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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 Dec 13 2017
Journal Name
Al-khwarizmi Engineering Journal
Experimental Study of the Effect of Condenser Tubes Distribution for Domestic Refrigerator
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The performance of a condenser in a domestic refrigerator system without wires and a condenser with a novel design consisted of number of loops as elliptical shape is investigated experimentally in this work. The experiment was conducted with a refrigerator designed to work with HFC134a, under no load and with loads of (1.5,3 and 12 liters of water). In particular, the effects of shape change of the condenser were very important in heat transfer enhancement and reduce of the frictional loss as a result of reducing the pressure drop in the condenser. The results shown that compressor work decreases with elliptical condenser about (8.6% to 11.3%), and then the power consumption decreases also. The performance of household refrigerator with

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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Comparison study of Information Criteria to determine the order of Autoregressive models
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بهذا البحث نقارن معاييرالمعلومات التقليدية (AIC , SIC, HQ , FPE ) مع معيارمعلومات الانحراف المحور (MDIC) المستعملة لتحديد رتبة انموذج الانحدارالذاتي (AR) للعملية التي تولد البيانات,باستعمال المحاكاة وذلك بتوليد بيانات من عدة نماذج للأنحدارالذاتي,عندما خضوع حد الخطأ للتوزيع الطبيعي بقيم مختلفة لمعلماته

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Publication Date
Mon Jan 01 2018
Journal Name
Aip Conference Proceedings
Study the effect of nano SiO2 on dielectric strength property of zirconia
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Publication Date
Thu Jun 01 2023
Journal Name
Journal Of Engineering
A Control Program for Hydropower Operation Based on Minimizing the Principal Stress Values on the Dam Body: Mosul Dam Case Study
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This study examines the vibrations produced by hydropower operations to improve embankment dam safety. This study consists of two parts: In the first part, ANSYS-CFX was used to generate a three-dimensional (3-D) finite volume (FV) model to simulate a vertical Francis turbine unit in the Mosul hydropower plant. The pressure pattern result of the turbine model was transformed into the dam body to show how the turbine unit's operation affects the dam's stability. The upstream reservoir conditions, various flow rates, and fully open inlet gates were considered. In the second part of this study, a 3-D FE Mosul dam model was simulated using an ANSYS program. The operational turbine model's water pressure pattern is conveyed t

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Publication Date
Tue Mar 01 2016
Journal Name
Al-academy
The effectiveness of visual intelligence strategy in the collection of students in the Department of Art Education in the perspective material: أسامة حسن عبد علي الصفار
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Select the researcher discussed problem of asking the following : Do you use visual intelligence strategy effective in the collection of students in the Department of Art Education in the foreseeable material ? The research aims to " measure the effectiveness of the strategy in the collection of visual intelligence students in the Department of Art Education in the foreseeable material ". To verify the objective of this research was identify hypotheses zero to measure the level of achievement in the foreseeable material second grade students in the Department of Art Education - Faculty of Fine Arts . The population of the research students in the Department of Art Education / Faculty of Fine Arts at the University of Baghdad who are stud

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Impact Of Application Of Jit In The Banking Sector On The Quality Of Banking Service
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Abstract 

          The research the impact of the application of some of the production system tools in the specified time, which can be adapted in the service sectors (banking sector) over the improvement and increase the quality of banking services, and highlights the research problem in the low quality of banking services provided to customers because of the reliance on traditional banking systems in the provision of services Because of the lack keep pace with global developments in the banking industry, and the goal of research is to clarify the applicability of the production system in the time specified in the service sector and th

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Prediction of the number of births in the Governorate of Basra for the period (1998-2050)
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The adoption of many mathematical concepts contributes to the construction of models of sports and the population can be interpreted to explain the movement and growth of the population lead to proper planning to manage the requirements of the population and meet their needs of providing education or providing medical services, health and others. In this study, the number of births in the Governorate of Basrah for the period (1998-2050) is estimated to be based on the assumption that the population of the visually impaired is a stable society. If the rate of growth is (0.0492), some demographic indicators are important for maintaining the average age of women at pregnancy (27.817). Each woman will give birth (3.74) female birth d

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Publication Date
Tue Nov 03 2020
Journal Name
Modern Sport
The effect of using multimedia in learning the skill of passing from the bottom of volleyball
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The aim of the research is to:. Preparation and implementation of special educational units using multimedia to learn the skill of scrolling from below. 2 to recognize the impact of the use of multimedia in learning the skill of scrolling from below. 3 to identify the differences between the tests after the two groups research in learning the skill of passing from the bottom volleyball. The research represented the students of the first stage and the sample of the research was drawn randomly and the number of (50) students were divided into two experimental and control groups and each group (25) students were used standardized tests and conducting pre-tests and the implementation of the main exp

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Publication Date
Mon Feb 14 2022
Journal Name
Journal Of Educational And Psychological Researches
The Educational dimensions of children's television programs in the light of the universal rights of child
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The research aims at determining the type of educational dimensions to be broadcasted in children's television programs, clarifying the technical forms used in children's TV programs, analyzing the educational dimensions provided by children's television programs, and studying the educational dimensions of children's television programs. The researcher used a sample of children's programs: all of us heroes, which is a daily program on the mbc3 channel as well as the program of Tel flowers on the Algerian channel. The researcher designed an analysis content form included categories of analysis. Spss program was used to process the collected data. The research reached several results; the concentration of educational dimensions in

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Publication Date
Thu Mar 19 2015
Journal Name
Al-academy
THE SIGN READING OF THE STRUCTRE OF UNIFICATION IN THE CIVILIZATION OF MESOPOTAMIA: جهينة حامد حساني
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The Mesopotamian artist conversed the functions of idols with multi-formation, varied pictured and structural significances sign momentum. Each phenomenon had an idol and each event had an idol. So multiplicity contributes in the enrichment of the Mesopotamian thought by the full and comprehensive familiarity of the characterization of the religious space which reached up to realize the start point of creation and formation and specify the concept of unification in such a way that considered as pagan multiplicity and Atheism according to what brought by most of the previous studies.Such a research as ( The Sign Reading of the Structure of Unification in the Civilization of Mesopotamia) aims to clarify this confusion through decoding the

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