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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
Sat Dec 21 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Synthesis, Characterization and Preliminary Anticancer Study of Novel 5-fluorouracil Conjugate with Pyrrolidine Dithiocarbamate as a Mutual Anticancer Prodrug
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 5-Fluorouracil is one of the commonly used chemotherapy drugs in anticancer therapy; unfortunately treatment with 5-FU by solely has many drawbacks  low lipophilicity, low permeability, low molecular weight, and its relatively poor plasma protein binding; also a brief half-life therefore frequent administration is required to maintain the optimal therapeutic plasma level which in addition to its poor selectivity, drug resistance and limited penetration to cancer cells; leads to increased incidence of side-effects to healthy cells/tissues and low response rates. In order to minimize these drawbacks; 5-FU was chemically  conjugated with pyrrolidine dithiocarbamate (PDTC) in a mutual prodrug moiety (S-(9H-purin-6-yl) 3-(

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Publication Date
Sat Apr 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
The Relationship Between the Above-Ground Biomass and the Vegetation Cover Indices at Different Salinity Levels
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Abstract<p>The current study was carried out to find out the relationship between the Above-Ground Biomass and the spectral vegetative indices (Normalized Difference Vegetation Index, Soil Adjusted Vegetation Index, Difference Vegetation Index) (NDVI, SAVI, DVI) for soils with different salinity levels. Al Salamiyat Project was chosen as a study area located at an altitude of 34 m above sea level and within the geographical coordinates (E 44°.09´13.65´´ N 33°.25´ 07.87´´ and E 44°.17´ 46.03´´ N 33°.2l´40.72´´), with a total area of 14265 Dunum. Surface and subsurface soil samples were chosen from the study area and according to the previously defined salinity units, except for th</p> ... Show More
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Publication Date
Thu Jan 17 2019
Journal Name
Plant Archives
EFFECT OF ANTI-STRESS ON THE GROWTH AND YIELD OF SWEET AND HOT PEPPERS AND ITS CONTENT OF PEROXIDASE AND IAA
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MS Elias, RGM AL-helfy, Plant Archives, 2019

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Publication Date
Thu Mar 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
An Artificial Intelligence Algorithm to Optimize the Classification of the Hepatitis Type
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Hepatitis is one of the diseases that has become more developed in recent years in terms of the high number of infections. Hepatitis causes inflammation that destroys liver cells, and it occurs as a result of viruses, bacteria, blood transfusions, and others. There are five types of hepatitis viruses, which are (A, B, C, D, E) according to their severity. The disease varies by type. Accurate and early diagnosis is the best way to prevent disease, as it allows infected people to take preventive steps so that they do not transmit the difference to other people, and diagnosis using artificial intelligence gives an accurate and rapid diagnostic result. Where the analytical method of the data relied on the radial basis network to diagnose the

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Publication Date
Sat Oct 20 2018
Journal Name
Journal Of Economics And Administrative Sciences
Measuring the performance of government units according to the government accounting system
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Abstract

This study aims at clarifying the current performance appraisal system in government units and the extent to which they contribute to the development of the performance of these units by evaluating and measuring the performance of these units on an ongoing basis to subject their services to an assessment and measurement process in order to improve the efficiency of these units to reach their objectives efficiently and effectively. (Iraqi hospitals) by trying to determine the possibility of the government accounting system in the process of evaluating performance, through the comparison of financial performance for successive years and different hospitals using the financial and non-financial model of the evaluati

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Publication Date
Thu Jan 05 2012
Journal Name
مجلة كلية التربية الأساسية/ جامعة بابل / بحوث المؤتمر العلمي الرابع لكلية التربية الأساسية/جامعة بابل 2011 م
THE DYNAMIC EVOLUTION OF THE SHELL NEBULAE BY USING INTERACTING WIND MODEL
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Publication Date
Fri Jul 01 2016
Journal Name
Al–bahith Al–a'alami
The Discourse of the Absent Woman Novel for Mahdi Issa Al-Saqr
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The semiotic trend of recent monetary trends task that took a wide range of attention of critics and readers alike, especially after the deployment, which accompanied him after widespread acts critic Grimas and powers applicable to the literary texts and is thus expanded its care circle, hence the choice of the novel (absent) woman Iraqi novelist (Mahdi ‘Issa falcon) model to be applied to the study chose to be a semiotic approach through the use of procedural mechanisms for its critical tool (Paris School of semiotics), cash and views of its founder critic Grimas.The research in the introduction and pave came we made it a vision for literary semiotic and its impact trend in cash and cash is and what it desire to clarify some poked suc

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Publication Date
Mon Nov 01 2021
Journal Name
Review Of International Geographical Education
Analysis of the agricultural insurance portfolio for the Iraqi National Insurance Company
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The agricultural sector suffers from many risks and natural disasters, such as droughts and heavy rains that cause floods, as well as hail and agricultural pests, etc., that threaten agricultural activity and reduce it, which leads to the failure of farmers and peasants for fear of being subjected to continuous losses. Nevertheless, we notice almost complete reluctance to move towards agricultural insurance, due to the dependence of farmers on the government, which adopts the principle of compensation instead of agricultural insurance when natural disasters happen despite the difficulties and financial hardship as well as the suspicion of corruption that haunt the compensation process and this represents the most important problem for resea

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Publication Date
Mon Oct 01 2018
Journal Name
Civil Engineering Journal
Developing Water Quality Index to Assess the Quality of the Drinling Water
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In the present study, an attempt has been to develop a new water quality index (WQI) method that depends on the Iraqi specifications for drinking water (IQS 417, 2009) to assess the validity of the Euphrates River for drinking by classifying the quality of the river water at different stations along its entire reach inside the Iraqi lands. The proposed classifications by this method are: Excellent, Good, Acceptable, Poor, and Very poor. Eight water quality parameters have been selected to represent the quality of the river water these are: Ion Hydrogen Concentration (pH), Calcium (Ca), Magnesium (Mg), Sodium (Na), Chloride (Cl), Sulphate (SO_4), Nitrate (NO_3), and Total Dissolved Solids (TDS). The variation of the water quality parameters

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of The College Of Education For Women
The Social Motive Behind the Inclusion of Moses Story Within Andalusi Poetry
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The significance of the social motivation lies in showing the great and important role of the story of the prophet of ( Moser ( Peace upon him) in Quran , especially , it is considered the greatest one in Quran , as that confirmed by the poets of Andalusera ,as it includes aspects similar to that prevailing over in their environments and their social life via the social motivation. Moreover , the relation's poets with the Andalus society where suitability prevailing over consistent with the events of the story; bedsides, artistic expression about the society for being considered as a trust mirror reflect real facts surrounded by the Andalussociety with all its sides and aspects . Thus , the poet takes Quran , especially the story of Mose

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