evaluate the role of single session autologous facial fat grafting in correcting facial asymmetries after mixing it with platelet-rich fibrin (PRF) and injecting them into rich vascular facial muscular plane.

Materials and Methods:

Fifteen patients (12 females and 3 males) with age ranging from 18 years to 40 years were included in this study and followed up during 6 months, all the patients were treated in the Al-Shaheed Ghazi Al-Hariri for specialized surgeries hospital (Medical City, Baghdad, Iraq).

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Publication Date
Sun Dec 01 2013
Journal Name
Alustath
"The Common Humanity That is in Us All": Earnest Gaines's (A Lesson before Dying)
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Gaines's A Lesson Before Dying (1993) is about more than the challenges associated with being blacking an Eurocentric society. Though Gaines positions the story within the context of the African American experience, its central theme investigates what it means to be human. The Afro-American writer Ernest Gaines consistently writes about people who face the problems of being denied humanity, dignity, and self-worth. The article illustrates one man's struggle to gain recognition of his humanity in the court (as his attorney insists on calling him a hog for a crime he did not commit) and how this recognition will initiate a change in the community.

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The impact of leadership styles in the crisis management center the Strategic planning - Field research in the Headquarters Ministry of electricity
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Abstract

The current research aims to testing the impact of leadership styles (autocratic, democratic) in crises management (Making decision response, communications and information flows, Mobilization of resources) through strategic planning (Mission, objectives, and environmental analysis, and strategic choice) among managers of the Iraqi Ministry of electricity. Questionnaire has been adopted as a tool in data and information relating to research, as it had prepared on the basis of number of scales and finished using the included Likert quintet, which  has been subjected to standards of validity and reliability and distributed to a sample consisting of (96) managers at the three departments of Min

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Publication Date
Wed Oct 01 2025
Journal Name
Studies In Big Data
Employing AI Tools to Achieve Integration Between the Target Costing Technique, SDG, and Their Role in Improving Administrative Decisions
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Publication Date
Fri Apr 05 2024
Journal Name
International Journal Of Science And Research (ijsr)
Effect of Body Mass Index on Eruption Time of Permanent First Molars and Incisors among a Group of 6- 8 Year Old Iraqi School Children
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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Monitoring of Defects Concentration in Deformed Aluminum Using Doppler Broadening Technique
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Doppler broadening of the 511 keV positron annihilation ??? ? was used to estimate the concentration of defects ?? different deformation levels of pure alnminum samples. These samples were compressed at room temperature to 15, 22, 28, 38,40, and 75 % thickness reduction. The two-state ^sitron-trapping model has been employed. 'I he s and w lineshape parameters were measured using high-resolution gamma spectrometer with high pure germanium detector of 2.1 keV resolution at 1.33 MeV of 60Co. The change of defects concentration (Co) with the deformation level (e) is found to obey an empirical formula of the form Cd - A £ B where A and ? are positive constants that depend mainly on the deformation procedure and the temperature at which the def

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
The sustainable urban development in Al_Kharkh historic center
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The problems of urban historic centers are considered some of the subjects which are widely dealt with in urban studies since the middle of the 20th century. literature of urban development have raised it , beside the fact that large number of urban development projects of the historical centers in many cities of the world ,and emerged from the application of these new problems projects added their original urban problems , because these projects have dealt with the physical structures with the neglect of the social and economic sides, which are the base in sustainable development nResearch problem was elaborated as : The unclearly of knowledge of the potentials of the sustainable development in solving the urban problems of historic cen

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Publication Date
Wed Jul 04 2012
Journal Name
J Bagh College Dentistry
Azithomycin as an adjunctive to non-surgical treatment in comparison with doxycycline in chronic periodontitis patients: 2-months randomized clinical trial
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Publication Date
Fri Mar 01 2024
Journal Name
Baghdad Science Journal
First Transition Metal Complexes Salts of Diazonium Derived from Nitrogen Heterocyclic Compound, Synthesis, Characterization and Biological Activity
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Metal complexes chrome(III), manganese(II), iron(III), cobalt(II), nickel(II), cupper(II) and zinc(II) with diazonium of 3-amino-2-chloropyridine of general formula [2-Cl-C5H3N≡N]n[MXm], where n=2 or 3 for divalent and trivalent metal, m= 4 or 6  were synthesized. The complexes have been characterized by flame atomic absorption, (C.H.N), molar conductance, magnetic susceptibility UV-vis spectra, infrared spectra,1H-NMR spectroscopy and thermo gravimetric analysis (TGA and DTA). The measurements showed that the divalent metal ion complexes (M2+) have (1:2) M:L ratio with tetrahedral geometry around metal ions while the trivalent metal ions (M3+) formed (1:3) m

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Publication Date
Fri Sep 09 2022
Journal Name
Journal Of Ovonic Research
The effects of CuO doping on structural, electrical and optical properties of CdO thin films deposited by pulsed laser deposition technique
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Thin films of (CdO)x (CuO)1-x (where x = 0.0, 0.2, 0.3, 0.4 and 0.5) were prepared by the pulsed laser deposition. The CuO addition caused an increase in diffraction peaks intensity at (111) and a decrease in diffraction peaks intensity at (200). As CuO content increases, the band gap increases to a maximum of 3.51 eV, maximum resistivity of 8.251x 104 Ω.cm with mobility of 199.5 cm2 / V.s, when x= 0.5. The results show that the conductivity is ntype when x value was changed in the range (0 to 0.4) but further addition of CuO converted the samples to p-type.

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