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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 Mar 08 2021
Journal Name
Baghdad Science Journal
Manufacturing concentrates Alholucramih for use in increasing the efficiency of solar cell
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A new way to Systems concentrates have been clarified and that allows a concentration high and analysis to automatically wavelengths of the spectrum of this system analyst of the spectrum and the center is built on Holucram Nafez gives less absorbency with efficient diffraction high when the wavelength (900 nm), which will be useful for Khallaya solar

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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Effect of Discussion Techniques in Composition performance for The fifth preparatory student
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The present study aims at knowing the effect of discussion method for students of fifth grade in preparatory school.

Methodology of the Study:

          In order to achieve the objective of the study, the researcher chooses non-randomly the preparatory school affiliated to the District Chamchamal \ Suliemnaniya. The sample attained 64 students in 32 per group (control and experimental) groups. The researcher used the discussion method which was applied on experimental group. She uses the traditional method on the control group.

The researcher matched the two group in ago, intelligence, marks at the Kurdish Language in the previous year , pretest and posts for the indepe

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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
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
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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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
The Effect of Assessment Techniques on EFL Learners’ achievement in TOEFL Test
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While many educators are highly focused on state test, it is important to consider that
over the course of a year, instructors can build in many opportunities to assess how learners
are learning. Therefore, assessment techniques are considered a good method to get benefit
for both instructors and learners in the process of teaching and learning. The sample consists
of 27 learners who participated in TOEFL training course in the Development and Continuous
Education Centre. Validity and reliability were verified.
To fulfill the aims and verify the hypothesis which reads as follows” It is hypothesized
that the TOEFL learners' scores will not be increased after TOEFL course training.” T-test
for two dependent samp

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