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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 Nov 17 2021
Journal Name
7th International Conference On Multidisciplinary Sciences (7th Icomus)
A Critical Pragmatic Study of Sarcasms in American and British Interviews
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APDBN Rashid, 7th International Conference on Multidisciplinary Sciences (7th ICOMUS), 2021

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Publication Date
Thu Feb 07 2013
Journal Name
Iraqi Journal Of Medical Science
A study of serum magnesium and calcium levels in missed abortion
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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
A Cognitive Linguistic Study of UP and DOWN in Iraqi Arabic
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This study is an attempt to investigate the conceptual metaphor of UP and DOWN commonly used in Iraqi community. Some of the metaphorical expressions in Iraqi colloquial Arabicarewidely used by Iraqi speakers in everyday language. Ithas been analyzed by following the cognitive theory of metaphor (Lakoff& Johnson,1980).The study indicates that the Iraqi speakerexperiences more of the metaphorical expressions of UP and DOWN to referto many of the abstract concepts that shape his/her impression of everyday life situations.

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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Performance evaluation of policies and programs accordance with guide prepared by a dutch court of audit and the board of supreme audit (case study in wasit state company for textile industries)
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Abstract\

preparation process of performance evaluation in organizations is of extreme importance, and under development in organizations and the opening of markets and technological developments in the industry and heightened competition among industrial organizations imposed systems are built for performance give a clear picture about performance and competition,  And centered research problem in answering the following questions: Is performance evaluation system is available in Wasit State Company for Textile Industries(Research sample ), This research aims to assess the performance of policies and programs in the company, according to guide performance evaluation of programs and policies prepared by the Dutch Cou

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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Bank credit and the most important ratios related to the granting: An analytical study of the company advanced Petrokimot Saudi Arabia
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  Bank credit is extremely important, as the generated revenues by a main focus of any bank earnings no matter how many and varied sources of revenue other, and without losing the bank and the main role function as an intermediary in financial economics . But at the faltering customers in payment of loans .   Therefore , uses a method of financial analysis using ratios as one of the important tools to measure the clients ability to pay , in spite of the need for the Bank analyzed the trend in this regard is focused on three main areas ( liquidity, profitability, and borrowing ) and can be to add another field is the possibility to cover fixed charges of the profits generated.   Finally I would like to emphas

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Publication Date
Sun Jan 03 2016
Journal Name
Journal Of Educational And Psychological Researches
The role of teachers in Sociology In the development of creative thinking for students stage Middle school section of the literary In Karkh II schools From the perspective of the teachers and the students themselves
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This study aimed identify the teachers of sociology. In the development of creative thinking. I have students in middle school .llvra literary. In schools. Second Karkh From the perspective of the teachers and the students themselves  numbered (41), a teacher and a school. As The study population   encompassed of some students the fourth and fifth preparatory stage in the Karkh II schools, totaling 200 male and female students. As the study sample were consisted of (7) and a teacher (34) and accented (85) of male students (115) were female student The researcher the questionnaire which consisted of (39) items And to achieve the objectives of the study it was ascertained sincerity And stability. And

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Publication Date
Fri Jun 23 2023
Journal Name
Cumhuriyet Dental Journal
The effectiveness of continuous versus sequential chelation in the removal of smear layer and their influence on push-out bond strength of Bio-C sealer (An in vitro study)
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Objectives: Successful endodontic treatment outcome requires effective shaping and cleaning of root canals. This study aims to evaluate the smear layer removal after continuous chelation (CC) ) NaOCL\HEDP( and sequential chelation (SC) )NaOCL\EDTA( and their influence on the push-out bond strength (POBS) of Bio-C sealer. Materials and Methods: Palatal roots of the maxillary first molar (n=72) were divided into four groups (n=18) as follows: 3% NaOCL, SC: 3% NaOCL followed by 17% EDTA, CC: 3% NaOCL \9% HEDP and Distilled water. Thirty-two roots (n=8/group) were split longitudinally for smear layer evaluation using SEM. Forty roots were obturated with Guttapercha and Bio-C sealer using a single cone technique. Thre

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Publication Date
Mon Aug 01 2016
Journal Name
Iraqi Journal Of Science
Synthesis, Characterization and Study of The Liquid Crystalline Behavior of Four and Six Heterocyclic Compounds
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The new compounds synthesized by sequence reactions starting from a reaction of 4-hydroxybenzaldehyde with 1,5-dibromo pentane to produce dialdehyde)I( .Then compound )I( reacted with different aromatic amines to give schiff bases )IIIV(,thereafter added acetyl chloride to schiff bases to yield N-acyl derivatives)VVII(.While1,3-diazetine derivatives)VIII-X( were synthesized from the reaction of N-acyl derivatives with sodium azide.The reaction of thiourea with N-acyl compounds led to formation of thiourea derivatives (XI-XIII).Finally, the pyrimidine compounds )XIV-XVI( were synthesized by ring closure reaction of compounds(XIXIII) with diethyl malonate.The synthesized compounds were characterized by measurements of melting points,FTIR,1H-N

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of The Mechanical Behavior Of Materials
A spherical fuzzy AHP model for contractor assessment during project life cycle
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Abstract<p>Measurement of construction performance is essential to a clear image of the present situation. This monitoring by the management team is necessary to identify locations where performance is exceptionally excellent or poor and to identify the primary reasons so that the lessons gained may be exported to the firm and its progress strengthened. This research attempts to construct an integrated mathematical model utilizing one of the recent methodologies for dealing with the fuzzy representation of experts’ knowledge and judgment considering hesitancy called spherical fuzzy analytic hierarchy process (SFAHP) method to assess the contractor’s performance per the project performance pa</p> ... Show More
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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
A Proposed Management System for Construction Practices during Sustainable Buildings Life Cycle
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For many years, the construction industry damages have been overlooked such as unreasonable consumption of resources in addition to producing a lot of construction waste but with global awareness growth towards the sustainable development issues, the sustainable construction practices have been adopted, taking into account the environment and human safety. The research aims to propose a management system for construction practices which could be adopted during constructing different types of sustainable buildings besides formulating flowcharts which clarify the required whole phases of sustainable buildings life cycle. The research includes two parts: theoretical part which generally ,handles the sustainability concepts at construction i

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