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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 04 2022
Journal Name
Journal Of Educational And Psychological Researches
Social Factors for Delaying the Age of Marriage among Working-Women at the University of Baghdad
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The phenomenon of delayed marriage triggered the intention of most researchers and specialists to reveal the social factors associated with the spread of this phenomenon in order to identify the characteristics of that phenomenon and the social factors resulting from it. Thus, the current research aims to identify the social factors most related to the delay in marriage age among working-women at the University of Baghdad, represented by family factors, economic factors-professional, psychological factors – subjective, and environmental factors. The researcher also aims to identify the differences in social factors associated with late marriage age for working women at the University of Baghdad in terms of the type of profession (teach

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Publication Date
Fri Dec 22 2023
Journal Name
Eastern-european Journal Of Enterprise Technologies
Evaluating the impact of structure parameters on the acoustic performance of an exhaust muffler with shells
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Recently, environmental noise has arisen from various sources, such as those from exhaust mufflers of combustion engines found in cars, trucks, or power generators, which produce significant noise during their operation. Controlling the radiated noise from these mufflers is a major factor in improving acoustic comfort and minimizing the impact on the surrounding communities. Numerous research has been presented for this reason by modification of the internal structure of the exhaust muffler. The main objective of this work is to reduce the noise level emitted from exhaust mufflers. This can be achieved by adjusting structure parameters to attenuate the surrounding environment's radiated noise. Analysis of pressure-wave propagation h

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Publication Date
Sun Jan 01 2023
Journal Name
Materials Today: Proceedings
The influence of water-gypsum ratio on the properties of national gypsum (Jοss) for various additives
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Publication Date
Fri Nov 01 2024
Journal Name
Semiconductors
Effect of ZnO Doping on the Humidity Sensing Properties of the PVDF/PVA Polymeric Blend Films
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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Mechanical Engineering Research And Developments
Effect of the shot peening surface treatment on the corrosion behavior of 2024-T3 aluminum alloy
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Publication Date
Tue Dec 26 2017
Journal Name
International Journal Of Science And Research (ijsr)
Investigating the Effect of Using Waste Glass on the Properties of Asphalt Concrete Wearing Course Mixture
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The reuse or recycling of waste materials in different aspects of life is served the objective of sustainability and be beneficial to society. In recent years, a wide variety of waste materials were used in pavement construction. One of these materials is glass that generally produces in large quantities and crushed glass can be considered feasible alternative source of aggregate for asphalt mixture production. This study focused on examining the asphalt mixture properties of wearing course using crushed glass as fine aggregates. Fine crushed glass with various percentages by total weight retained on sieve 2.36 mm, 0.3 mm and 0.075 mm was used in the study. The results indicate that mixes containing crushed glass had lower Marshall stabilit

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Functional Satisfaction for Faculty Members To Girls College of Education at The University of Baghdad
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The aim of this research is to find out the satisfaction functional for faculty members
To Girls College of education at the University of Baghdad, and to find out the differences in this variable according to gender and qualification of education.
The sample was chosen from 60 teachers (males – females), they applied a questionnaire consisting of (30) paragraphs after the verifying of sincerity and persistence for paragraphs.
The main findings of the studies,
The results are indicated that the samples (faculty members) have a good level of satisfaction functional. In addition, results are shown; there are no significant differences of statistically between males and females for the faculty members. However, results are sho

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
Проблематика современного значения некоторых устаревших слов The misconception of the modern meaning of some old words
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The dictionary meaning of the word is a linguistic category of the thing in a specific way . it is also a brief description of it .The main function of the concept lies in the total scientific reflection of the things where as the main function of the meaning is a brief reference to a certain content (extralinguistic ) which shows human knowledge .   The meaning is (a storage unit ) of knowledge of the world ,but this does not give the extra linguistic meaning which the old words have . Hence, additional cultural ,ethnic,communicative

and genetic information is needed.

        All the old words which are brought into us

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Publication Date
Wed Apr 01 2009
Journal Name
Journal Of Engineering
THE EFFECT OF OPERATING CONDITION FOR CUMENE CRACKING ON THE PERFORMANCE OF PREPARED HX - ZEOLITE CATALYST
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The present study reports the effect of temperature and liquid hourly space velocity (LHSV) on the cumene cracking reaction rate and selectivity by using a laboratory continuous flow unit with fixed bed reactor operating at atmospheric pressure. The prepared HX zeolite was made from Iraqi kaolin with good crystallinity .The activity and selectivity of prepared HX-zeolite was compared with standard HY zeolite and HX zeolite catalysts in the temperature range of 673-823K and LHSV of 0.7-2.5 h-1 . It was found that the cumene conversion increases with increasing temperature and decreasing LHSV at 823K and LHSV of 0.7 h-1 the conversions 65.32, 42.88 and 59.42 mol% for HY, HX and prepared HX catalysts respectively and at LHSV of 2.5 h-1 and th

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Publication Date
Mon Oct 01 2012
Journal Name
Iraqi Journal Of Physics
The effect of sulfide content(x) on the electrical properties of (ZnSx Se1-x) thin films
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Thin films of ZnSxSe1-x with different sulfide content(x)
(0, 0.02, 0.04, 0.06, 0.8, and 0.1), thickness (t) (0.3, 0.5, and 0.7 μm) and annealing temperature (Ta) (R.T 373 and 423K) were fabricated by thermal evaporating under vacuum of 10-5 Toor on glass substrate. The results show that the increasing of sulfide content (x)and annealing temperature lead to decrease the d.c conductivity σDC of and concentration of charge carriers (nH) but increases the activation energy (Ea1,Ea2), while the increasing of t increases σDC and nH but decrease (Ea1,Ea2). The results were explained in different terms

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