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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
Wed Mar 09 2022
Journal Name
Technium Social Sciences Journal
The layered structure of the clause in English and Arabic ditransitive verbs: A Role and Reference Grammar Perspective
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This paper presents the syntactic dimension of ditransitive verbs in terms of the universal theory of Role and Reference Grammar (RRG). This theory is syntactic in nature, but it also covers the semantic as well as the pragmatic aspects of any linguistic phenomenon. It assumes a universal framework through which syntactic constructions can be analyzed. However, the morphological structure that each language enjoys renders the universal treatment more complicated and can question the universal nature of such a theory. In this paper, an attempt is made to check if the universal tenet of the theory is maintained over two typologically different languages: English and Arabic in respect of the way that double-object constructions (DOCs)

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Improve the performance of solar cells using new designs for pelvic center wheel Type V compound mirrors encased by Vernil glasses
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Design and build a center basins new p-type four mirrors were studied its effect on all parameters evaluating the performance of the solar cell silicon in the absence of a cooling system is switched on and noted that the efficiency of the performance Hzzh cell increased from 11.94 to 21 without cooling either with cooling has increased the efficiency of the

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Publication Date
Wed Jan 01 2020
Journal Name
Biochemical & Cellular Archives
MORPHOLOGICAL STUDY OF THE BRAIN AND SPINAL CORD OF THE IRAQI FROG, RANA RIDIBUNDA RIDIBUNDA
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The frog has a highly developed nervous system. It consists of a brain, a spinal cord and nerves. The brain is the only center for the control of all vital activities as it receives impulses from different parts of the body through sensory nerves and issues orders through motor fibers to different parts of the body for appropriate action. The Aims of studyis general morphological structural of the brain and spinal cord in the Iraqi frog Rana ridibunda ridibunda. The brains of twenty of frogs belonging to class Amphibia were studied using conventional techniques of dissecting microscopy. All samples were sacrificed and anesthetized and then they were removed completely from the neurocranium, cranial, sensory nerves and the meninges and trans

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Publication Date
Tue Jan 01 2019
Journal Name
Aip Conference Proceedings
Study the effect of addition of Ar to N2 gas on the EEDF and the correspondent coefficients of electron transport
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Publication Date
Sun Mar 01 2020
Journal Name
Baghdad Science Journal
Synthesis, Characteristics and Study the Photoluminscience of the CdSxSe1-x Nanocrystaline Thin Film
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 The present work focuses on the changing of the structural characteristics of the grown materials through different material characterization methods. Semiconductor CdSxSe 1-x nano crystallines have been synthesized by chemical vapor depostion. (X- ray Diffraction; XRD), (Field Emission Scanning Electron Microscopy; FESEM), measured the characterization of Semiconductor CdSxSe1-x nano crystallines. The optical properties of semiconductor CdSxSe1-x nanocrystallines have been studied by the photoluminescence (PL) (He-Cd pulsed ultraviolet laser at 325nm excitation wavelength) at room temperature. The results showed the change rule of photoluminsence peak at different S

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Publication Date
Thu Jun 30 2011
Journal Name
Al-khwarizmi Engineering Journal
Study of Adding Ethanol to Gasoline Effects on Produced Noise Intensity of Single Cylinder Spark Ignition Engine
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Since 1990 internal combustion engines and variable systems has been considered as emission. Noise can be defined as undesirable sound, and in high levels it can be considered ahealth hazard. Large internal combustion engines produce high levels of noise. In many countries there are laws restricting the noise levels in large engine rooms and fixed applications. Locomotives engines have the minimum emission influence because of noise control techniques capability.

In this paper study on a single cylinder internal combustion engine was conducted. The engine works by adding ethanol to gasoline, at variable speeds, without adding ethanol, and with adding 10 and 20% ethanol in volumetric ratio. Using one sound insulator or two or with

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Publication Date
Tue Mar 31 2015
Journal Name
Al-khwarizmi Engineering Journal
Study Tensile Strength and Wear Rate for Unsaturated Polyester Resin and Nitrile butadiene Rubber Polymer Blend
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Abstract

    Binary polymer blend was prepared by mechanical mixing method of unsaturated polyester resin with Nitrile Butadiene Rubber (NBR) with different weight ratios (0, 5, 10 and 15) % of (NBR). Tensile characteristics and wear rates of these blends were studied for all mixing ratios. The microstructure of fracture surfaces of the prepared samples were investigated by optical microscope. The results were showed that strain rates of the resin material increase after blending it with rubber while the ultimate tensile strength and Young’s modulus values of it will decrease. It is also noticed that the wear rate of resin decreases with increasing of (NBR) content.

Keywords:<

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Relationship between the age of the pregnant mother and the values hemoglobin blood and packed cell volume (PCV) in the Third Trimester for different age groups (descriptive study)
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Pregnancy pose an additional burden on the body of the mother so as to meet their needs and the needs of the fetus and the body's need to iron increases excessively during pregnancy and iron is an essential element for the formation of hemoglobin blood Either hemoglobin is the key ingredient for red blood cells which carries oxygen to parts of the body, alas, most of the pregnant women begin their pregnancy inadequate stocks of iron in their bodies, which does not cover their need and requirement of the fetus, especially in the second and third trimesters of pregnancy When you reach the mother to the period in which they did not have the adequate amount of iron to produce hemoglobin become the mother was anemic So emerged the problem of

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Publication Date
Sat May 05 2012
Journal Name
Journal Of Planner And Development
planning and design of a tourist village in the marshes of southern Iraq
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This study analyzes how to make use of the resources in the marshlands of Iraq and how to utilize them, especially after the water returns to these areas and they are revitalized. We take an example of AL- Saheen Marsh and plan an ideal tourist resort there. This example can further expand to include other parts of the marshlands. The resort will utilize the local environment and tourist characteristics as it will have a feel and architectural resemblance to the houses and buildings that are currently built there. In addition the transportation methods will be the same as those used by the locals. Yet the resort will still posses all the facilities required by a modern tourist resort that includes all the services that will make

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
study the effects of the polluted waste water on the environment
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to study the discribrion and the pollution in the environment in the south of baghdad samples of waste water from industrail units using the mercury in its process also

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