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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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Sun Mar 06 2022
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Journal Of Positive School Psychology
Designing A Quality Costing System In Commercial Banks (Applied Research In The Investment Bank Of Iraq)
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Publication Date
Sun Sep 15 2019
Journal Name
Al-academy
Intellectual and Aesthetic Relationship between the Public and the Modern Theater (the play Oh Lord!) as a model: فيصل عبد عودة
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The issue of the public in the directions and theories of the theater director in the world theater, especially after the emergence of realism and the crystallization of the term direction and the definition of the role of the director in 1850 AD by the Duke Max Mengen took different paths to the Greek, Roman and even Elizabethan audience because it was here subjected to the theatrical equation from  its production and presentation due to the fact that the  theatrical performance is a technical artistic production, and the audience participation, watching and consumption, and here the participation of the audience was subjected to three directions:  the enlightenment in the sense of arousing sense, the incitement in the se

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
Evaluating the level of readiness to teach science in the light of the information, media, and technology skills among undergraduate students at the Faculty of Education, King Khalid University
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This research aimed to evaluate the level of readiness to teach science in the light of the information, media, and technology skills among undergraduate students at the Faculty of Edu-cation, King Khalid University. To achieve this goal, a descriptive and analytical approach was used. A list of readiness to teach science was prepared in the light of Information, media, and technology skills, and in the light of this list, a cognitive test, observation sheet, and attitude scale were prepared to assess readiness to teach science in its three aspects, cognitive, behavioral, and emotional. The sample of the research consisted of (42) students enrolled in field training courses at the sixth, seventh and eighth levels. Research tools were app

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Thu Feb 07 2019
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Iraqi Journal Of Laser
Creating a Conductive Surface of the PMMA by Laser Cladding with DWCNT and MWCNTS
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This work studied the electrical and thermal surface conductivity enhancement of polymethylmethacrylate (PMMA) clouded by double-walled carbon nanotubes (DWCNTs) and multi-walled carbon nanotube (MWCNTs) by using pulsed Nd:YAG laser. Variable input factors are considered as the laser energy (or the relevant power), pulse duration and pulse repetition rate. Results indicated that the DWCNTs increased the PMMA’s surface electrical conductivity from 10-15 S/m to 0.813×103 S/m while the MWCNTs raised it to 0.14×103 S/m. Hence, the DWCNTs achieved an increase of almost 6 times than that for the MWCNTs. Moreover, the former increased the thermal conductivity of the surface by 8 times and the later by 5 times.

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Publication Date
Sun Apr 01 2007
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Journal Of The Faculty Of Medicine Baghdad
Observations on the ultrastructure of a rat mammary gland treated with harmal and borage
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Wed Feb 05 2003
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COMPUTATIONAL AND EXPERIMENTAL INVESTIGATION OF THE AERODYNAMIC CHARACTERISTICS FOR A FORWARD SWEPT WING AIRCRAFT
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The aerodynamic characteristics of the forward swept wing aircraft have been studied theoretically and experimentally. Low order panel method with the Dirichlet boundary condition have been used to solve the case of the steady, inviscid and compressible flow. Experimentally, a model was manufactured from wood to carry out the tests. The primary objective of the experimental work was the measurements of the wake dimensions and orientation, velocity defect along the wake and the wake thickness. A blower type low speed (open jet) wind tunnel was used in the experimental work. The mean velocity at the test section was (9.3 m/s) and the Reynolds number based on the mean aerodynamic chord and the mean velocity was (0.46x105). The measurements sho

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Tue Feb 21 2017
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A novel method for non-invasively detecting the severity and location of aortic aneurysms
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The influence of an aortic aneurysm on blood flow waveforms is well established, but how to exploit this link for diagnostic purposes still remains challenging. This work uses a combination of experimental and computational modelling to study how aneurysms of various size affect the waveforms. Experimental studies are carried out on fusiform-type aneurysm models, and a comparison of results with those from a one-dimensional fluid–structure interaction model shows close agreement. Further mathematical analysis of these results allows the definition of several indicators that characterize the impact of an aneurysm on waveforms. These indicators are then further studied in a computational model of a systemic blood flow network. This demonstr

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Sun May 08 2011
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The Effect of the Natural and Cultural Environments Factors on the Architectural and Planning Characteristics of Sulaymaniyah Mosques
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Most of the mosques in the Islamic world fall under specific and known forms and patterns to a large extent, and such patterns have grown and evolved from the few basic and uniform models, but they changed slowly due to the impact with a mixture of changing functional requirements and cultural landscapes because of the variables of time and place to form patterns known and famous in this day across parts of the Islamic world and its borders. There was no exception to these patterns, but small numbers of mosques that were probably the result of personal experiences or improvisational resolutions, or in response to specific or temporary stimuli. However, the emergence of a specific pattern which does not belong to any of these patt

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Thu May 18 2023
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The battle of Dumat al-Jandal And its impact on the era of prophecy And the righteous caliphate
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The research in Islamic history is considered a title for the glory of the nation and a mirror for the intellectual and mental maturity of the men of the Islamic state who played an important role in saving humanity from darkness to light and from ignorance to knowledge and to show their position in building the Islamic state, and to highlight the importance of their conquests of neighboring cities and the expansion of Islam, and for this reason they appear The importance of writing on the topic (The Battle of Dumat al-Jandal and its impact on the era of the Prophethood and the Rightly Guided Caliphate). The reason for choosing this topic was to show the status of Dumat al-Jandal and its importance in the Islamic state and its great role

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