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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
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
The Use of English as Lingua Franca in the Classes of UKM: as A Case of Study
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           English has for long been one of the most widely used media of communication globally, especially in the Malaysian universities. It has been termed as a Lingua Franca because it is shared with other languages which are considered first languages by different speakers. For this reason, English as a Lingua Franca (ELF) has attracted a number of researchers to investigate its variety via other languages in various communities. The objective of this paper is therefore to establish the strategies which are employing by the international students at the National University of Malaysia/ UniversitiKebangsaan Malaysia (UKM) as an example of one of the Malaysian universities; when they e

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The effect of the marketing channel of the service on marine insurance losses: a case study in the Iraqi insurance company
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All businesses seek to improve their levels of profits through various means, most notably their marketing channels, which ensure the delivery of their products to their customers in a safe manner in a timely manner. It considers losses to a minimum and that insurance companies place great interest in marine insurance losses because they often constitute huge amounts compared to other losses, hence the problem of research, which is centred on the type and size of the impact owned by the channel The Iraqi insurance company was chosen to be applied according to the intentional sample method because this company is closely related to the subject matter. The research has reached a set of conclusions, most notably that the choice of i

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measure the cost of the service in the insurance sector: A study for the Department of Insurance auto / / National Insurance Company
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Insurance is one of effective high-impact activities in the economic and social aspects of development and that the insurance companies after the creation of stability, balance and support other sectors. The insurance of financial institutions with economic and social importance has an impact on the development and help shoulder the burden of risk and distribution. And measuring Indicators of service and cost her help in evaluating the performance and activity of insurance, and the study of sectors needed by society, institutions and individuals and development of the company. Covering all aspects of life and activity. In this study will focus on the insurance sector in the field of car accidents and so plentiful and their problems and d

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Publication Date
Mon Mar 01 2010
Journal Name
Journal Of Economics And Administrative Sciences
The study of the effect of the use of programming in the linear programming model (applied study)
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The parametric programming considered as type of sensitivity analysis. In this research concerning to study the effect of the variations on linear programming model (objective function coefficients and right hand side) on the optimal solution. To determine the parameter (θ) value (-5≤ θ ≤5).Whereas the result، the objective function equal  zero and the decision variables are non basic، when the parameter (θ = -5).The objective function value increases when the parameter (θ= 5) and the decision variables are basic، with the except of X24, X34.Whenever the parameter value increase, the objectiv

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Publication Date
Sun Dec 08 2019
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Estimating total dissolved solids and total suspended solids in Mosul dam lake in situ and using remote sensing technique
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Publication Date
Fri Jan 01 2021
Journal Name
Aip Conference Proceedings
Deposited Cu (In, Ga) Se2 (CIGS) by spin-coating technique as an absorber layer of solar-cells
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Cu (In, Ga) Se2 (CIGS) nano ink were synthesized from molecular precursors of CuCl, In Cl3, GaCl3 and Se metal heated to 240 °C for 1 hour in N2-atmosphere to form CIGS nanocrystal ink, Thin films were deposited onto Au/soda-lime glass (SLG) substrates. This work focused on CIGS nanocrystals, including their synthesis and application as the active light absorber layer in photovoltaic devices (PVs). This approach, using spin-coating deposition of the CIGS light absorber layers (75 mg/ml and 150 nm thickness), without high temperature selenization, has enabled up to 1.398 % power conversion efficiency under AM 1.5 solar illumination. X-ray diffraction (XRD) studies show that the structural formation of CIGS chalcopyrite structure. The mo

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Publication Date
Sat Jan 05 2019
Journal Name
Iraqi Journal Of Physics
Synthesis of Au –Ag– Cu trimetallic alloy nanoparticles prepared by electrical exploding wire technique in distilled water
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Formation of Au–Ag–Cu ternary alloy nanoparticles (NPs) is of particular interest because this trimetallic system have miscible (Au–Ag and Au–Cu) and immiscible (Ag– Cu) system. So there is a possibility of phase segregation in this ternary system. At this challenge it was present attempts synthetic technique to generate such trimetallic alloy nanoparticles by exploding wire technique. The importance of preparing nanoparticles alloys in distilled water and in this technique makes the possibility of obtaining nanoparticles free of any additional chemical substance and makes it possible to be used in the treatment of cancer or diseases resulting from bacterial or virus with least toxic. In this work, three metals alloys Au-Ag-Cu

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Publication Date
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Computer Assisted Immunohistochemical Score Prediction Via Simplified Image Acquisition Technique
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Background: techniques of image analysis have been used extensively to minimize interobserver variation of immunohistochemical scoring, yet; image acquisition procedures are often demanding, expensive and laborious. This study aims to assess the validity of image analysis to predict human observer’s score with a simplified image acquisition technique. Materials and methods: formalin fixed- paraffin embedded tissue sections for ameloblastomas and basal cell carcinomas were immunohistochemically stained with monoclonal antibodies to MMP-2 and MMP-9. The extent of antibody positivity was quantified using Imagej® based application on low power photomicrographs obtained with a conventional camera. Results of the software were employed

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Publication Date
Mon Mar 06 2023
Journal Name
Environmental Monitoring And Assessment
Copper metal elimination from polluted soil by electro-kinetic technique
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Publication Date
Sun Jan 10 2016
Journal Name
British Journal Of Applied Science &amp; Technology
Robust Watermarking for Video Using Modulation Technique on RGB Domain
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In this paper, a robust invisible watermarking system for digital video encoded by MPEG-4 is presented. The proposed scheme provides watermark hidden by embedding a secret message (watermark) in the sprite area allocated in reference frame (I-frame). The proposed system consists of two main units: (i) Embedding unit and (ii) Extraction unit. In the embedding unit, the system allocates the sprite blocks using motion compensation information. The allocated sprite area in each I–frame is used as hosting area for embedding watermark data. In the extraction unit, the system extracts the watermark data in order to check authentication and ownership of the video. The watermark data embedding method is Blocks average modulation applied on RGB dom

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