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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 Oct 01 2018
Journal Name
Iraqi Journal Of Physics
SiO2 particles effect on the mechanical properties of the starch/PVA blends
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The present work studies the mechanical properties of SiO2 μPs, and NPs in St/PVA blends. The samples were prepared by casting method as PVA, St/PVA blends at different concentrations (30, 40, 50, and 60 %). DSC and TGA tests were carried out to the samples evolved. The result showed a single glass transition temperature (Tg) for all St /PVA blends that was attributed to the good miscibility of the blends involved. It was found that (Tg) decrease with starch ratio increase. It was seen that (PVA) of (Tg=105 oC); The glass transition temperature which was decrease with starch ratio that was attributed to glass transition relaxation process due to micro-Brownian motion of the main chain back bond. The endothermic peak at 200 oC was attrib

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Use of Replacement Models On Determine the Optimal Time to Replacement
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Abstract:-

            The approach maintenance and replacement one of techniques of operations research whom cares of the failure experienced by a lot of production lines which consist of a set of machines and equipment, which in turn exposed to the failure or work stoppages over the lifetime, which requires reducing the working time of these machines or equipment below what can or conuct  maintenance process once in a while or a replacement for one part of the machine or replace one of the machines in production lines. In this research is the study of the failure s that occur in some parts of one of the machines for the General Company for Vege

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
The shapes of adjacent structures for informing the stage show for children
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This research talked about the importance of adjacent structures for informing the stage show for children. The researcher began from the importance of adjacent structures for informing the show to introduce the various and different proofs, on the level of creativity and artistic shape of the accomplishment over it’s shifts that contribute to formation the show and it's intellectual, artistic, technical and cognitive Marks that contribute in dynamism the interactive show and contact the idea that connect with the design and directional vision for the beauty and cognitive. Lead to the eager operation in attention, sensitive and attractive the child. The research consist of four chapters: The first chapter include methodological framewo

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Publication Date
Sat Oct 20 2018
Journal Name
Journal Of Economics And Administrative Sciences
Measuring the performance of government units according to the government accounting system
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Abstract

This study aims at clarifying the current performance appraisal system in government units and the extent to which they contribute to the development of the performance of these units by evaluating and measuring the performance of these units on an ongoing basis to subject their services to an assessment and measurement process in order to improve the efficiency of these units to reach their objectives efficiently and effectively. (Iraqi hospitals) by trying to determine the possibility of the government accounting system in the process of evaluating performance, through the comparison of financial performance for successive years and different hospitals using the financial and non-financial model of the evaluati

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Publication Date
Sun Sep 04 2011
Journal Name
Baghdad Science Journal
Spectroscopic Study for Resonance Effects on the Carbonyl Double Bond Order in Urea Schiff Bases Which Contain Conjugated System
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In this work we prepared some schiff bases by condensation urea and benzaldehyde or its derevative ( bromo benzaldehyde or hydroxy benzaldehyde ) as ( 1 : 1 ) mole ( urea : benzaldehyde or its substitution ) to prepare compounds ( A1 , B1 , C1 , D1 , E1 , F1 , G1 ) and ( 1 : 2 ) mole ( urea : benzaldehyde or its substitution ) to prepare compounds ( A2 , B2 , C2 , D2 , E1 , F2 , G2 ) . The prepared compounds identified spectroscopic by infrared spectroscopy FT-IR and Thin layer chromotography T.L.C . The force constant calculated from the wave number for the carbonyl stretching from FT-IR chart and by using the following equation K = 4?2C2?'2? The change in double bond order for carbonyl deteremined in according with some past re

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Publication Date
Wed Dec 29 2021
Journal Name
Al-khwarizmi Engineering Journal
Comparison of Prediction Programs for Short Wave Circuit Link from Iraq to Test points on Both Earth Hemispheres during Solar Minimum
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This paper compare  the accurecy of HF propagation  prediction programs for  HF circuits links between Iraq and  different points world wide  during August 2018 when  solar cycle 24 (start 2009 end 2020) is at minimun activity and also find out the best communication mode  used. The prediction   programs like Voice of America Coverage Analysis Program (VOACAP) and ITU Recommendation RS 533 (REC533 )  had been used to generat HF circuit link  parameters like Maximum Usable Frequency ( MUF) and Frequency of Transsmision (FOT) .Depending  on the predicted parameters (data)  , real radio contacts had been done using a radio transceiver from Icom  model IC 7100 with 100W RF

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The instrumental support search strategies and avoid coping to psychological stressors and their relationship to the cognitive motivation of Al-Anbar University students.
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the Current research aims to identify the psychological stressors coping strategies and their relationship to the cognitive motivation among Al-Anbar University students through the following hypotheses: 1) no statistically significant differences at a level (0.05) among the sample according to the instrumental support strategy depending on the variable type and specialization, 2) No statistically significant differences at a level (0.05) among the sample in regard of coping avoiding strategy depending on the variable type and specialization, 3) There is no statistically significant difference at a level (0.05) in cognitive motivation level among Al-Anbar University students, 4) No statistically significant differences at a level (0.05)

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Publication Date
Sat Jun 04 2022
Journal Name
Journal Of Inorganic And Organometallic Polymers And Materials
Improving the Mechanical Properties, Roughness, Thermal Stability, and Contact Angle of the Acrylic Polymer by Graphene and Carbon Fiber Doping for Waterproof Coatings
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Publication Date
Sat Apr 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
The Relationship Between the Above-Ground Biomass and the Vegetation Cover Indices at Different Salinity Levels
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Abstract<p>The current study was carried out to find out the relationship between the Above-Ground Biomass and the spectral vegetative indices (Normalized Difference Vegetation Index, Soil Adjusted Vegetation Index, Difference Vegetation Index) (NDVI, SAVI, DVI) for soils with different salinity levels. Al Salamiyat Project was chosen as a study area located at an altitude of 34 m above sea level and within the geographical coordinates (E 44°.09´13.65´´ N 33°.25´ 07.87´´ and E 44°.17´ 46.03´´ N 33°.2l´40.72´´), with a total area of 14265 Dunum. Surface and subsurface soil samples were chosen from the study area and according to the previously defined salinity units, except for th</p> ... Show More
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Publication Date
Sat May 11 2024
Journal Name
Tech Hub Journal
The prevailing leadership Patterns and personal traits and their relationship to innovative thinking of female physical education teachers in middle schools in Baghdad
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Teachers play a critical role in planning, organizing, coordinating, monitoring, and instructing, hence the topic of leadership styles receives a lot of attention. As a result, the physical education school is regarded as the most significant component of the educational process because it has the ability to weave together the teaching and educational skills, attitudes, and capacities that its students develop. Fits into their identities through her relationship with them. Teachers play a critical role in planning, organizing, coordinating, monitoring, and instructing, hence the topic of leadership styles receives a lot of attention. As a result, the physical education school is regarded the most significant aspect in the educational proces

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