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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 01 2023
Journal Name
Results In Engineering
Effectiveness of embedded through-section technique in strengthening reinforced concrete spandrel beams
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Publication Date
Fri Jun 28 2013
Journal Name
Journal Of Materials Science And Engineering B
Synthesis of Zirconia Nanoparticles in Distilled Water Solution by Laser Ablation Technique
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Pulsed laser ablation in liquid (PLAL) has become an increasingly important technique for metals production and metal oxides nanoparticles (NPs) and others. This technique has its many advantages compared with other conventional techniques (physical and chemical). This work was devoted for production of zirconia (ZrO2) nanoparticles via PLAL technique from a solid zirconium target immersed in a wet environment in order to study the effect of this environment on the optical properties and structure of ZrO2 nanoparticles. The solutions which used for this purpose is distilled water (D.W). The produces NPs were characterized by mean of many tests such as UV-visible (UV-Vis.), transmission electron microscope (TEM) and Z-Potential. The UV-Vis.

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Publication Date
Tue Mar 30 2010
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Minimization of Toxic Ions in Waste Water Using Emulsion Liquid Membrane Technique
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In the present study, the removal of zinc from synthetic waste water using emulsion liquid membrane extraction technique was investigated. Synthetic surfactant solution is used as the emulsifying agent. Diphenylthiocarbazon (ditizone) was used as the extracting agent dissolved in carbon tetrachloride as the organic solvent and sulfuric acid is used as the stripping agent. The parameters that influence the extraction percentage of Zn+2 were studied. These are the ratio of volume of organic solvent to volume of aqueous feed (0.5-4), ratio of volume of surfactant solution to volume of aqueous feed (0.2-1.6), pH of the aqueous feed solution (5-10), mixing intensity (100-1000) rpm, concentration of extracting agent (20-400) ppm, surfactant co

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Publication Date
Sun Sep 07 2008
Journal Name
Baghdad Science Journal
The Extent of Homogeneity in the Distribution of Petrophysical Properties that Affecting the Primary and Enhanced Oil Recoveries of Reservoir Rocks in Zubair Formation of South Iraq
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Records of two regionalized variables were processed for each of porosity and permeability of reservoir rocks in Zubair Formation (Zb-109) south Iraq as an indication of the most important reservoir property which is the homogeneity,considering their important results in criterion most needed for primary and enhanced oil reservoirs.The results of dispersion treatment,the statistical incorporeal indications,boxes plots,rhombus style and tangents angles of intersected circles indicated by confidence interval of porosity and permeability data, have shown that the reservoir rocks of Zubair units (LS),(1L) and (DJ) have reservoir properties of high quality,in contrast to that of Zubair units (MS) and (AB)which have reservoir properties of less q

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Publication Date
Wed Dec 13 2017
Journal Name
Al-khwarizmi Engineering Journal
Large Eddy Simulation in Duct Flow
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In this paper, the problem of developing turbulent flow in rectangular duct is investigated by obtaining numerical results of the velocity profiles in duct by using large eddy simulation model in two dimensions with different Reynolds numbers, filter equations and mesh sizes. Reynolds numbers range from (11,000) to (110,000) for velocities (1 m/sec) to (50 m/sec) with (56×56), (76×76) and (96×96) mesh sizes with different filter equations. The numerical results of the large eddy simulation model are compared with k-ε model and analytic velocity distribution and validated with experimental data of other researcher. The large eddy simulation model has a good agreement with experimental data for high Reynolds number with the first, seco

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Publication Date
Mon Aug 28 2023
Journal Name
Journal Of Planner And Development
Activating the developmental potential of the historical center to city of Baghdad (Rusafa side)
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The types of development potential in the city vary, from the nature of city, to its society, environment, economy, and history. The city of Baghdad contains many historical development potentials out of using, and most of them towards declining, this will be the research problem, within the aim of trying to clarify how to invest one of the important historical elements in the development of the city, based on the hypothesis that the sustainable development of the city should be stand on the activation of its historical assets. The historical wall of Baghdad is located on the Rusafa side, which is a wall that has not been left except for one gate and the site of another gate from it is f

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Publication Date
Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
Isolation and identification of fungi from fish feedstuff of cyprinus carpio and detection of aflatoxin b1 and ochratoxin a using ELISA technique
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This study was conducted at the College of Education for Pure Sciences (Ibn Al-Haitham), University of Baghdad. The aim of this study was to isolate and diagnose fungi from fish feedstuff samples, and also detection of aflatoxin B1 and ochratoxin A in fish muscles and feedstuffs. Randomly, the samples were collected from some fish farms from Baghdad, Babil, Wasit, Anbar, and Salah al-Din provinces. This study included the collection of 35 feedstuff samples and 70 fish muscle samples, and each of the two fish samples fed on one sample of the feedstuff. The results showed the presence of several genera of different fungi including Aspergillus spp, Mucor spp., Penicillium spp., Yeast spp., Fusarium spp., Rhizopus spp., Scopiolariopsis spp., Ep

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
Investigating the Factors that Affect the Oral Classroom Participation of Arab Postgraduate Students
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This study examines the factors that affect oral participation of six Arab postgraduate students (two Iraqis, two Jordanians, and two Libyans), namely, three male participants and three female participants. For this purpose, a semi-structured interview was employed. The results showed that female as well male interviewees share some factors that make oral participation in classroom disheartening. These factors include high levels of anxiety, lack of confidence, shyness, and lack of preparation. It was also that there is no difference between male and female interviewees in relation to the factors that make them feel disheartened from oral classroom participation.

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Towards Perceptions building a descriptive and procedural for the knowledge assets at the center of learning and growth for the techniques of Balanced Score card in the light of the strategic map concepts to achieve the strategic and operational: requirements of the contemporary business
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Abstract:

   Witness the current business environment changes rapidly reflected on the performance of the facility wishing to stay , which is no longer style reaction enough to handle installations with their environment , and quickly began to lose its luster with the emergence of a message and the vision of contemporary business environment from a set of parts interacting with each other and the concept of behavioral includes all dimensions of performance, it is imperative to adopt a system installations influence variables and positive interaction through the development of strategic plans and the use of implementation and follow-up strategies to ensure the effectiveness of the method for meas

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Publication Date
Thu Dec 27 2018
Journal Name
Revue Académique De La Recherche Juridique
The Scope of the Judge’s Authority in Completing a Contract and the Limitations Thereon – A Comparative Study
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The contractual imbalance is perceived today by the majority of the doctrine as being one of the pitfalls to the execution of the contracts. As a result, most legislations grant judges the power to intervene to restore it. Granting the judge the power to complete the contract raises the question of the extent to which the judge can obtain such power. Is it an absolute authority that is not limited? If so, is it a broad discretion in which the judge operates in his conscience, or is it a power of limited scope by specific legal texts and conventions? This is what we will try to answer in this research.

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