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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 31 2020
Journal Name
College Of Islamic Sciences
Remorse in the poetry of the Dick gins hums
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      Regret is a feeling that affects a person when he does something, realizing that his present situation would be better if he did not commit this act, or behaved differently in the past. It is also a look back. It makes a person feel dissatisfied, and hopes if he can change In the past, this research deals with the remorse of the hair of Dick Homs al-Jinn, who killed his sweetheart and his wife (Ward), after an alleged treason without being confirmed, and when he found out the truth he regretted killing her all his life. His poetry is studied carefully, and he has not received the attention of scholars like other poets of his time; and his unwillingness to keep up with

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Publication Date
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
The benefits of striking proverbs in the Holy Quran
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The researcher dealt with the importance of striking proverbs in the Holy Qur’an and their uses and benefits in Islamic education and ethics and between the types of proverbs, so it emerged through the study the following things that the proverbs are of three types: authorized, latent, and transmitted, and it has been shown through the current study that the proverb has conditions that the proverb is not valid except There are five: (realism, clarity, environmental, meaning injury, and good pronunciation). If the example violates these conditions, it is not an example. This study showed that proverbs have a prominent role in persuasion, argument, statement, education, clarity, approximation, education, refinement, correct belief, etc.

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Publication Date
Tue Apr 01 2025
Journal Name
International Journal Of Humanities And Educational Research
THE SUFI SYMBOL IN THE POETRY OF AHMED BAKHIT
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Publication Date
Thu Jan 01 2015
Journal Name
Iraqi Postgraduate Medical Journal
Immunohistochemical Study of Leydig Cells in the Testicular Interstitial Tissue of Rats Treated with Tribulus Terrestris Using P450scc.
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BACKGROUND: Tribulus terrestris has been commonly used in folk medicine to energize, vitalize and improve sexual function and physical performance in men and laboratory rats. OBJECTIVE: To study the effect of Tribulus terrestris on the number of Leydig cells. MATERIALS AND METHODS: Tribulus terrestris was given to mature male rats as an oral single herbal suspension in a dose of 2.0mg /1000gbody weight for 14 days to stimulate spermatogenesis. Formalin fixed paraffinembedded tissue sections were performed for histological, immunohistochemical and morphometrical studies. RESULTS: Histological study revealed wider seminiferous tubules and increased spermatocytes population with an increased sperm density inside the lumen of the tubul

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Publication Date
Sun Oct 09 2022
Journal Name
Journal Of Research In Medical And Dental Science
Efficacy of Locally Applied K-Carrageenan on the Healing of Thermal Burn in Rat-Experimental Model: Histological Study
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ABSTRACT Wound is damage or disruption to the normal anatomical structure and function. Carrageenan is sulphated polysaccharide found in Gigartina, Chondrus and Eucheuma species in the red algal family. Having anticancer, anti-inflammatory and renewal of tissues. Our study aimed to detect the role of kappa carrageenan in the burned skin wound repair. Skin burn were performed in the right and left cheek of 20 male rats (aged 7-8 weeks weighing 300-350 g). Burned skin rats were categorized into two equal groups. Burned areas of right side were treated with a local application of 1 ml of kappa carrageenan solution once daily (treatment group) and the left side receive no treatment (control group). After 5, and 10 days, 5 rats from each

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluation of the actual reality of supply chain operations in Noor Al-Kafeel Food Products Company/ case study.
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Abstract:

                This research aims to identify the actual reality of the supply chain processes applied in the Noor Al-Kafeel Food Products Company, which was chosen as a research sample by measuring the application and documentation gap. The current research relies on the case study method to reach the desired results, and the seven-scale scale was relied on to identify the reality of the supply chain operations applied in the researched company and the use of quantitative and qualitative methods in data collection and analysis, as quantitative methods such as the arithmetic mean were used weighted, percentage measurement, and g

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Publication Date
Fri Jul 01 2022
Journal Name
Structures
Reliability analysis of deteriorated post-tensioned concrete bridges: The case study of Ynys-y-Gwas bridge in UK
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Concrete structures are exposed to aggressive environmental conditions that lead to corrosion of the embedded reinforcement and pre-stressing steel. Consequently, the safety of concrete structures may be compromised, and this requires a significant budgets to repair and maintain critical infrastructure. Prediction of structural safety can lead to significant reductions in maintenance costs by maximizing the impact of investments. The aim of this paper is to establish a framework to assess the reliability of existing post-tensioned concrete bridges. A time-dependent reliability analysis of an existing post-tensioned involving the assessment of Ynys-y-Gwas bridge has been presented in this study. The main cause of failure of this bridge was c

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Publication Date
Sun Jan 01 2023
Journal Name
Dental Hypotheses
Assessment of the Salivary Level of Malondialdehyde in Localized Periodontitis Versus Generalized Periodontitis: An Analytical Cross-Sectional Study
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Publication Date
Sun Sep 30 2018
Journal Name
الجامعة المستنصرية كلية الإدارة و الاقتصاد
The possibility of adoption of hybrid cloud computing in Iraqi universities : an analytical study using technology acceptance model
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الناصر، عامر عبد الرزاق عبد المحسن والكبيسي، صلاح الدين عواد كريم. 2018. إمكانية تبني الحوسبة السحابية الهجينة في الجامعات العراقية : دراسة تحليلية باستخدام أنموذج القبول التكنولوجي. مجلة الإدا

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Publication Date
Thu May 18 2023
Journal Name
Journal Of Engineering
An Experimental Study of the Effects of Coolant Fluid on Surface Roughness in Turning Operation for Brass Alloy
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The effect of different cutting fluids on surface roughness of brass alloy workpiece during turning operation was carried out in this research. This was performed with different cutting speed, while other cutting parameters had been regarded as constants(feeding rate , and depth of cut). Surface roughness of machined parts that will be tested by electronic surface roughness tester .The results show that the standard coolant gives the best values of surface roughness for fixed cutting speed ,followed by sun flower oil that has approximately the same effect, while the air stream as a coolant gave unsatisfied results for the evaluation of surface roughness.

In the other hand the best values of surface roughness were recorded for max

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