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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
Sun Dec 01 2013
Journal Name
Alustath
"The Common Humanity That is in Us All": Earnest Gaines's (A Lesson before Dying)
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Gaines's A Lesson Before Dying (1993) is about more than the challenges associated with being blacking an Eurocentric society. Though Gaines positions the story within the context of the African American experience, its central theme investigates what it means to be human. The Afro-American writer Ernest Gaines consistently writes about people who face the problems of being denied humanity, dignity, and self-worth. The article illustrates one man's struggle to gain recognition of his humanity in the court (as his attorney insists on calling him a hog for a crime he did not commit) and how this recognition will initiate a change in the community.

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Publication Date
Fri Sep 09 2022
Journal Name
Journal Of Ovonic Research
The effects of CuO doping on structural, electrical and optical properties of CdO thin films deposited by pulsed laser deposition technique
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Thin films of (CdO)x (CuO)1-x (where x = 0.0, 0.2, 0.3, 0.4 and 0.5) were prepared by the pulsed laser deposition. The CuO addition caused an increase in diffraction peaks intensity at (111) and a decrease in diffraction peaks intensity at (200). As CuO content increases, the band gap increases to a maximum of 3.51 eV, maximum resistivity of 8.251x 104 Ω.cm with mobility of 199.5 cm2 / V.s, when x= 0.5. The results show that the conductivity is ntype when x value was changed in the range (0 to 0.4) but further addition of CuO converted the samples to p-type.

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Oscillation of the per capita growth rate
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in this paper cquations of the per capita growth rate are considered sufficient conditions for oscillation of all solutions are obtained the asymptotie behavior of the nonoscillatory solution of all souliotions are obtained

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measuring the cost of consulting services under the traditional cost approach and the performance-based costing technique and its impact on achieving profits : Applied research in the advisory office of Al-Khwarizmi College of Engineering - University of Baghdad
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Abstract:

                    This research aims to apply the Performance Focused Activity Based Costing System in the consultant office of Al-Khwarizmi College of Engineering at the University of Technology for the purpose of measuring the cost of consulting services provided by these offices in order to reduce costs and their reflection in achieving profits. For the purpose of calculating costs accurately, and to test the hypothesis of the research, the research was applied in the office of the consultant of the College of Engineering Al-Khwarizm - University of Baghdad through the financial statement

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Monitoring of Defects Concentration in Deformed Aluminum Using Doppler Broadening Technique
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Doppler broadening of the 511 keV positron annihilation ??? ? was used to estimate the concentration of defects ?? different deformation levels of pure alnminum samples. These samples were compressed at room temperature to 15, 22, 28, 38,40, and 75 % thickness reduction. The two-state ^sitron-trapping model has been employed. 'I he s and w lineshape parameters were measured using high-resolution gamma spectrometer with high pure germanium detector of 2.1 keV resolution at 1.33 MeV of 60Co. The change of defects concentration (Co) with the deformation level (e) is found to obey an empirical formula of the form Cd - A £ B where A and ? are positive constants that depend mainly on the deformation procedure and the temperature at which the def

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Bowel Cleansing Quality in Morning Versus Evening Preparation Regimens for colonoscopy; a Prospective Study
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Background :Evening preparation for colonoscopy is often unsatisfactory and inconvenient. This study was performed to compare the efficacy of bowel preparation at two different timings: night before and morning of endoscopy and to compare the cecal intubation rate and disturbance of sleep hours between these two groups.
Methods: In this prospective randomized endoscopist- blinded trial, 150 patients were enrolled between March 2010 and August 2011. Patients aged between 18 to 80 years needing colonoscopy were included. Patients with prior bowel surgery, suspected bowel obstruction or those who didn't completely fulfill the preparation instructions were excluded. Patients received polyethyelen glycol electrolyte preparation in a mornin

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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
Political Transformations in The Republic of Turkmenistan During the Period (1991-2021)
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After the fall of the Soviet Union, a number of Eastern Bloc countries and Soviet republics have witnessed political transition. However, Turkmenistan, as one of the former Soviet republics, succeeded to preserve the authoritarian nature of the former Soviet regime. This study seeks to answer a number of research questions, the most prominent of which are: How were the political elite in Turkmenistan able to preserve the legacy of the Soviet policy based on centralization of power and individual rule?. The study reaches a set of conclusions, the most important of which are:

1-The roots of the tyranny in Turkmenistan are du to internal and external structural factors. The most important of which are: the former Soviet policies of m

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Publication Date
Fri Apr 05 2024
Journal Name
International Journal Of Science And Research (ijsr)
Effect of Body Mass Index on Eruption Time of Permanent First Molars and Incisors among a Group of 6- 8 Year Old Iraqi School Children
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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Success rate of Percutaneous Coronary Intervention of Chronic Total Occlusion in Ibn Al-Baitar Hospital for cardiac surgery and Al-Nassyeria cardiac center
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Back ground: Chronic total occlusion (CTO) of coronary arteries remains one of the most challenging lesion subsets in interventional cardiology even with the development of medical devices and operator expertise. Successful revascularization results in improved in angina status ,increased exercise capacity and reduces the need for lat CABG surgery .
Objectives: This study sought to determine the overall procedural success rate of percutaneous coronary intervention (PCI) for CTOs and to examine the relation between variables such as; patients’ characteristics, risk factors, lesion characteristics and procedural success rate.
Methods: In this study ,clinical and coronary angiography data of (80) patients with CTO who underwent PCI

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Publication Date
Wed Jul 04 2012
Journal Name
J Bagh College Dentistry
Azithomycin as an adjunctive to non-surgical treatment in comparison with doxycycline in chronic periodontitis patients: 2-months randomized clinical trial
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