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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 Dec 15 2022
Journal Name
Al-adab Journal
Metaphors and comparisons as a means of rethinking the phenomena of the surrounding world
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The article characterizes metaphors and comparisons as a means of rethinking the phenomena of the surrounding world; two directions are named within which metaphors and comparisons are studied: 1) the linguo-classification direction combines several classifications of metaphors and comparisons, which are basically focused on comparing two denotations through the meanings of word forms that are part of the trope; 2) the theoretical and conceptual direction is associated with the concept of conceptual displacement and is the basis of the theoretical and methodological study of metaphor and comparison, i.e. the modern theory of metaphor is being formed; The main attention is focused on the comparative concept of Aristotle, which postul

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Publication Date
Sun Sep 04 2016
Journal Name
Baghdad Science Journal
The Synbiotic Effect Of Volaticle Oil Extracted From Leaves Rosmarinus Officinolis And Nigellai Sativa On Microbial And Sensory Characteristics Of Minced Poultry Meat During Cold Storage
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The objective of present study was to investigate the effect of using duplex volaticle oil of Rosmarinusoficinolis and Nigella sativain microbial quality, sensing and extending storage time of minced cold poultry meat. Duplex volaticle oil was added at 25, 50 and 75 mg/kg to minced poultry meat , these treatments were stored individually for (0 ,4 and 7) days at( 4-7) C0 . After making several microbial and sensing test. The following results were obtained:- The process of adding duplex volaticle oil of Rosmarinus officinolis and Nigella sativa to minced poultry meat led to significant reduced (P<0.01) in total arobic count, psychrophilic count and coliform bacteria during refrigerated storage periods. The results showed asignificant sens

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Publication Date
Thu Jun 01 2023
Journal Name
2023 Ieee 36th International Symposium On Computer-based Medical Systems (cbms)
Toward a Minimal sEMG Setup for Knee and Ankle Kinematic Estimation during Gait
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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Bacteriological study of water tributary Zab down and its impact on the environment the waters of the Tigris River
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During the study the current selection seven stations in the Zab River bottom and the Tigris River took samples a month to study the signs of bacterial contamination study coliform and colon fecal Almsobhaat and Almsobhaat Bazah and the total number of bacteria and bacterial gangrene gas causing Knkeran as well as a study to isolate and diagnose some races and types of bacterial pathogens in water or intensityusing the traditional system and the system of intestinal bacteria

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
A specimen of the internal control system on the stock in light of the application JIT system In construction companies
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Suffer most of the facilities of the high cost of inventory , which affects the high cost of the product and thus affects many administrative decisions , as well as suffer the facilities of the systems developed by the provisions of inventory control , and this problem is exacerbated in the construction sector where the inventory in the form of Construction spin of the Year for another it becomes difficult to control the cost effectively , and is the research problem in question follows: What are the implications of the use of the system in time inventory accounting system for the contracting company does kills Alrkaah to the provisions of the cost of inventory and what is the optimal approach to inventory control ? Find assumed

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Publication Date
Mon Jul 13 2020
Journal Name
Biochem. Cell. Arch
MORPHOLOGICAL STUDY OF THE TONGUE IN MONGOOSE (HERPESTES JAVANICUS)
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The aim of the current study is to identify the morphological description of the tongue in mongoose (Herpestes javanicus) and its relation to the feeding pattern. For this purpose the (5) samples of tongues were dissected from the head of mongoosecaught from different areas of Al-Najaf province, cleaned in normal saline and examined under the dissecting microscope. The results showed the absence of the middle groove in the lingual apex area. As well as the absence of lingual prominence in the body area. The dorsal surface is characterized by the presence of four types from lingual papillae (filiform, cylindrical, fungiform, circumvallate), while the ventral surface is free of lingual papillae. The filiform papillae spread throughout the dor

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Publication Date
Tue Jan 19 2021
Journal Name
Isprs International Journal Of Geo-information
The Potential of LiDAR and UAV-Photogrammetric Data Analysis to Interpret Archaeological Sites: A Case Study of Chun Castle in South-West England
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With the increasing demands to use remote sensing approaches, such as aerial photography, satellite imagery, and LiDAR in archaeological applications, there is still a limited number of studies assessing the differences between remote sensing methods in extracting new archaeological finds. Therefore, this work aims to critically compare two types of fine-scale remotely sensed data: LiDAR and an Unmanned Aerial Vehicle (UAV) derived Structure from Motion (SfM) photogrammetry. To achieve this, aerial imagery and airborne LiDAR datasets of Chun Castle were acquired, processed, analyzed, and interpreted. Chun Castle is one of the most remarkable ancient sites in Cornwall County (Southwest England) that had not been surveyed and explored

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Forced displacement in Iraq its causes and its effects on displaced families (A field study of displaced families to the city of Baghdad)
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After a temporary halt to forced thghebr in different cities of Iraq this methodlogy
opeations returned directiy in the areas of political conflict on the ground which are translated
operations and forced displacement violence es they operations aimed at completing the
forced displacement that occurred after the occupation in(2003)which took an upward curve
publicly after these events and some of which are aimed at the liquidation of some provinces
than any demographic diversity of religious or sectarian or alhens and others aimed at
redemographic distribution within the province itself to produce a net sectarian zones as is the
case in Diyala Nineveh and Babylon Baghdad has the epicenter of sectarian violence and th

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Publication Date
Fri Jul 01 2022
Journal Name
Iop Conference Series: Earth And Environmental Science
A study Some Technical Indicators Under Impact Tillage Depth and Disk harrow Angle of the Compound Machine
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Abstract<p>The research included studying the effect of different plowing depths (10,20and30) cm and three angles of the disc harrows (18,20and25) when they were combined in one compound machine consisting of a triple plow and disc harrows tied within one structure. Draft force, fuel consumption, practical productivity, and resistance to soil penetration. The results indicated that the plowing depth and disc angle had a significant effect on all studied parameters. The results showed that when the plowing depth increased and the disc angle increased, leads to increased pull force ratio, fuel consumption, resistance to soil penetration, and reduce the machine practical productivity.</p>
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Publication Date
Sun Jan 01 2017
Journal Name
Aro-the Scientific Journal Of Koya University
A Comparative Study for String Metrics and the Feasibility of Joining them as Combined Text Similarity Measures
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