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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
Wed Oct 06 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Image segmentation by using thresholding technique in two stages
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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Laboratory Investigation on Roller Compaction Technique in Concrete Construction
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Roller compacted concrete (RCC) is a concrete compacted by roller compaction. The concrete mixture in its unhardened state must support a roller while being compacted. The aim of this research work was to investigate the behavior and properties of roller compacted concrete when constructed in the laboratory using roller compactor manufactured in local market to simulate the field conditions. The roller compaction was conducts in three stages; each stage has different loading and number of passes of the roller. For the first stage, a load of (24) kg and (5) passes in each direction had been employed. For the second stage, a load of (104) kg and (10) passes in each direction were conducted. Finally, at the third stage, a load of (183) kg a

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Publication Date
Sat Jan 01 2022
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees21gr
The possibility of implementing smart mobility in the traditional city: Studying the possibility of establishing an intelligent transportation system in the city center of Kadhimiya
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The possibility of implementing smart mobility in the traditional city: Studying the possibility of establishing an intelligent transportation system in the city center of Kadhimiya

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Publication Date
Sat Sep 30 2017
Journal Name
Al-khwarizmi Engineering Journal
Study the Effect of Multilayer Single Point Incremental Forming on Residual Stresses for Bottom Plates
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Abstract

 

Knowing the amount of residual stresses and find technological solutions to minimize and control them during the production operation are an important task because great levels of deformation which occurs in single point incremental forming (SPIF), this induce highly non-uniform residual stresses. In this papera propose of a method for multilayer single point incremental forming with change in thickness of the top plate (0.5, 0.7, 0.9) mm and lubrication or material between two plates(polymer, grease, grease with graphite, mos2) to knowing an effect of this method  and parameters on residual stresses for the bottom plates. Also compare these results for the

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Publication Date
Thu Feb 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Possible Options in Managing the Exchange Rate of the Iraqi Currency in light of Current Economic Conditions
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The management of the exchange rate of the most important tools of economic policy because of its wide area in achieving stability and economic growth through the provision of stability in the exchange rate of the currency of the country concerned , as well as the impact and influence of money supply and then treat the economic crisis monetary and reduce the risk of currency exchange rate .For the management of the exchange rate in Iraq has passed through several stages , from installation to link to a basket of currencies to float freely , and we are dealing with in this research regard to the achievements of monetary policy , especially after the enjoyment of independence on according to the Iraqi Central Bank Law No. 56 of 2004 and Ma

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Publication Date
Wed Oct 05 2016
Journal Name
Al-academy
Dialectical relationship between digital Technique and aesthetic Picture TV
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The technical development has significant effects on the mediator Alcinmatugrave, and TV originated mainly based on technical, with the development and the continuation of these technologies and the enormous impact on the level of the television picture, initially dramas in recent times approaching in the aesthetic composition of the film thanks to the employment of modern digital technologies, Montag was not only one of the cinematic elements that went into television thanks to technical developments analogue and digital, and which added the possibility of large processors in the picture, high-definition digital cameras that have led to dispense often for artificial lighting intensive imaging light available, as these cameras have helpe

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Analysis The Consistency Between The Tariff And The Exchange Rate And Their Reflection On The Trade Balance In Iraq
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       The trade balance is considered as a way to join the national economy with the world, So it is the mirror that reflect the economic center of the country and it is point to competitive ability of it, The tariff and the exchange rate perform a great role to motivate the domestic production and improve the trade balance if we direct them to achieve the same purpose. The Iraqi economic has trade balance which achieve overabundant during the years of studying because of the oil exports, while the other exports represent a small percentage it is hardly remember, and expansion in imports from other side causes exhaustion in oil revenues, and this make the trade balance in permanent

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Publication Date
Tue Jan 01 2019
Journal Name
Molecular Biology Research Communications
Association study of two single nucleotide polymorphisms rs10757278 and rs1333049 with atherosclerosis, a case-control study from Iraq
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Publication Date
Tue Jun 30 2015
Journal Name
College Of Islamic Sciences
Structural and contextual dimensions of the coming   Intervals Between that diluted and her experience
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In the name of of Allah the Merciful
Praise be to Allah, Lord of the Worlds, and prayers and peace be upon the Seal of the Prophets and Messengers. The envoy is a mercy to the worlds Muhammad Sadiq Al - Amin, and to the pure and good companions of the Tayyibites.
The formula of the morphological formulas, which have diverged from other meanings, whether lexicon or contextual and what this formula contains many meanings (effective source) and (effective in the sense of effective) and (effective sense reactor) and (effective sense) and ( (F) in the sense of a similar character) and ((the name of the) (collect). This was dealt with in the formula in Surat al-Nisaa a gramophone study. As mentioned in the study of the morphological subj

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Publication Date
Tue Jan 06 2004
Journal Name
Iraqi Journal Of Science
Cluster and factor analyses R and Q mode technique of geochemical and petrological data of the Shalair Metamorphic Rock Group, Shalair Valley area, Northeastern Iraq
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