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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
Sun Mar 01 2009
Journal Name
Baghdad Science Journal
Evaluation of the electron correlation for lithium atom (Li) in ground state
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The aim of this work is to study the correlation between the electrons for Li atom in ground state through the calculation of the inter-particle distribution function f (r12) and inter-particle expectation values . By using the f(r12) function for KL shell in both singlet and triplet state .The Fermi hole have been evaluated .In this work the Hartree-Fock wave function (1993) have been used.

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Publication Date
Sat May 30 2020
Journal Name
Neuroquantology
Desertification Monitoring in the South-West of Iraqi Using Fuzzy Inference System
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In this research, the region in the south-west of Iraq is classified using a fuzzy inference system to estimate its desertification degree. Three land cover indices are used which are the Normalized Difference Vegetation Index, Normalized Multi-Band Drought Index and the top of atmosphere surface temperature to build a fuzzy decision about the desertification degree using eight decision roles. The study covers a temporal period of 38 years, where about every 10 years a sample is elected to verify the desertification status of the region, starting from 1990 to 2018. The results show that the desertification status varied every 10 years, wherein 2000 encountered the highest desertification in the south-west of Iraq.

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Publication Date
Tue May 09 2023
Journal Name
Buildings
Identification of Desired Qualifications for Construction Safety Personnel in the United States
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Construction is a hazardous industry with a high number of injuries. Prior research found that many industry injuries can be prevented by implementing an effective safety plan if prepared and maintained by qualified safety personnel. However, there are no specific guidelines on how to select qualified construction safety personnel and what criteria should be used to select an individual for a safety position in the United States (US) construction industry. To fill this gap in knowledge, the study goal was to identify the desired qualifications of safety personnel in the US construction industry. To achieve the study goal, the Delphi technique was used as the main methodology for determining the desired qualifications for constructio

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Publication Date
Sat Dec 15 2018
Journal Name
Journal Of The College Of Education For Women
Identity Crisis in the Novel Cuffs of Papers for Yusef Hadi Mays
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This research deals with the study of the identity lost in the novel (handcuffs of paper) by Writer (Kuwaiti / Iraqi ) Yousif Hadi Mays.This is because of The strange subject presented by the writer ,Kuwait has chosen a sbace for his novel and chose apurely Kuwaiti theme. Hence the importance of the novel, as it came to the subject of identity completely dntdiffere from what we wwrote after the fall off the regime (2003), Which is related to the last coming from outside the country, which remained oscillataing between his mother,s identity where language, religion and history and  the identity of the other by virtue and dazzling, and integration and here con not belong to either party. This is a violation of the taboos of

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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of The College Of Languages (jcl)
Pushkin quotes in the works of Chekhov: Пушкинские цетаты в произведениях чехова
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Pushkin's quotations in Chekhov's works are one of the means of expressing connections between texts, performing the most important constructive role: behind them Chekhov reveals a deep development of the plot-thematic structure, ideas and, more broadly, Pushkin's artistic philosophy.

The scientific relevance of our work is the analysis of the similarities between the literary texts of Pushkin and Chekhov, and touches on quotations in Chekhov's works.

Аннотация

Работа посвящена проблеме функционирования пушкинской традиции в прозе А.П. Чехова . Творчество Чехова занимает уникальное

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Publication Date
Mon Mar 15 2021
Journal Name
Al-academy
Virtual Art Exhibitions In Times Of The Corona Pandemic: منى سعد القرني
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This study aims to identfy virtual plastic art exhibitions in light of the challenges of the Corona pandemic. It used a descriptive analytical method through several questions and examining future challenges via the Internet in publishing virtual plastic art exhibitions in many parts of the world in light of the challenges of the Corona pandemic. For that, it used Arab and foreign references.
The study reached many results, the most important of which are: The detection of virtual reality applications and their impact on the plastic arts exhibitions sector. Besides, the insights gained from future art gallery research with VR technology could provide direct and practical value for this sector. By using a technology, similar to the “

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Publication Date
Wed Mar 15 2023
Journal Name
Journal Of Survey In Fisheries Sciences
The Correlation of DAZ1 Gene Methylation with Azoospermia in Iraqi Infertile Men
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After about twelve months or maybe more, some people can’t achieve pregnancy. This might be a sign of infertility as a reproductive system disease. The following study was carried out to investigate the DAZ 1 gene methylation level and its association with azoospermia in Iraqi patients. One hundred and fifty human blood samples were collected from from different regions in Baghdad governorate, including (private medicals Labs and the high institute for infertility diagnosis assisted reproductive techniques and Kamal Al- Samara'ay IVF Hospital) from both fertile and infertile men. The control group consists of 50 samples ranging from 22 to 51 years old, while the patient (infertile group) consists of 100 samples ranging between 25 and 51 y

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Publication Date
Wed Dec 19 2018
Journal Name
Brazilian Journal Of Physics
The Induced Electron Density Effects of Swift Heavy Ions in Polymethyl Methacrylate
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Publication Date
Sun Jul 09 2017
Journal Name
Current Research In Microbiology And Biotechnology
The chronic effects of glucosamine sulfate (GS) on kidney in Albino Mice
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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Measure of The Capital Adequacy in Islamic Banc According to Basle II
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Capital Adequacy is on of the most importance of financial position element because its role is enhance against varions risks of Banking procese . Which this risks is a result of the nature of its operations , investment , Financing tools in addition , in order to  Faced any clients withdraws un expected .

So This study aim to measure The Capital Adequacy according to basel II and explin the different risk in  the Islamic Bank as aresult to nature and different investment and financing tools as participation speculation , murabah and natures of its assets and liabilities related to commercial banks .

Find out we concludes that the Islamic Banks needs to increase the ca

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