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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 2013
Journal Name
Political Sciences Journal
The regional attitude towards the change in the Arab region: turkey as a case study
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This research deals with the nature of the Turkish attitude towards the events of the Arab Spring which the Arab region witnessed recently, as this attitude is characterized by hesitation and utter confusion about those events at its beginning. However, the development of events and the consequent repercussions led the Turkish decision makers of the foreign policy to reconsider their attitude towards those events for political, economic, cultural and social motives.

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Publication Date
Wed Jan 15 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of credit policies in agricultural development: The activity of co-operative agricultural bank as a case study
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The objective of this study is to explain the role of credit policies in agricultural development of Iraq during the period 1979-1989 which were represented by the policy of co-operative agricultural bank the organization that responsible to finance agricultural sector for various reasons. It has been shown that there was no clear credit policy existed during the period concerned due to the differences between loans from year. The loan growth rate was low in general comparing with objectives of the agricultural development plans, a low production rates comparing with loans paid, the growth rate of average number of trees in each donum and the growth rate of livestock number was also low.In conclusion there should be a clear plan for cred

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
The role of GRI standards in reporting the dimensions of sustainable development - An applied study in a number of local companies on the Iraq Stock Exchange
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The current research aims to shed light on the Global Reporting Initiative (GRI), which helps to report financial and non-financial information by economic units in general and listed on the Iraq Stock Exchange in particular. The research was based on a main premise that apply the criteria of the Global Reporting Initiative (GRI) would provide useful information to users to help them make appropriate decisions. To achieve the goal of the research, the descriptive analysis method was used, and quantitative analysis was used. At the level of the descriptive analysis method, a desk survey was conducted. As for the quantitative analysis, it relied on applied data through a questionnaire form (Questioners) as a research tool, and the

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Publication Date
Sun Jun 07 2009
Journal Name
Baghdad Science Journal
Influence of Brucella melitensis Viability by the Activity of Classical Yoghurt Starter During Milk Fermentation
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Brucella melitensis isolates were obtained from human infections , and milk which obtained from aborted sheep at Mosul city vicinity . One isolate from each source was used in carrying out this study. Brucella liquid culture was added to sheep milk at 2.5 % for treatments . To first treatment 2 % of yoghurt starter ( Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus salivarius subsp. thermophilus ( 1: 1 ) ) . Second treatment was carried out without addition of yoghurt starter but the pH was lowered using lactic acid in pattern similar to first treatment . Third treatment was similar to the first treatment but contained buffer to alleviate the reduction in pH , which reduced to 6.1 in comparison to 4.9 of the first treatment .

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Publication Date
Tue Jan 01 2019
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees19gr
I-V characteristics of n-Si /ZnO/Se/MWCNTs nanocomposite solar cell fabricated by solvothermal technique
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Publication Date
Fri Aug 20 2021
Journal Name
Iraqi Journal Of Laser
Permeability of Radicular Dentine after Using Different Irrigant Activation Techniques Including Photo Induce Photoacoustic Streaming Technique
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Background: preparation of root canals is an important step in root canal treatment. Mechanical instrumentation of root canals cause an irregular layer of debris, known as the smear layer. As a result, several studies reported that preferring the removal of the smear layer. Objective: To study the influence of the energy (100 mJ) of Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser at short pulse duration (60 μs)  on smear layer removal of apical third after using Photon induced photoacoustic streaming technique. Materials and methods: Eighteen straight single-rooted mandibular premolars were used. The roots length were uniform to 14mm from the anatomic apex and

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Publication Date
Mon Apr 22 2024
Journal Name
2024 21st International Multi-conference On Systems, Signals &amp;amp; Devices (ssd)
Digital Twin-Based Decision-Making Technique for Diagnostic 2D Environment Line Following Error of Mobile Robot
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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of The College Of Languages (jcl)
A study of some of the of the Verbs’ Arabic Roots in the stories of Osman Ceviksoy Like a Voice in The Dark.: Osman Çeviksoy'un "Karanlıkta Ses Gibi" Başlıklı Öykü Kitabında Arapça Kökenli Türkçe Fillerin İncelenmesi
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Due to the Geographical links, language is one of the multiple affects among Arabs and Turks. As the different studies demonstrate, Turkish contains many words derived from other languages, yet Arabic remains the language that has great affects on Turkish. Unlike Turkish language, Arabic is a derivative language that requires no suffixes. Thus, Arabic verbs are tuned into Turkish verbs by adding auxiliary verbs. The present study traces some of the Turkish compound words of Arabic roots with an explanation that shows the Auxiliary added to form the Turkish verb as found in the stories of Otman Chevek Sawy’s Like A voice in the Dark. The conclusion sums up the findings of the study illustrated by numbers.

Özet<

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Publication Date
Thu Nov 03 2016
Journal Name
Int. J. Pharm. Sci. Rev. Res.
Impacts of simultaneous administration of omega-3 fatty acids with amoxicillin/clavulanic acid on albino rats' liver and bile
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Most drugs undergo some metabolism in the liver before excretion by the kidneys or bile. Thus, it is not surprising that liver injury may be provoked due to its exposure to various drugs and compounds. Drug-induced cholestatic liver injury may occur particularly under conditions of increased drug concentrations, genetic alterations in expression of enzymes or transporters. Additionally, the drug-induced cholestasis can be caused by direct toxic effects of drugs or their metabolites on different hepatic cell types or through an immune-mediated process. Amoxicillin/ clavulanic acid, an antibiotic that is therapeutically utilized for the treatment of a number of bacterial infections. Omega-3 fatty acids are unsaturated fatty acids that have ro

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Publication Date
Sun Dec 01 2019
Journal Name
Baghdad Science Journal
Symmetric- Based Steganography Technique Using Spiral-Searching Method for HSV Color Images
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Steganography is defined as hiding confidential information in some other chosen media without leaving any clear evidence of changing the media's features. Most traditional hiding methods hide the message directly in the covered media like (text, image, audio, and video). Some hiding techniques leave a negative effect on the cover image, so sometimes the change in the carrier medium can be detected by human and machine. The purpose of suggesting hiding information is to make this change undetectable. The current research focuses on using complex method to prevent the detection of hiding information by human and machine based on spiral search method, the Structural Similarity Index Metrics measures are used to get the accuracy and quality

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