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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
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of changing the exchange rate in bank loans : Applied research on a sample of Iraqi commercial banks
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Abstract

          The aim of the research is to measure the effect of changing the exchange rate on bank loans, and in order to achieve this goal, the (official exchange rate) was chosen as an independent variable and its effect was studied on the dependent variable, which is bank credit. Commercial Gulf, Baghdad, A Shore International for Investment (and the financial indicators (growth rate of loans) and the statistical program (Eviews 12) were used to measure the impact of the exchange rate change on the bank credit of banks, the research sample for the period 2012-2022, and the research reached a group Among the conclusions, the most important of which is that the

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Publication Date
Wed May 27 2020
Journal Name
Research Gate
Information Booklet COVID-19 Graphs For Iraq First 3 Months
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This booklet contains the basic data and graphs forCOVID-19 in Iraq during the first three months of thepandemic ( 24 February to 19 May - 2020 ) , It isperformed to help researchers regarding this health problem (PDF) Information Booklet COVID-19 Graphs For Iraq First 3 Months. Available from: https://www.researchgate.net/publication/341655944_Information_Booklet_COVID-19_Graphs_For_Iraq_First_3_Months#fullTextFileContent [accessed Oct 26 2024].

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Publication Date
Tue Jun 01 2021
Journal Name
Iraqi Journal Of Physics
Effect of Transition Metal Dopant on the Electrical Properties of ZnO-TiO2 Films Prepared by PLD Technique
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In this article, the influence of group nano transition metal oxides such as {(MnO2), (Fe2O3) and (CuO)} thin films on the (ZnO-TiO2) electric characteristics have been analyzed. The prepared films deposited on glass substrate laser Nd-YAG with wavelength (ℷ =1064 nm) ,energy of (800mJ) and number of shots (400). The density of the film was found to be (200 nm) at room temperature (RT) and annealing temperature (573K).Using DC Conductivity and Hall Effect, we obtained the electrical properties of the films. The DC Conductivity shows that that the activation energies decrease while the σRT at annealing temperature with different elements increases the formation of mixed oxides. The Hall effect, the elec

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Publication Date
Thu Dec 31 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
QUALITY EVALUATION OF THE INTERNAL METALLIC COATING FOR SOME FOODS THAT AVAILABLE IN THE LOCAL MARKETS: QUALITY EVALUATION OF THE INTERNAL METALLIC COATING FOR SOME FOODS THAT AVAILABLE IN THE LOCAL MARKETS
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The study aimed to estimate the content of lead and determine the quality of the internal coating of metal cans through electrical conductivity as well as to determine the accuracy of the information card for some types of canned food that available in local markets. The information card test showed that all of these samples contained the name of the food, trade mark, country origin, weight, and components, as was indicated by the company producing in all of them except for the C12 sample which was otherwise, and the batch number was mentioned in all samples except for the C3 and C17 which was not clear and not mentioned in the C21, and the validity period was observed (produce and fini

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Publication Date
Wed Dec 01 2010
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIRST RECORD OF FIVE NEMATODE SPECIES IN SOME WATER BIRDS FROM AL-HAMMAR MARSH, SOUTH OF IRAQ
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Parasitological investigation of piscivorous birds in Al-Hammar marsh south of Iraq during December-February 2004 and December 2005 were revealed that water birds infected with five nematode species, which belong to three different superfamilies, Desmidocercella numidica (Seurat, 1920) (Superfamily: Aproctoidea) from three piscivorous birds including Grey heron Ardea cinerea, Bittern Botaurusstellaris, and small white heron Ardeola ralloides; Avioserpens sp. 1 and Avioserpens sp. 2 (Superfamily: Dracunculoidea) from small bittern Ixobrychus minutus and black glossy ibis Plegadisfalcinellus respectively; Baruscapillaria sp. and Baruscapillarinae gen. sp. (Sup

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Publication Date
Mon Jan 01 2018
Journal Name
Fme Transaction
The influence of frictional facing thickness on the contact pressure distribution of multi-disc dry clutches
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Publication Date
Mon Jan 01 2018
Journal Name
Fme Transaction
The influence of frictional facing thickness on the contact pressure distribution of multi-disc dry clutches
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Frictional heat is generated when the clutch starts to engag. As a result of this operation the surface temperature is increased rapidly due to the difference in speed between the driving and driven parts. The influence of the thickness of frictional facing on the distribution of the contact pressure of the multi-disc clutches has been investigated using a numerical approach (the finite element method). The analysis of contact problem has been carried out for a multiple disc dry clutch (piston, clutch discs, separators and pressure plate). The results present the distribution of the contact pressure on all tShe surfaces of friction discs that existed in the friction clutch system. Axisymmetric finite element models have been developed to ac

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Publication Date
Sun Oct 01 2017
Journal Name
Applied Energy
Hourly yield prediction of a double-slope solar still hybrid with rubber scrapers in low-latitude areas based on the particle swarm optimization technique
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Publication Date
Wed Mar 30 2022
Journal Name
Gsc Biological And Pharmaceutical Sciences
Using the silicon (luminal cast plastination technique) for the lower respiratory tract in sheep as an alternative to cement
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The lower respiratory tract of sheep was studied to determine the torsion and branching of the bronchial tree. The respiratory system of ruminants and all living organisms is one of the most important organs in the body that controls the amount of gas exchange between the heart and lungs through the airways, it is clear that in sheep it consists of a narrow bronchial tube that reaches the extent of lung tissue repercussions. He used silicon, water, acid, and at room temperature, and the substance was injected with an injection gun through the trachea and was pushed gently to spread and distribute in all parts of the lungs with moderate manual pressure. The results showed that the mold shape in the lung and the bronchial branches of

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Publication Date
Mon Dec 31 2012
Journal Name
College Of Islamic Sciences
The hadiths that al-Mazy cited in his book "Tuhfat al-Ashraf" from the Imam Ahmad Imam's collection and study
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This research seeks to attempt to reveal the intention of Al-Hafiz Al-Mazi from his market to hadiths from Imam Ahmad’s Musnad in his book “Masterpiece of Supervision in Knowing the Parties”, and researchers know that this book was classified by Al-Mazi to collect the parties to the six books: Sahih Al-Bukhari, Sahih Muslim, Sunan Abi Dawud, Jamea Al-Tirmidhi and Sunan Al-Nasa’i and Sunan Ibn Majah, in addition to some of the books ’authors’ books, and arranging them according to the Musnad, and it is not Musnad Ahmad from his condition, even if it is close to the arrangement of Mazi’s work, as he was a follower of that to the original owner Abu al-Qasim bin Asaker in his book “Supervising Knowledge of the Parties” in M

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