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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 Jul 01 2019
Journal Name
Journal Of Engineering
The Characters of the Form in the Vernacular Architecture A comparative study of the form's characters of facades of individual houses and commercial buildings in the City of Baghdad after 2003–Zayoona district as a case study
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The characters of facades' form of the Iraqi building after 2003 have been changed, it has been described by many names. The problem of the research is that what are the features of the characters of the form in the façades of the buildings in Baghdad city after 2003? Are the façade of the individual houses or the commercial buildings is the heaviest in the visual weight? The research aims to answer those questions by choosing the vernacular architecture as a measurement tool. It is the informal image of the architecture, which is built by people informally and spontaneously, without official control and legislation to be organized. This is smellier to what has happened in Baghdad, after 2003 according to previous stud

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Publication Date
Sun Sep 27 2020
Journal Name
Journal Of The College Of Education For Women
Feminization and Masculinization of the Word Sun in the Holy Quran: A Semantic Study
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It is no secret for those concerned with language concerns that the issue of figurative feminization is one of the issues that does not follow a grammatical rule governed by the fact that the subject of knowledge of this is due to hearing as indicated by linguistic references and lexicons.This research opts to find out the origin of the feminization of the word sun in the Arabic language and in light of what some language specialists have argued that the origin of figurative feminization was due to non-linguistic motives related to religious and metaphysical beliefs, and that it was memory preserved in light of the linguistic heritage.The research concluded that the feminization of the sun goes back to what settled in their minds, which

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Publication Date
Tue Dec 31 2024
Journal Name
Indian Journal Of Clinical Biochemistry
Farnesoid X Receptor-Mediated Bile Acids Regulation in Cholestasis
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The main process, for the elimination of cholesterol from the human body, involves the alteration of cholesterol into bile acid (BA), by the liver. The farnesoid X receptor (FXR), a member of the nuclear receptor superfamily, is essential for the regulation of BA, glucose, and lipid metabolism. It is largely found in the liver, intestines, kidney, and adrenal glands, and to a smaller degree in the heart and adipose tissue. The binding locations, of the FXR, are in close proximity to formerly undisclosed target genes, with distinctive activities associated with transcriptional regulators, autophagy, apoptosis, hypoxia, inflammation, RNA processing, and a number of cellular signaling pathways. The preservation of BA homeostasis, by the FXR, e

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Publication Date
Thu Aug 31 2023
Journal Name
Journal Of Kufa For Mathematics And Computer
Four Points Block Method with Second Derivative for Solving First Order Ordinary Differential Equations
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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Insertion Rate on The Adaptability of Gutta-Percha and The Apical Extrusion of Thermoplasticized Gutta Percha Obturation Techniques.
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Background: In the Thermafil as a root canal obturation, system little is known about the effect that varying rates of insertion have on the adaptability of thermoplasticized GP and the amount of apical extrusion. Materials and methods: thirty simulated root canals were obturated with thermafil obturators and Apexit Plus sealer at three different insertion rates. The obturated canals were sectioned at three different levels, the sealer average film thickness for each section was calculated and the amount of apical extrusion for each canal was conducted. Results: the higher adaptability was seen with the faster insertion rate while the slower insertion rate showed fewer tendencies to cause apical extrusion. Conclusions: the intermediate i

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Publication Date
Tue Nov 30 2021
Journal Name
Research Journal Of Pharmacy And Technology
Diagnostic approach to Perimenopausal bleeding by Pipelle or Dilatation and Curettage
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Perimenopausal bleeding, is a very common problem, which is an alarming symptom for both; women and their doctors because of the rising fears of cellular changes or tumor of endometrium. In our study we tried to prove that collecting endometrial samples using the outpatient method of Pipelle is as effective as collecting the endometrial samples in the traditional method of Dilation and Curettage (DandC) in operation theatre which necessitates general anesthesia. Ninety four patients more than 40 years old were included in the study, all of them were complaining of abnormal uterine bleeding (pregnant ladies and ladies using hormonal contraception were excluded from the study) and endometrial samples were collected first in outpatient

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of creative accounting practices that are reflected on the sincerity and fairness of financial statements on tax evasion
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The research aims to achieve a set of objectives, the most important of which is to educate the management of companies operating in the private sector about the advantages and risks of using creative accounting practices, as on the one hand they serve the interests of the company and improve its image, and on the other hand it exposes it to the risks of non-compliance with tax laws and legislation or the risks of default and bankruptcy as a result of exploiting gaps and flexibility in the application Accounting standards, and in line with the objectives and through the research problem that was formulated in the form of a question (Are their creative accounting practices that are reflected in the honesty and fairness of financia

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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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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
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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