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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
Sat Jul 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
A Statistical Analysis of the Effects of Afforestation on the Environment in Iraq (Northern Iraq)
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Abstract<p>The significance of the research conducted in northern Iraq comes despite the expansion of afforestation projects; yet, the suffering of the forests has increased due to their lack of scientific study, unpredictability of the climate, and adverse effects on the spread and growth of plant species Therefore, the goal of the study is to understand the effects of afforestation through a statistical analysis of plant diversity in northern Iraq and its distinctivenessThe analysis revealed that natural groupings had improved qualitatively more than other groups, particularly some dwindling species that are able to compete and occupy new areas. drought-prone vegetation, vegetation, and climat</p> ... Show More
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Publication Date
Fri Sep 01 2023
Journal Name
Iklīl For Humanities Studies
The Decline of Language Loyalty in the Age of Audiovisual Nearness: A Socio-linguistic Approach
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This article investigates the decline of language loyalty in the age of audiovisual nearness. It is a socio-linguistic review of previous literature related to language disloyalty. It reviews the current theoretical efforts on the impact of audiovisual nearness created by social media and language loyalty. The descriptive design is used. The argument behind this review is that the audiovisual nearness provided by social media negatively affects language loyalty. This article concludes that the current theoretical efforts have paid much attention to the relationship between the audiovisual nearness and language loyalty. Such efforts have highlighted the fact that the social media platforms have provided unprecedented nearness that provoke in

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Publication Date
Mon Feb 19 2018
Journal Name
Al-academy
The preoccupation of mental image in the designs of internal spaces (cinema) is a model
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The design studies, especially in their contemporary stages, have not been isolated from the subjects that underpin advanced ideas in the field of technical treatments that enrich and improve the social life of users through those technological innovations that have enhanced and changed life styles, Especially in the field of general institutional techniques, including cinemas, as the ideal places for people and visitors to this space, which can contribute to the promotion of cultural, social and technical aspects within this millennium. DONC as reflected on the positive communication and communication between the intellectual and cognitive develop individuals, including cultural and technical side of the individual. The first chapter co

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Publication Date
Sat Mar 01 2008
Journal Name
Al-khwarizmi Engineering Journal
Study the Effect of Carbon Fiber Volume Fraction and their Orientations on the Thermal Conductivity of the Polymer Composite Materials.
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      The effect of fiber volume fraction of the carbon fiber on the thermal conductivity of the polymer composite material was studied. Different percentages of carbon fibers were used (5%, 10%, 15%, 20%, and 25%). Specimens were made in two groups for unsaturated polyester as a matrix and carbon fibers, first group has parallel arrangement of fibers and the second group has perpendicular arrangement of fibers on the thermal flow, Lee's disk method was used for testing the specimens. This study showed that the values of the of thermal conductivity of the specimens when the fibers arranged in parallel direction was higher than that when the fibers arranged in the perpendicular direction  

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Publication Date
Tue Apr 16 2024
Journal Name
Ecancermedicalscience
Prostate cancer across four countries in the Middle East: a multi-centre, observational, retrospective and prognostic study
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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Knowledge of marketing and its impact on the performance of the company for the distribution of oil products –an exploratory study of the views of asample in the general company for oil products distribution/ Distribution Authority, Baghdad
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This study seeks to address the impact of marketing knowledge dimensions (product, price, promotion, distribution) on the organizational performance in relation to a number of variables which are (efficiency, effectiveness, market share, customer satisfaction), and seeks to reveal the role of marketing knowledge in organizational performance.

In order to achieve the objective of the study the researcher has adopted a hypothetical model that reflects the logical relationships between the variables of the study. In order to reveal the nature of these relationships, several hypotheses have been presented as tentative solutions and this study seeks to verify the validity of these hypotheses.

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Publication Date
Sat Jun 01 2024
Journal Name
Journal Of Physics: Conference Series
Study of The Effect of Concentration on The Efficiency of The Sensitive N749-TiO2 Solar Cell
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In this research, we studied the effect of concentration carriers on the efficiency of the N749-TiO2 heterogeneous solar cell based on quantum electron transfer theory using a donor-acceptor scenario. The photoelectric properties of the N749-TiO2 interfaces in dye sensitized solar cells DSSCs are calculated using the J-V curves. For the 〖(CH_3)〗_3 COH solvent, the N749-TiO2 heterogeneous solar cell shows that the concentration carrier together with the strength coupling are the main factors affecting the current density, fill factor and efficiency. The current density and current increase as the concentration increases and the strength coupling increases as the N749-TiO2 heterogeneous in solar cell. However, the efficiency is more sens

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Degree of Management Practice of Roaming and Its Role in Achieving Organizational Justice ((An analytical Study of the Opinions of Directors in Anbar Education Directorate))
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Abstract

This Study aimed to investigate the reality of the application of the degree of management practice by Walking Around, namely (discovery of facts, improvement of communication, motivation, development, creativity and feedback) and Its role in achieving organizational justice (procedural justice, distributive justice, Interactional Justice),The availability of the core principles of this system from the point of view of the senior management personnel in the Directorate of Anbar Education, and the importance of research in the philosophical rooting of the nature of the variables as a modern administrative terminology, the research dealt with a problem expressed by a number of intellectual and appl

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Publication Date
Fri Jul 24 2020
Journal Name
Al-kindy College Medical Journal
Speculations of Immunotherapy in COVID-19 Patients with Practical Applications During Childhood and Pregnancy
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The rapid spread of novel coronavirus disease(COVID19) throughout the world without availablespecific treatment or vaccine necessitates alternativeoptions to contain the disease. Historically, childrenand pregnant women were considered high-riskpopulation of infectious diseases but rarely have beenspotlighted nowadays in the regular COVID-19updates, may be due to low global rates of incidence,morbidity, and mortality. However, complications didoccur in these subjects affected by COVID-19. Weaimed to explore the latest updates ofimmunotherapeutic perspectives of COVID-19patients in general population and some added detailsregarding pediatric and obstetrical practice.Immune system boosting strategy is one of therecently emerging issue

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Publication Date
Fri Jul 24 2020
Journal Name
Al-kindy College Medical Journal
Speculations of Immunotherapy in COVID-19 Patients with Practical Applications During Childhood and Pregnancy
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The rapid spread of novel coronavirus disease
(COVID19) throughout the world without available
specific treatment or vaccine necessitates alternative
options to contain the disease. Historically, children
and pregnant women were considered high-risk
population of infectious diseases but rarely have been
spotlighted nowadays in the regular COVID-19
updates, may be due to low global rates of incidence,
morbidity, and mortality. However, complications did
occur in these subjects affected by COVID-19. We
aimed to explore the latest updates of
immunotherapeutic perspectives of COVID-19
patients in general population and some added details
regarding pediatric and obstetrical practice.
Immune system boo

... Show More
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