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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 Jun 22 2021
Journal Name
Turkish Journal Of Computer And Mathematics Education
Analysis of the content of the applied fifth grade chemistry book according to life skills
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The current research aims to analyze the chemistry books for the preparatory stage according to life skills for the academic year (2019-2020) and to know the life skills contained in the chemistry books for the preparatory stage through the following two questions:1-What life skills should be available in the content of chemistry books prescribed for middle school students approved by the Ministry of Education, General Directorate of Curricula in the academic year(2019-2020). 2-What is the percentage of life skills included in the content of chemistry textbooks prescribed for middle school students approved by the Ministry of Education, General Directorate of Curricula in the academic year (2019-2020). To achieve the objectives of the resea

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Publication Date
Mon Sep 09 2024
Journal Name
Научный Форум
the functioning of artificial intelligence for the development of communication skills among foreigners learning Russian
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Publication Date
Wed Dec 18 2019
Journal Name
Baghdad Science Journal
Effect of the Dielectric Barrier Discharge Plasma on the Optical Properties of CDS Thin Film
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Cadmium sulphide CdS films with 200 nm have been prepared by thermal evaporation technique on glass substrate at substrate room temperature under vacuum of 10-5mbar.In this paper, the effect of Dielectric Barrier Discharge plasma on the optical properties of the CdS film. The prepared films were exposed to different time intervals (0, 3, 5, 8) min. For every sample, the Absorption A, absorption coefficient α , energy gap Eg ,extinction coefficient K and dielectric constant ε were studied. It is found that the energy gap were decreased with exposure time, and absorption , Absorption coefficient, refractive index, extinction coefficient,  dielectric constant increased with time of exposure to the plasma. Our study conside

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Publication Date
Tue Nov 11 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effects of unilateral premature loss of maxillary primary molars on the dental arch dimensions
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Background: The aim of the study was to evaluate the amount of changes in the horizontal and vertical maxillary arch dimensions measurements following the premature loss of primary molars. Materials and methods: The sample consist of (50) children with unilateral prematurely extracted either first or second primary molars at the mixed dentition stage. Results and Conclusions: Results shows that there was an increase in the vertical incisor to canine distance (A) with both premature loss of first & second primary molars due to distal movement of primary canines and at the same time there were a significant loss of space in the extraction space with premature loss of second primary molar due to a mesial movement of maxillary first permanent

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Economics And Finance Studies
THE EFFECTS OF INFORMATION TECHNOLOGY ADOPTION ON THE FINANCIAL REPORTING: MODERATING ROLE OF AUDIT RISK
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Publication Date
Sun Jun 11 2017
Journal Name
Al-academy
The reflection of diode technology light emitting (LED) on the modular design of external lighting
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Search marked (the reflection of diode technology light emitting (LED) on the modular design of external lighting) is an analytical study of the units, external lighting for gardens and adopted in its work on the diode technology emitting light to reach the magnitude of the effect and the change happening where according to this technique was the problem of the research in which is (what emotion the formal and functional units of external lighting according diode technology light emitting) and identified in the first part of it, including the goals came Search of b (statement reversal winning technical transformation of lighting from incandescent bulbs to light emitting diode technology (LED) on each of shape design and the nature of the

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Publication Date
Thu Aug 22 2019
Journal Name
Al-khwarizmi Engineering Journal
Optimizing the Parameters of Hot-wire CNC Machine to Enhance the Cutting of Plastic Foam
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     Hot-wire cutting is one of the important, non-traditional thermomechanical way to cut polymer, usually expanded foam and extruded foam, in low volume manufacturing. The study and analysis of Hot-Wire cutting parameters play an important role to enhance the quality and accuracy of the process and products. The effects on the surface have been investigated by using experimental tests designed according to the Taguchi orthogonal array (OA). In this study, four parameters with five levels for each parameter have been used: [temperature of wire (A) (100, 120, 130, 150, 160) °C], [diameter of wire (B) (0.3,0.4,0.5,0.7,0.8) mm], [velocity of cutting (C) (200, 300,400,500,600) mm/min], [and density of foam (D) (0.01,0.0

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Publication Date
Tue Dec 01 2020
Journal Name
Al-khwarizmi Engineering Journal
Impact of using Double Layers Perforated Liners on the Acoustic Treatments of the Combustor Systems
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The response of the combustor’s liner to the air-flow that passes through it is the key reason for the combustion chambers noise, hence the instabilities of those chambers that decreases the mechanical efficiency of such sections, by increased its mechanical vibrations, which increases the failure rate created during originating of the cracks spreading by the shakes producing by the series of high-level frequencies. Accordingly, any work debating the impact of the context of liners in the combustion chamber can provide grasping for the combustion noise generated by the undesirable vibrations, and benefits the industrial firms to design an ideal production procedure which increases the lifespan of the combustor. The goal of this work is

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Publication Date
Thu Mar 19 2015
Journal Name
Al-academy
Theatrical Visual System between the Cultural Identity and Globalization Culture Iraqi Theatre as Case Study: فرحان عمران موسى
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It seems that the features of the theatrical discourse , since its early establishment by the Greeks, were cultural features specifically confined to that society. Such features determined the direction of the theatrical discourse for this state instead of that state. There could be some sort of similarity among those features , nevertheless they remained within the general humanitarian framework . What achieved relatedness were those features and particularities that distinguished the theatrical community. Such features and particularities vary from one show to another. This is what we call " Local Specificity" .The Iraqi theatrical memory has always emphasized the concept of Experimentation through originality and renewal since the arr

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Effect the Natural Lighting In The Visual Comfort & Workers Satisfaction in Industrial Companies
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Energy crisis and the requirements of health and feel good, all this renewed attention to the importance of natural lighting in all kinds of factories.
    Research problem was how to achieve the plant's own natural outlets visual comfort and satisfaction of workers in
Companies, the industries of cotton and general al-fedaa.

     The research compuns address the impact of daylight to provide visual comfort in the factory. Indeed, the light must be treated very carefully, and natural lighting should be thinking from the perspective of the occupants of the plant and not wishing to view from the outsid

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