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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
Mon Apr 14 2014
Journal Name
Elsevier Procedia Economics And Finance
Economic Growth and Foreign Direct Investment Inflows: The Case of Qatar
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Recently, Qatar, a well-known oil production country, has been convinced as a successful case in attracting foreign direct investment (FDI) as a smaller economy. This paper aims to investigate how FDI inflows affect Qatar’s business cycles. Time series data was selected from 1990 to 2010 as available. The VAR Impulse Responses and the Granger Causality test were mainly employed by using Eviews. The derived result shows that the FDI inflows and the economic growth in Qatar interact with each other in a relatively long term.

Publication Date
Thu Nov 01 2018
Journal Name
قضايا سياسية
The Iraqi Constitution of 2005: Between Constitutional Stagnation and Political Stagnation
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Browse Iraqi academic journals and research papers

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Publication Date
Sat Nov 02 2013
Journal Name
Arabian Journal Of Geosciences
Facies architecture and basin development of the Qamchuqa succession, NE Iraq
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Publication Date
Sat Aug 31 2019
Journal Name
Iraqi Journal Of Physics
Investigate Salts type and concentration on the conductivity of Polymer Electrolyte
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Polymer electrolytes systems compose of (PEO+KI+I2) and (PEO+RbI+I2) with different concentration, and a fixed amount of ethylene carbonate (EC) and propylene carbonate (PC) over temperatures range 293-343 K prepared by solution cast me

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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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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
Wed May 26 2021
Journal Name
Communications In Mathematical Biology And Neuroscience
Modelling and stability analysis of the competitional ecological model with harvesting
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The interplay of predation, competition between species and harvesting is one of the most critical aspects of the environment. This paper involves exploring the dynamics of four species' interactions. The system includes two competitive prey and two predators; the first prey is preyed on by the first predator, with the former representing an additional food source for the latter. While the second prey is not exposed to predation but rather is exposed to the harvest. The existence of possible equilibria is found. Conditions of local and global stability for the equilibria are derived. To corroborate our findings, we constructed time series to illustrate the existence and the stability of equilibria numerically by varying the different values

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Publication Date
Sun Jan 01 2023
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Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte
THE PSYCHOLOGICAL EFFECTS OF PERFECTIONISM ON SPORT, ECONOMIC AND ENGINEERING STUDENTS
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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of accounting standards, audit and finances in control On agricultural activity to achieve sustainable development
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The agricultural activity has a great significance in the all four dimensions of sustainable development. Firstly, the economic dimension which it contributes with the GDP, as well as, it is considered as an important source to attract the investment. Secondly, the environmental dimension which also contributes with conserving of the biodiversity, combating the desertification, and increasing the farmlands. Thirdly, for its role in the social dimension to achieve the food security, to eradicate the poverty, and providing jobs. Fourthly, toward the institutional dimension as well it is considered as a source that allows all people to participate effectively, and to exchange of the local and universal experiences and perspectives. For conf

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