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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 Sep 09 2022
Journal Name
Journal Of Ovonic Research
Effect of dopant of aluminum on the structural and optical properties of NiTsPc thin films
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The (NiTsPc) thin films operating by vacuum evaporation technique are high recital and good desirable for number of applications, were dumped on glass substrates at room temperature with (200±20nm) thickness and doped with Al at different percentage (0.01,0.03) besides annealing the sample with 200˚C for 1 hours . The stimuluses of aluminum dopant percentage on characterization of the dropped (Ni Ts Pc) thin films were studied through X-ray diffraction in addition from the attained results, were all the films have polycrystalline in nature, as well the fallouts of XRD aimed at film illustrations polycrystalline, depending on the Al ratio doping, the results, SEM exposed the surface is regularly homogeneous. Utilizing first-ideolog

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Publication Date
Sat Jan 12 2019
Journal Name
Journal Of The College Of Education For Women
Self- Awareness of Emotions and its Relation to the Way of Helping of Kindergardens' Children
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The self-awareness interactions reflects with emotions,assess the child in respect to its relations with the social standards; they are not merely simply reactions , but rather they connect with his moral behavior and other 's thinks. When the self- awareness gets developed with emotions within the child , the latter become highly sensitive, causing him prone to be blamed . AS a result , the children test the self –awareness interactions with emotions and in age 3 years , where the self –awareness interactions with emotion clearly link to the self- assessment. The children in stage of kindergarten could not describe the self-awareness interactions accurately ; they test it under different circumstances in comparison to the youngest o

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Awareness of the problem technological poisoning Media of parents of kindergarten children and their teachers
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The childhood stage is considered the most important stage of all the stages through
the human being’s life. In this stage the human being will be more affected by the various
factors that surround him/her. The first five years of his/her life leave a great impact not only
on the human being personality, but also on his/her whole life. Therefore, it is worthwhile tobe concerned with and focus at the raising up and the teaching of the child during the
childhood stage.
The mission of raising up children in this era - the era of globalization and information
bursting or news flooding – has become a very difficult or even an impossible mission.
Furthermore, not only in the Arabic world, but also all over the world, t

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Ovonic Research
Effect of dopant of aluminum on the structural and optical properties of NiTsPc thin films
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Publication Date
Tue Feb 01 2022
Journal Name
Academy Of Accounting And Financial Studies Journal
EFFICIENCY OF PERFORMANCE AND COLLECTION OF INCOME TAX -REALISTIC VIEW OF THE GENERAL TAX AUTHORITY
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The process of evaluating and measuring tax performance is critical to support the tax collection process. The comparison of the amount of revenue collection with what is expected and the process of measuring tax performance continuously by the tax administration leads to increase the collection of tax, determine the size of deviations and stand and know the reasons and take the necessary measures to address them to get a better result in the future. According to the different tasks assigned to them, criteria and indicators for measuring the tax performance vary from one organization to another. These are indicators or criteria that measure tax revenue (i.e., amounts). One of the research's main findings was to raise the tax collection leve

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Effect of irrigation type and method on the cost of producing dunum of wheat crop
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Abstract :  This research is concerned with studying the best type and method of  irrigation as well as the best cultivated area to reduce the cost of producing  dunums of wheat crop in Iraq , and was based on data taken from the Ministry of Planning / Central Statistical Organization About cost of wheat crop production for (12) Iraqi governorates except Kurdistan, Nineveh, Salah al-Din, Anbar) and the sample size (554) according to the cost survey carried out by the Ministry of Planning / Central Statistical Organization for 2017, The results of the research showed that there are significant statistical differences between production costs when using t

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Publication Date
Wed Jan 01 2020
Journal Name
Plant Archives J.
Evaluation of the performance of introduced varieties of maize under different planting dates and environments
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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Stress and Its Associated Factors among Students of the College of Nursing University of Baghdad
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Objectives: The current study aims at identifying the level of perceived stress among nursing college students and determining the factors associated with stress they have. Methodology: A cross-sectional descriptive study initiated for the period on November 1st, 2014 to May 1st, 2015. The study has been conducted on the undergraduate nursing college students / University of Baghdad. The sample of the study was consisted of (128) students who were selected purposively. The questionnaire of the study was adopted and modified for the present study which consisted of socio-demographic data and the scale of

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Publication Date
Fri Feb 12 2016
Journal Name
International Journal Of Applied Mathematical Research
The dynamics of nutrient, toxic phytoplankton, nontoxic phytoplankton and zooplankton model
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<p>The objective of this paper is to study the dynamical behavior of an aquatic food web system. A mathematical model that includes nutrients, phytoplankton and zooplankton is proposed and analyzed. It is assumed that, the phytoplankton divided into two compartments namely toxic phytoplankton which produces a toxic substance as a defensive strategy against predation by zooplankton, and a nontoxic phytoplankton. All the feeding processes in this food web are formulating according to the Lotka-Volterra functional response. This model is represented mathematically by the set of nonlinear differential equations. The existence, uniqueness and boundedness of the solution of this model are investigated. The local and global stability

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Publication Date
Sun Jan 22 2012
Journal Name
Arabian Journal Of Geosciences
Geohistory analysis and basin development of the Neogene succession, NE Iraq
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