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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
Fri Feb 17 2023
Journal Name
Sustainability
Sustainable Utilization of Machine-Vision-Technique-Based Algorithm in Objective Evaluation of Confocal Microscope Images
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Confocal microscope imaging has become popular in biotechnology labs. Confocal imaging technology utilizes fluorescence optics, where laser light is focused onto a specific spot at a defined depth in the sample. A considerable number of images are produced regularly during the process of research. These images require methods of unbiased quantification to have meaningful analyses. Increasing efforts to tie reimbursement to outcomes will likely increase the need for objective data in analyzing confocal microscope images in the coming years. Utilizing visual quantification methods to quantify confocal images with naked human eyes is an essential but often underreported outcome measure due to the time required for manual counting and e

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Publication Date
Mon Sep 30 2024
Journal Name
Iraqi Geological Journal
Advanced Technique of Rock Typing Characterization of Mishrif Formation, Amara Oil Field in Southern Iraq
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Reservoir rock typing integrates geological, petrophysical, seismic, and reservoir data to identify zones with similar storage and flow capacities. Therefore, three different methods to determine the type of reservoir rocks in the Mushrif Formation of the Amara oil field. The first method represents cluster analysis, a statistical method that classifies data points based on effective porosity, clay volume, and sonic transient time from well logs or core samples. The second method is the electrical rock type, which classifies reservoir rocks based on electrical resistivity. The permeability of rock types varies due to differences in pore geometry, mineral composition, and fluid saturation. Resistivity data are usually obtained from w

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Publication Date
Wed Mar 30 2022
Journal Name
College Of Islamic Sciences
The Holy Totem in Qur’an, a study in the light of sociolinguistics
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The sacred totem is one of the social phenomena that occupied the ideas of researchers, and took up a wide area of ​​their research, and it is one of those phenomena that emerged from one of the translations of the Tabu; Who took a psychological and anthropological analysis   Because it is one of the social practices, and the main focus of it is the human group and its source is religion. Therefore, this research came with demands, the first of which is to give a semantic concept of the Tommy sanctuary, and then the analytical aspect by standing on the sacred things in the Qur’anic text that God Almighty sanctified, and the third requirement is to examine what people have sanctified, as an analysis of the verses that have

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Human Sport And Exercise - 2019 - Spring Conferences Of Sports Science
The use of the electrical stimulation device for the muscles in the limit determines the elbow joint during the lifting of the disabled weightlifting players
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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
North Korea's nuclear program is facing the International Atomic Energy Agency (IAEA)
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لخلاصة Nuclear energy is among the most important discoveries reached by the human terms contributed to the solution of many problems faced by the states. The last of these that are not only utilizing it in a peaceful area, but tended toward the military field and the nuclear weapons industry , Among these countries, we find North Korea, which has openly declared their manufacture of nuclear weapons and thus entry to the club of nuclear countries. International Atomic Energy Agency has worked to resolve the North Korea standoff but has not been able to achieve positive results, prompting the intervention of European countries in order to end the crisis. تعدُّ الطاقة النووية من بين أهم الاستكشافا

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Publication Date
Sun Sep 05 2010
Journal Name
Baghdad Science Journal
Effect of Partial Coherence illuminated bar on evaluation technique of diffraction image
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In this work, we are obviously interested in a general solution for the calculation of the image of a single bar in partially coherent illumination. The solution is based on the theory of Hopkins for the formation of images in optical instruments in which it was shown that for all practical cases, the illumination of the object may be considered as due to a self – luminous source placed at the exit pupil of the condenser , and the diffraction integral describing the intensity distribution in the image of a single bar – as an object with half – width (U0 = 8 ) and circular aperture geometry is viewed , which by suitable choice of the coherence parameters (S=0.25,1.0.4.0) can be fitted to the observed distribution in various types of mi

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Difficulties toward third level students in the department of Arabic language for both Education for Women College and Ibn Rushd/University of Baghdad for the studying of Arabic language curriculum: Difficulties toward third level students in the department of Arabic language for both Education for Women College and Ibn Rushd/University of Baghdad for the studying of Arabic language curriculum
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Abstract
The curriculum is amodern science which reflects the social philosophy and
what it needs . It searches for amothod that limits the knowledge that the
indiridual gets in the society and the sorts of the culture that suits the enrironment
in which they live. It also clears for them their history and their great in heritance.
It has a great in flunce in their mental growth ,and it teacher the students new
roles in the thin king ,and training then on what they have learned . According to
there points the problem concentrats on the mostimpotant difficulties which facer
thestudents in studing Arabic langnage text-books
In spite of the great care that the text taker but it is full of subjects and studies
w

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Using The Maximum Likelihood And Bayesian Methods To Estimate The Time-Rate Function Of Earthquake Phenomenon
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In this research, we dealt with the study of the Non-Homogeneous Poisson process, which is one of the most important statistical issues that have a role in scientific development as it is related to accidents that occur in reality, which are modeled according to Poisson’s operations, because the occurrence of this accident is related to time, whether with the change of time or its stability. In our research, this clarifies the Non-Homogeneous hemispheric process and the use of one of these models of processes, which is an exponentiated - Weibull model that contains three parameters (α, β, σ) as a function to estimate the time rate of occurrence of earthquakes in Erbil Governorate, as the governorate is adjacent to two countr

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Preparation and identification of oxidatin derivaties for Salts and acids of bile for medical uses
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The purified prepared compounds were identified through different methods of identification i.e, I.R, UV-vi^ble-spectroscopy in addition to (coloured tests) Calculation of the sum of OH groups. TLC techniques were also used to test the purity and the speed ofthe rate of flow (RF).

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Publication Date
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
Political Thought in Russia During the 21st Century, Targets and Features
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The features of strategic thought transformation in Russia based on attempt confirm the Russian influenced on Region of Eastern Europe through series of common defense treaties and mutual security between USSR and another states this treaties emphasis size on direct Russian supervision on these states in addition, Russia in trusted to formation communism regimes in its vital space, Russia inherited the status of former USSR in political and economic levels.

           Shortly we can see that Russia witnessed large Transformation in political strategic thought as a result of change in internal strategic environment and change of nature understanding which influenced on Russia. This

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