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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
Tue Mar 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Measurement and analysis of the production function of the transport sector in the Iraqi economy
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Transportation Sector classified as one of the services sectors which is without the production activities cannot be complete its rule. Is act asmoving actions which operate at production and non production goals for the organization and individuals insides the country and with others, that is why this sector act as one of the main which is occupied an important status on the way the economic activities and on the level of the economic institutions the transportation work on transforming all the commodities and products from productions locations to consumption location then its effect the productivity process and create the location utility and on the level of economic it considered as one of the economic supportive structure an

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
The Spatial Poetics and the "Murder of the Real"in Paul Auster's City of Glass*
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Paul Auster's City of Glass is here singled out as representative of the writer's The New
York Trilogy. All throughout his novelistic career, Auster has been working on a pseudothesis
that adheres to a certain aesthetic of disappearance. The study engages this Austerian
aesthetic apropos of certain theoretical stretches such as the Emersonian "Not Me", the
Thoreauvian "interval" or "nowhere", the Deleuzian "nomadic trajectory", the Derridian
"grammè" or "specter", and the Baudrillardian "disappearance". The city of the novel's titling
is here seen as the trope of all that which has already disappeared, and hence it is seen as the
space (mise en scène) where the perfect crime of the murder of the real is to be thoro

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Publication Date
Sat Oct 08 2022
Journal Name
Journal Of Computational Design And Engineering
Twisted-fin parametric study to enhance the solidification performance of phase-change material in a shell-and-tube latent heat thermal energy storage system
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Abstract<p>Phase change material (PCM) is considered as one of the most effective thermal energy storage (TES) systems to balance energy supply and demand. A key challenge in designing efficient PCM-based TES systems lies in the enhancement of heat transmission during phase transition. This study numerically examines the privilege of employing twisted-fin arrays inside a shell-and-tube latent heat storage unit to improve the solidification performance. The presence of twisted fins contributes to the dominating role of heat conduction by their curved shapes, which restricts the role of natural convection but largely aids the overall heat-transfer process during solidification. The heat-discharge </p> ... Show More
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Publication Date
Fri Mar 01 2019
Journal Name
Iraqi Journal Of Physics
Study the effect of Ag nanoparticles and ZnO nanoparticles at different concentrations on the viscosity and surface tension of Polyacrylamide solutions
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Polyacrylamide Solutions of different concentrations (0.2, 0.4, 0.6, 0.8, 1.0 %) of Ag nanoparticles and ZnO nanoparticles were prepared, the viscosities and surface tension were measured for all solutions, where measurements indicated an increase in these properties with increased concentration, where the relative viscosity of polyacrylamide/zinc nanoparticles increased from 1.275 to 2.243, and the relative viscosity of polyacrylamide/silver nanoparticles increased from 1.178 to 1.934. Viscosity is significant parameters during electrospinning process. While the surface tension of the polyacrylamide/zinc nanoparticles has changed from 0.0343 Nm-1 to .0.0.0 Nm-1 and changed from .0.000Nm-1 to.0.0.0 Nm-1. Also the constants KH and KK were

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Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Comparison of the Marginal Fitness of the Ceramic Crowns Fabricated with Different CAD/CAM Systems (An In Vitro Study)
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Background: The marginal fit is the most characteristic that closely related to the longevity or success of a restoration, which is absolutely affected by the fabrication technique. The objective of present in vitro study was to evaluate the effect of four different CAD/CAM systems on the marginal fit of lithiµm disilicate all ceramic crowns. Materials and Methods: Adentoform tooth of a right mandibular first molar was prepared to receive all ceramic crown restoration with deep chamfer finishing line (1mm) and axial reduction convergence angle of 6 degree, dentoform model duplicated to have Nickel-Chromiµm master die. Thirty two stone dies produce from master die and distributed randomly in to four groups (8 dies for each group) accor

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Pharmaceutical Negative Results
The diagnostic value of Paraoxonase (PON 1) enzyme activity in the diagnosis of knee joint osteoarthritis: case control study
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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
Loqmania commandments in the Koran And its impact in the refinement of the doctrine and morals emerging
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Luqman's story stated that human instinct, if I was brought up properly, reaches wisdom and inflicts the right to everything. It is to go to worship God and adhere to the satisfaction of morals and high morals that are ordered to meet among human beings in this life, because this worship educates in the soul the most beautiful morals needed by human beings of honesty, honesty and modesty, and the work of good and virtues, and distancing the soul from evil and vices.

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Publication Date
Fri Dec 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
The Effect of Power Sources in the Agricultural Tractor and the Developed Sprayer System on the Performance of the Electrical and Mechanical Sprayer System and some Performance Indicators of the Engine
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Abstract<p>An experiment was conducted to study the effect of the sprayer type according to the source of power and the size of the spray nozzle concerning the quality of the spray produced and fuel consumption.Two types of sprayers were used: a conventional boom sprayer (S1) and a modified (electrified) boom sprayer (S2), along with three sizes of the XR TeeJet 110 spray nozzle (N). The following technical performance indicators were examined: Density of coverage (drops/cm2) using ImageJ software, a 600dpi business card scanner, specifically the ScanShell 800N by CSSN, Inc, and water-sensitive paper (WSP), rate of spray nozzles discharge (ml/min), and fuel consumption (liters/hectare) using a c</p> ... Show More
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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Study of the Protective Effects of Benfotiamine Against CCl4-Induced Hepatotoxicity in Rats
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Liver is considered as the first target for the toxic effects of toxins and other xenobiotics, and this can be attributed to its role as a site which receive all absorbed xenobiotics from the gastrointestinal tract and its role as a major site for biotransformation of xenobiotics. The present study was designed to evaluate the possible hepatoprotective effect of benfotiamine against CCl4-induced hepatotoxicity in rats. The study was conducted on 48 male albino rats; the animals were allocated into 8 groups (6 rats in each group) and treated as follow: 4 groups treated with oral doses of either normal saline, benfotiamine (100 mg/kg), thiamine (100 mg/kg), N-acetylcystein (400 mg/kg) only without induction of hepatic damage. Th

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Publication Date
Fri Sep 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of the Color Stability of Clear Elastomeric Ligatures (An In Vivo Study)
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Background: The desire for an attractive appearing fixed orthodontic appliance fueled the use of ceramic brackets and clear accessories. Elastics are one of the most versatile materials available to orthodontists so studying their effect on the esthetic appearance is important. This an in vivo study, conducted to evaluate the effect of exposing stretched clear elastomeric ligatures to the oral environment from four different companies (OrthoTechnology, Morelli, Ortho Organizer, and Ormco). Materials and Methods: A total of 240 elastomeric modules were examined, 60 modules from each brand. Each of the 60 patients enrolled in the study, received 4 elastomeric modules on the 4 lower incisors, one from each brand. The specimens were placed on t

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