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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 Oct 01 2020
Journal Name
International Communications In Heat And Mass Transfer
Thermal behaviour of the flow boiling of a complex nanofluid in a rectangular channel: An experimental and numerical study
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Publication Date
Wed May 17 2023
Journal Name
Journal Of Engineering
The Effect of Tool Path Strategy on Twist Behavior In Single Point Incremental Sheet Metal Forming
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In Incremental sheet metal forming process, one important step is to produce tool path, an
accurate tool path is one of the main challenge of incremental sheet metal forming
process. Various factors should be considered prior to generation of the tool path i.e.
mechanical properties of sheet metal, the holding mechanism, tool speed, feed rate and
tool size. In this work investigation studies have been carried out to find the different tool
path strategies to control the twist effect in the final product manufactured by single point
incremental sheet metal forming (SPIF), an adaptive tool path strategy was proposed and
examined for several Aluminum conical models. The comparison of the proposed tool path with t

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Publication Date
Wed May 15 2024
Journal Name
International Journal Of Religion
(The Importance of Knowledge and Work in Islamic Thought) A Study of the Stages of Spiritual Purification According to Imam Al-Ghazali
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Science occupies great importance in Islamic thought. Science and learning are considered an essential part of Islamic teachings, and this importance appears in several aspects,Among them is thatScience as a means of understanding religion :Science is a means of understanding the teachings of the Islamic religion. Islam encourages thinking and rational research to understand the Holy Quran and the Sunnah of the Prophet, enabling Muslims to direct their lives and actions in accordance with the directives of their religion,And also to encourageResearch :Islam encourages scientific research and the use of reason in understanding the nature of the universe and God’s signs in it. Muslims are encouraged to study the natural and social s

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Publication Date
Sat Jun 06 2020
Journal Name
Journal Of The College Of Education For Women
Spatial Analysis of Soil Characteristics and its Effect on Determining the Susceptibility of lands of the RasheedRegion: A Study in Soil Geography
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Twelve pends were selected and distributed on three verticals transects paths on the Tigers river in Al Rasheed county.Passing through land covers, that classified and covers the whole region. Based on the 8 Landsat of the year 2015. It was oriental classified by using Erdas 10.2 . The pedons were distributed on the area of each varicty of these classes. the series of soil according of the transect series (DW74,MMg,DMu6 , Df96) respectively were represented P1 , P2 , P3 , P4  .

The second transits series(DM97,MM5,DM96,DF115) respectively were  represented P5 , P6 , P7 , P8  .The third  transits series(DM46,MMg,MF12,MM11) re

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Publication Date
Sun Jul 01 2007
Journal Name
Journal Of Faculty Of Medicine Baghdad
A Comparative Study of the Frequency of Occurrence of Genetic Skeletal Disorders in Iraq before and after the Second Gulf War, 1991
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BACKGROUND: Genetic skeletal abnormalities are a heterogeneous group of genetic disorders frequently presenting with disproportionate short stature. AIM OF THE STUDY: To give an idea about the frequency of genetic skeletal abnormalities, and to find out whether these disorders are really increasing in the last 16 years or not. METHODS: During the period extending from (Jan, 1st 2003-April, 1st 2007), all cases of genetic skeletal disorders referred to the Genetic Counseling Clinic, Medical City – Baghdad who were born after 1991 were included in this study as the post-war group; the pre-war group, included all cases of skeletal disorders referred prior to 1991 (Jan., 1st 1987-Jan., 1st 1990). The demographic parameters, family history of

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Publication Date
Wed Dec 15 2021
Journal Name
Arab World English Journal
Reading Difficulties in English as a Second Language in Grade Five at a Saint Patrick’s High School for Boys, Hyderabad- India
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Reading is one of the essential components of the English language. Countries that use English as a second language (ESL) sometimes have difficulties in reading and comprehension. According to many researches, mother tongue has proved some interferences with learning a second language. This study investigated the results of reading difficulties of young second language learners in terms of accuracy, comprehension, and rate using the Neale Analysis of Reading Ability test. The study was carried out in one of the High Schools for Boys in Hyderabad, India and included Grade five, aged 10-12 years. In order to understand the reading difficulties of English as a second language, a qualitative approach was employed. Interview, reading tes

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Publication Date
Sat Apr 10 2021
Journal Name
المؤتمر العلمي الدولي الثالث - المجلة الامريكية الدولية للعلوم الانسانية والاجتماعية
Public Governance and Sustainable Development - A descriptive study of the reality of public institutions in Iraq
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In light of crises, the need for efficient and flexible public administrations to make quick and decisive decisions, also institutions capable of directing the internal elements and components of them and adapting them to the requirements of rapid change due to crises and disasters, which led to scarce resources becoming scarcer and economic, political and social problems becomes more prominent. For the majority of developing countries, including Iraq, the increasing need for the importance of moving towards enhancing the efficiency of the performance of public institutions while trying to predict their future, can only be achieved. Through solid mechanisms and principles of governance that enhance the ability of institutions and make them

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
Semantic Exchange A study of rooting the term
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The term "semantic exchange" was popularized in Arabic, especially in derivatives, grammatical structures, etc., but it came under different names or terms, including deviation, deviation, transition, displacement, tooth breach, replacement, attention, etc. In the rooting of this term through its study in language and terminology, and among linguists, grammar and others, we have reached a number of results, including The existence of a harmonization between the lexical and idiomatic meaning of the term exchange, and the phenomenon of semantic exchange is a form of expansion in language, and that the first language scientists They had turned to this And studied under Cairo for different names, as noted above.

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Publication Date
Fri Dec 30 2022
Journal Name
Journal Of The College Of Education For Women
The Death Scene in the "Ayniyah" Poems of Abi Thuayib Al-Huthali and Suda bint Shamardal: A Contrastive Study
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This study is an objective literary study of the poems of Abu Dhu'ayb Al-Hudhali and Su'da Bint Al-Shamrdal. It aims to shed light on the philosophy of death in the poems, and the way this philosophy is treated by both poets. Thus, the main prominent poetic images have been addressed and the outstanding ones have been singled out. The study further investigates the intertextuality with other poetic verses and Quranic verses and reviews the deviation in their semantic, syntactic, and phonetic types. The study adopts the historical approach to examine the occasion of the poems by referring to several historical sources that indicate the seniority. It also adopts the and descriptive-analytical approach represented by the use of content anal

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of financial technology in improving the financial performance of banks: A field study on a sample of private banks in Erbil governorate
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Abstract:

               Today, the financial and banking sector is witnessing a qualitative shift thanks to financial technology services, which provide their services to many individuals and companies in quick, easy and less expensive ways compared to traditional means. Financial technology is a new form of financial science that combines financial transactions and technological skills concerned with providing financial services and improving the work environment within Banking institutions, and financial technology provides many advantages such as lower transaction costs, instant payment, and saving more time and effort in conducting banking

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