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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 01 2021
Journal Name
Journal Of Engineering
Effect of Seismic Loading on Variation of Pore Water Pressure During Pile Pull-Out Tests in Sandy Soils
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Experimental model was done for pile model of L / D = 25 installed into a laminar shear box contains different saturation soil densities (loose and dense sand) to evaluate the variation of pore water pressure before and after apply seismic loading. Two pore water pressure transducers placed at position near the middle and bottom of pile model to evaluate the pore water pressure during pullout tests. Seismic loading applied by uniaxial shaking table device, while the pullout tests were conducted through pullout device. The results of changing pore water pressure showed that the variation of pore water pressure near the bottom of pile is more than variation near the middle of pile in all tests. The variation of pore water

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Publication Date
Tue Jun 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Evaluating the effects of reservoir level and foundation depth on the dynamic behaviour of a rockfill dam using three-dimensional finite elements modelling
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Abstract<p>This paper presents a three-dimensional Dynamic analysis of a rockfill dam with different foundation depths by considering the dam connection with both the reservoir bed and water. ANSYS was used to develop the three-dimensional Finite Element (FE) model of the rockfill dam. The essential objective of this study is the discussion of the effects of different foundation depths on the Dynamic behaviour of an embanked dam. Four foundation depths were investigated. They are the dam without foundation (fixed base), and three different depths of the foundation. Taking into consideration the changing of upstream water level, the empty, minimum, and maximum water levels, the results of the three-dimensional F</p> ... Show More
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Publication Date
Sun Jun 30 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Proposed model for the work of audit committees in the public sector and its interaction with the Federal Board of Supreme Audit to reduce the incidents of fraud
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This growing interest of the international scientific specialized commissions is due to the role that the audit committee can play, as one of companies’ governance tools, to increase the accuracy and transparency of the financial information disclosed by the companies, through its oversight role on the process of preparing financial reports, its supervision on the internal audit function within the companies, and supporting its independency, as well as coordinating the efforts between the internal control unites and the external auditor represented by the (Board of Supreme Audit) to clear the observations and irregularities in order to reduce the fraud cases.

This research was built on an applied sample of audit committee works

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Publication Date
Fri Jan 01 2016
Journal Name
Al–bahith Al–a'alami
Designing the Websites of the Iraqi Electronic Newspapers and its Role in Attracting Visitors
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The researcher seeks to know the extent of applying the concept of design by Iraqi electronic press sites to provide media product with the acceptance of their browsers and ensure their repeated visits to such sites in the framework of the guiding rules for laser browsing. The researcher uses analytical study on a sample of six Iraqi electronic newspaper sites to identify the general features of their design and the methods of distribution of the structural elements of the pages. The researcher also conducts a field study on a sample of the surfers of electronic newspaper sites to see the extent of their evaluation to their design and the degree of their satisfaction.

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
biofuels industry and impact on the development of the agricultural sector in developing countries
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Abstract

       Although the subject of biofuels industry is linked directly to the energy sector, but has links and numerous indirect effects, in particular effects on the environment and agriculture, this study (opportunities and challenges of biofuels industry and impact on the development of the agricultural sector in developing countries) a modest step to identify the industry in detail and identify the types of products and raw materials entering, then define or limit the positive and negative impacts of this industry in General and for specific products In particular, detailed, and then flip all those effects on the agricultural sector in developing countries can benef

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Publication Date
Thu Jan 03 2002
Journal Name
Iraqi Journal Of Architecture And Planning
The technological indicators of the relationship between structure and form in contemporary interior space
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Publication Date
Mon Mar 17 2025
Journal Name
Medicine Advances
Alone in the Mind: Review of Research Examining the Link Between Loneliness and Dementia
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This narrative review focused on research investigating the impact of loneliness on the prevalence of dementia and its relationship with other risk factors. A comprehensive and rigorous search was conducted using a variety of scientific databases with specific keywords to identify all prior studies that examined the correlation between dementia and loneliness. The inquiry was confined to articles published in English from January 2017 to March 2024. The narrative review identified a consensus regarding the role of loneliness in enhancing the risk of all‐cause dementia, with a particular emphasis on the subjective perception of loneliness. This phenomenon may be caused by the sensations of exclusion, discrimination, and alienation that are

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Publication Date
Thu Dec 07 2023
Journal Name
The New Armenian Medical Journal
ASSOCIATION BETWEEN CAFFEINE, ANXIETY AND THE OCCURRENCE OF APHTHOUS STOMATITIS IN THE ARMENIAN ETHNICITY
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Abstract Introduction: Aphthous stomatitis is a recurring oral ulceration condition that affects a significant proportion of the population. While several factors have been proposed to contribute to its occurrence, the link between caffeine consumption, anxiety levels, and the development of aphthous stomatitis remains unknown. This survey-based study aimed to understand the association between coffee, anxiety, and the development of aphthous stomatitis in this specific demographic, which can provide useful insights for medical management as well as preventive strategies. Material and methods: A structured online questionnaire was distributed via various social media platforms targeting a sample of the Armenian population. The quest

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Publication Date
Sat Oct 01 2022
Journal Name
Iraqi Journal Of Veterinary Sciences
The histological and histochemical features of the esophagus in local breed dogs (Canis familiaris)
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Publication Date
Wed May 02 2018
Journal Name
Indian Journal Of Natural Sciences
Histological and Histochemical Characters of the Pancreas in the Adult Indigenous Gazelle (Gazella subgutturosa)
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LO Hamza, Indian Journal of Natural Sciences, 2018 - Cited by 3

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