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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 May 01 2016
Journal Name
Journal Of Engineering
Assessing Asphalt and Concrete Pavement Surface Texture in the Field
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The incorporation of safety characteristics into the traditional pavement structural design or in the functional evaluation of pavement condition has not been established yet. The design has focused on the structural capacity of the roadway so that the pavement can withstand specific level of repetitive loading over the design life. On the other hand, the surface texture condition was neither included in the AASHTO design procedure nor in the present serviceability index measurements.

The pavement surface course should provide adequate levels of friction and ride quality and maintain low levels of noise and roughness. Many transportation departments perform routine skid resistant testing, the type of equipment us

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Publication Date
Mon Jan 08 2024
Journal Name
Al-academy
Aesthetic visual discourse and the audio system in theatrical performance
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Technologies of the theatre show elements get great transferring concerning the creative embodiment of its aesthetic elements including its raws, forms, parts and masses in an attempt to achieve the prin cipal expressive progress to embody the main theme of the idea and the intended subject .
This is within the criterion of supporting the way to deal with technologies (décor elements , lighting music tones vocal affects , fashion and makeup) that achieving the emagintional appropriate atmosbheres which the writer and the director of the theatre show aim to make it present and succeed by furming active participation tunches of the ability of the cinogra . phic – element dsigners in order to invlve the theatre space atmospheres in cl

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Publication Date
Tue Oct 31 2023
Journal Name
College Of Islamic Sciences
Selling the sample in Islamic law and its contemporary applications
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Praise be to God, who taught with the pen, taught man what he did not know, and may blessings and peace be upon our master Muhammad, may God bless him and grant him peace, and upon all his family and companions.
As for after......
The science of financial transactions is one of the important topics that Muslims must need at all times and places, due to its great importance in clarifying the ruling of the Shari’ah on contemporary financial issues.
The jurists, may God have mercy on them, have spoken about financial issues in all their aspects in detail, as in the Book of Sales, whether in terms of the validity of the sale, its invalidity, or its invalidity, i.e., the invalidity of the sale. Among these issues is the issue of th

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Postoperative Wound Infections and the Antimicrobial Susceptibility in Baghdad Hospitals
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Nosocomial infections are one of the most important causes of mortality and morbidity in hospitals. These are major public health problems worldwide, but particularly in developing countries. The purpose of this research was to analyze the frequency of the microorganisms in the specimens taken from the surgical wounds, and to examine antimicrobial susceptibility for some isolates . Wound swabs were examined from June 2010 to January 2011. The isolates were identified by conventional methods, antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method as per NCCLS guidelines.A total of 102 wound swabs were examined 22(21.56%) swabs were sterile and 80(78.43%) were positive for microorganisms. The results showed

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Entrepreneurial performance in accordance with the competitive intelligence and strategic
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 The research aims to study the entrepreneurial performance of the banks, according to the intelligence of competitive and strategic as the entrepreneurial performance is the one who does not stand the benefits of excellence in accomplished when just achieving the bank's objectives planned, but exceed it down to creativity in accomplishing these goals in a manner leads to making a entrepreneurial bank in the markets and the focus the eyes of competitors and the banks and other Following his example.

Was chosen the subject of research and strategic intelligence and competitive because of its impact on the strategic success of the banking sector, the fact is the entrepreneurial in the Iraqi banking mar

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Publication Date
Wed Dec 15 2010
Journal Name
Iraqi Journal Of Laser
Evaluation the Effect of 805 nm Wavelength Diode Laser on Repair of Mandibular Bone Repair and Skin Incisions in Rabbits
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The long healing time of bone after tooth extraction in order to construct artificial teeth is uncomfortable to the patient because of aesthetic or masticatory problems in addition to the daily visit to dental clinic. The objective of this study was to evaluate the effect of 805 nm diode laser with long time intervals on repair of bone and skin incisions in rabbits through biochemical, radiological and histological findings. Eighteen New-Zealand rabbits were undergone surgical operations to make a cavity in the bone of the lower jaw, the rabbits were divided into two groups:- Group A (control group) containing nine rabbits. Group B (lased group) containing nine rabbits in which two cavities were done, one on the right side and the other

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Publication Date
Wed Jun 19 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Impact of Self-Assessment on Income and Sale Tax Collection' From the Point View of Income Tax Auditors in Jordan
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This study aimed to show the extent of compliance with the income taxpayer  to provide tax returns and increase the speed of collection of these taxes in addition to increasing confidence in  Income Tax department and reduce the number of cases transferred to the courts and promote taxpayer awareness in charge of the importance of self-assessment system, and study sought to investigate the effect of the existence of records documents, technical audit, and computational audit and documentary audit on income tax collections in Jordan, from the point of viewof Jordanian income tax auditors ,results shows there's a strong  relation between these variables and Income Tax collections.

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Publication Date
Thu Sep 01 2016
Journal Name
J Bagh College Dentistry
Comparison of Immunoglobulin IgA level in the stimulated saliva of caries-free and caries-active children aged 7-10 year
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Background: Salivary immunoglobulin IgA plays an essential role in the immune response against dental caries. This studywas conducted to compare the salivary IgA levels and flow rate of stimulated saliva in caries active and caries free children. Materials and methods: The present study included sixty healthy children age 7-10 yearswho were divided into two groups. They were caries free and caries active children (30 children in each group). Assessment and recording of caries – experience were through the application of Decayed, Missing and Filled Tooth Index (DMFT) and (dmft) index, for permanent and deciduous teeth respectively. After dental examination, stimulated saliva samples were collected from the subjects and performed und

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Publication Date
Sat Oct 01 2011
Journal Name
Baghdad Science Journal
Studying the Effect of Aqueous Extract from Curcuma Longa on Some Parameters of Cytogenetic, Immunity and Fertility in Female Mice
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The research work was conducted to investigate the effect of oral administration of aqueous extract of turmeric at doses of (5, 10) mg/kg body weight for two weeks daily by determining the genotoxic effect (mitotic index), evaluation of immunological effect (IgG, IgM, IgA, C3, C4) and measuring fertility hormones (follicles stimulation hormone/FSH, lutenising hormone/LH) levels with histological examinations of female albino swiss mice ovaries in comparison with control (normal saline). A clear effect in increasing mitotic activity was reveled for both doses in comparison with control. Results also showed a significant increase in the value of all immunological parameters at both doses, in comparison with control. Also, obvious raise was se

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The use of multi choice Goal Programming to reduce storage and shortage costs of blood units in health care centers
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We use of multi-choice Goal Programming (MCGP), which is a developed model of Goal Programming where it is used in circumstances of the multiplicity and difference of goals when choosing between decision alternatives in cases of allocating resources, as it is a model that seeks to find the closest and best solutions to the specific values ​​of the goals within the aspiration levels, as the first goal in the multi-choice goal programming model that is used to reduce the total cost of storage and shortage, while the other goal was to reduce the difference between the real demand that the hospitals need from the blood transfusion center and the units that already achieved. The case Iraqi Center

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