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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
Fri Oct 28 2022
Journal Name
Political Sciences Journal
The Path of China-India Relations After 2013: Opportunities and Challenges
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China and India are considered both rising countries, and both are among the world's most populous and fastest growing economies. The long-term growth of both China and India has reinforced the importance of their bilateral relationship. The relations between China and India are complex, as relations between them have undergone great changes during the past seven decades, ranging from friendship to hostility. This study proceeds from the hypothesis that the nature and path of Sino-Indian relations after 2013 are affected by several factors and variables, some of which represent opportunities, others represent challenges and obstacles. Several opportunities have contributed to the reformulation of bilateral relations in terms of mutual ga

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Publication Date
Sat Jul 01 2023
Journal Name
Chalcogenide Letters
Investigating the optical and electrical characteristics of As60Cu40-xSex thin films
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In this work, As60Cu40-xSex thin films were synthesized, and the pulsed laser deposition method was used to study the effected partial replacement of copper with selenium. The electrical characteristics and optical characteristics, as indicated by the absorbance and transmittance as a function of wavelength were calculated. Additionally, the energy gap was computed. The electrical conductivity of the DC in the various conduction zones was calculated by measuring the current and voltage as a function of temperature. Additionally, the mathematical equations are used to compute the energy constants, electron hopping distance, tail width, pre-exponential factor, and density of the energy states in variation zones (densities of the energ

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Advanced Pharmacy Education And Research
The effect of formulation and process variables on prepared etoricoxib ‎Nanosponges
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Publication Date
Sun Sep 04 2016
Journal Name
Baghdad Science Journal
Studying The Optical Properties of CdO and CdO: Bi Thin Films
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Cadmium Oxide and Bi doped Cadmium Oxide thin films are prepared by using the chemical spray pyrolysis technique a glass substrate at a temperature of (400?C) with volumetric concentration (2,4)%. The thickness of all prepared films is about (400±20) nm. Transmittance and Absorbance spectra are recorded in the wave length ranged (400-800) nm. The nature of electronic transitions is determined, it is found out that these films have directly allowed transition with an optical energy gap of (2.37( eV for CdO and ) 2.59, 2.62) eV for (2% ,4%) Bi doped CdO respectively. The optical constants have been evaluated before and after doping.

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Publication Date
Sun Jul 01 2018
Journal Name
Computers &amp; Mathematics With Applications
Analytical and numerical solutions for the nonlinear Burgers and advection–diffusion equations by using a semi-analytical iterative method
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Publication Date
Thu Jan 24 2019
Journal Name
Journal Of Education College Wasit University
Postmodernism and Technology in Don Delillo's Novel The White Noise
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This paper aims at investigating the effect of postmodernism and technology on the social life in Don Delillo's novel The White Noise. In this novel, Don Delillo portrays the chaotic life by using modern technology which has been presented by three ways. The first way is by television as being a source of information and entertainment. The second way is by the toxic event whereas the third is by Dylar's episode and its destructive consequences. He depicts that through the atmosphere of Jack's family plus its effects on the life and thoughts of the elders and society. He proves that technology is leading humanity not to safety, but to death. He further highlights that by showing the impact of technology on the life of the main charac

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Publication Date
Sun Dec 16 2018
Journal Name
Al-academy
The Pressing References towards Abstraction in Arab and Islamic Art
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The Arab Islamic art was best known as pure abstraction or realism distorted from what is natural. The two styles, or one of them, was the most prominent in the Islamic arts, such as decoration, photography and architecture. The analogy that was prevalent in the non-Islamic world did not have a presence equivalent the aforementioned styles despite the great openness to the cultures of different countries, which characterized that stage, which resulted from the Islamic conquests, the conversion of many people to the Islamic faith, and their migration to the Islamic cities at the time, bringing with them their arts and methods of formulation. This makes us question the influential references that invite the Arab Muslim artist to follow the

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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 Jun 20 2018
Journal Name
Al-academy
Style in contemporary Iraqi painting before and after the war
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What happened on the Iraq war in 2003 put the problematic about what can happen from a shift in the style of individual or collective in contemporary Iraqi art similar to what is known in the history of the modern art world.

It wanted the researcher to identify this dilemma in academic study looking for an explanation of this Alastfhamat from the entrance of the definitions shows laparoscopic destination, as it determines the address (b style in painting contemporary Aeraa before and after the war) was a comparative analysis, through a choice of two Iraqi artists who have production style known sets since before the war, in order to read the transformation that took place in art before and after their tactics, and in order to off

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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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