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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 Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Strategies of Rebulding Iraqi Cities That War Destroyed
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This study includes the rebuilding of cities that war destroyed, which include some of the special policies that should be followed in order to build cities that war destroyed and which have importance in the national and humanitarian level, as well as some international experiences discussed including Warsaw, and the regional experiences, including Lebanon and concentrates on the foundation stone and evaluate it with global and regional experiences so that we can concluded with an integrated strategy that will achieve the best results in doing the reality that we live in these cities which are suffering from such disasters . In order to achieve the best goals we should review the best concepts and theories related to reconstruction afte

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Publication Date
Mon Jun 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Theoretical Study and calculation The cold Reaction Rate of Deuteron Fusion In Nickel Metal Using Bose–Einstein Condensate Theory
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In this paper, we focused on the investigated and studied the cold fusion reaction rate for D-D using the theory of Bose-Einstein condensation and depending on the quantum mechanics consideration. The quantum theory was based on the concept of single conventional of deuterons in Nickel-metal due to Bose-Einstein condensation, it has supplied a consistent description and explained of the experimental data. The analysis theory model has capable of explaining the physical behaviour of deuteron induced nuclear reactions in Nickel metals upon the five-star matter, it's the most expected for a quantitative predicted of the physical theory. Based on the Bose-Einstein condensation theorem formulation, we calculation the cold fusion reaction rate fo

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Physics: Conference Series
Hiding text in gray image using mapping technique
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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Engineering
Risk Assessment in BOT Contracts using AHP Technique
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The process of risk assessment in the build-operate transfer (BOT) project is very important to identify and analyze the risks in order to make the appropriate decision to respond to them. In this paper, AHP Technique was used to make the appropriate decision regarding response to the most prominent risks that were generated in BOT projects, which includes a comparison between the criteria for each risk as well as the available alternatives and by mathematical methods using matrices to reach an appropriate decision to respond to each risk.Ten common risks in BOT contracts are adopted for analysis in this paper, which is grouped into six main risk headings.The procedures followed in this paper are the questionnaire method

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Publication Date
Wed Mar 16 2022
Journal Name
2022 Muthanna International Conference On Engineering Science And Technology (micest)
A hybrid feature selection technique using chi-square with genetic algorithm
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Publication Date
Tue Feb 01 2022
Journal Name
Journal Of Engineering
Self-Repairing Technique Based on Microcapsules for Cementitious Composites- A Review
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Self-repairing technology based on micro-capsules is an efficient solution for repairing cracked cementitious composites. Self-repairing based on microcapsules begins with the occurrence of cracks and develops by releasing self-repairing factors in the cracks located in concrete. Based on previous comprehensive studies, this paper provides an overview of various repairing factors and investigative methodologies. There has recently been a lack of consensus on the most efficient criteria for assessing self-repairing based on microcapsules and the smart solutions for improving capsule survival ratios during mixing. The most commonly utilized self-repairing efficiency assessment indicators are mechanical resistance and durab

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Publication Date
Mon May 01 2023
Journal Name
Journal Of Engineering
Experimental Investigation of Heat Transfer Enhancement in a Double Pipe Heat Exchanger Using Compound Technique of Transverse Vibration and Inclination Angle
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Numerous tests are recently conducted to assess vibration's role in accelerating the heat transfer rate in various heat exchangers. In this work, the enhancement of heat transfer by the effect of transfer vibration and inclination angles on the surface of a double pipe heat exchanger experimentally has been investigated. A data acquisition system is applied to record the data of temperatures, flow rates, and frequencies over the tests. A compound technique was adopted, including the application of a set of inclination angles of (0°, 10°, 20°, and 30°) under the effect of frequency of vibration ranging from sub-resonance to over-resonance frequencies. The results showed that the overall heat transfer coefficient enhan

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Publication Date
Thu Mar 01 2018
Journal Name
مجلة الباحث في العلوم الإنسانية و الإجتماعية
The Rate of Performance of Scientific Committees in the University of Baghdad in Accordance to the Department’s Heads’ Viewpoint
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The research aims at recognition of The rate of performing tasks done by the scientific committees in the scientific departments in the University of Baghdad, within the evaluative perspective of the departments’ Heads. To find any statistically significant differences in the responses of the research sample to the rates performance of the scientific committees in scientific departments in the University of Baghdad, within the evaluative perspective of the departments’ Heads, according to the two variables of the social gender; male and females, and field of specialization of Scientific and Humanities. The research sample consisted if (107) heads of the scientific department in the University of Baghdad. The researchers designed a

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Publication Date
Thu Dec 01 2022
Journal Name
Caspian Journal Of Environmental Sciences
Histological study of liver in Dhub lizard Uromastyx aegyptius microlepis (Blanford, 1874) during the period of hibernation
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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Economic Conditions of Living in the City of Mosul: Income and Labor Market during the Period 2004-2007
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Abstract

 

This study cares for the economic living conditions in Mosul City. Its importance lies in the critical period that has been covered
(2002-2007), which was dominated by far–reaching events at political economic and social levels.
Among the main results that have been revealed are the following: the rate of economic growth in the City has been the lowest among major urban centers in Iraq. Besides, real income per capita in the City has stayed stagnant during the period of the study. However, the inequality in distribution of income has decreased. The main bulk of the city's population rely on their income from wages and salari

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