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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 Dec 04 2016
Journal Name
Baghdad Science Journal
A comparative anatomic study of leaves of the genus Stachys L. in Iraq
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The anatomic characteristics of the leaves of 22 taxa of Stachys L. representing seven of the currently recognized sections distributed in northern Iraq, were examined. The study did not found any variations in the characteristics of the stomata system of the leaves.Therewere variations with a good taxonomic value in other anatomic characteristics.Thevariations in characters of the mesophyll tissue in S.kurdica var.brevidens Bom ex Bhattacharjeewas bifacial but in S.kurdica var.kurdica Boiss. & Hohen.was unifacial .The study also found that the taxa S.benthamiana Bioss., S.lanigera (Bornm.) Rech.f. andS.kotscyi Bioss. with 3 vascular bundles in the middle vein while the taxa S.ballotiformis Vatke., S.megalodonta Hausskn. &Bo

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Publication Date
Thu Jun 29 2017
Journal Name
College Of Islamic Sciences
Qur'anic contextual integration of the end of heaven: (a study in scientific interpretation)
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In The Name of Allah Most Gracious Most Merciful

This is a study dedicated to explaining the conditions of the end of heaven, stage by stage; And to draw the final picture of it, through the facts of the Qur’an, and to make the contextual integration of the verses of the end of heaven, and their arrangement in an intentional arrangement, a path that guides us to knowing the integrated picture of it on the Day of Resurrection, according to scientific interpretation.

The importance and usefulness of the research lies in:

Extracting the order of the stages of the end of heaven, from its first state to its last, which came in separate verses of the Qur’an, each one of which was placed in a surah that was consistent w

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Publication Date
Fri Aug 19 2022
Journal Name
International Journal Of Health Sciences
A study of the mechanical and electrical activities of the heart and their relationship to the phosphagenic and lactic energy systems of young basketball players
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It was found that there was a significant correlation between all tests of the mechanical and electrical activity of the heart (systolic force FC, stroke volume SV, end-diastolic volume, EF volume, and left ventricular volume during diastole LVDD) with the test of the oxygen-phosphating energy system (Markaria). - As safe (Margaria-Kalamen( It was found that there is a significant correlation between all tests of the mechanical and electrical activity of the heart (myocardial systolic force FC, stroke volume SV, end-diastolic volume EDV, and the percentage of heart pumpingEF blood, and left ventricular volume during diastole (LVDD) with the Lactational Oxygen Energy System Test (Wingate Test 30 Second(

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Publication Date
Sat Dec 11 2021
Journal Name
Neuroquantology
Investigate and Calculation Electron Transfer Rate Constant in the N749 Sensitized Dye Contact to ZnSe Semiconductor
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The dye–semiconductor interface between N749 sensitized and zinc semiconductor (ZnSe) has been investigated and studied according to quantum transition theory with focusing on the electron transfer processes from the N749 sensitized (donor) to the ZnSe semiconductor (acceptor). The electron transfer rate constant and the orientation energy were studied and evaluated depended on the polarity of solvents according to refractive index and dielectric constant coefficient of solvents and ZnSe semiconductor. Attention focusing on the influence of orientation energies on the behavior of electron transfer rate constant. Differentdata of rate constant was discussion with orientation energy and effective driving energy for N749-ZnSe system.

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Publication Date
Wed Aug 04 2021
Journal Name
Ibn Al-haitham International Conference For Pure And Applied Science (ihicps)
Effect of Annealing on structural and optical properties of Indium Selenide (InSe) Thin films prepared by vacuum THERMAL EVAPORATION TECHNIQUE
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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
ترجمه هاى تكرارى وعوامل ظهور آن Repeated Translations and the factors that Affect their Appearance
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Abstract

 

     My research dealt with the phenomenon of  repeated translation.

First Section deals with identifying repeated translation from both linguistic and terminological sides . Section two display the reasons and factors that stand behind this phenomenon while section three sheds light on the positive and negative sides of the phenomenon understudy and in  the last section , the researcher sets several recommendations which lead to prevent the widespread of repeated translation phenomenon .

 

چکیده

    این بحث که با عنوان (ترجمه های تکرار

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Green Regulatory Tapes and Their Reflections on the Job Development - A Study for the Sample of Employees in the Nineveh Directorate for Bridges & Roads
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The performance of job effectively requires narrowing the meaningful routine activities and attempting employing the job procedures in favor of public welfare through adding the green impact as well as removing them from the red tapes which reflect the firmness of procedures, to enable the job parties to make their job independently, and pushing them to gain priority in the competition layer. This is not attaining easily amidst the regulatory problems expressed by the complication of procedures, the thing which make identifying the problem of the study through the following question:

Should we make the complex of procedures and their firmness a way to adopt the idea of the green regulatory tapes supportin

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Publication Date
Fri Dec 01 2017
Journal Name
International Journal Of Science And Research (ijsr)
Histological Study of Some Isolation Fungi from Iraq / Baghdad Hospitals Apparatus that affected in Liver, Kidney and Testes in Albino Mice
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Publication Date
Tue Mar 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Employing the indicators of stereotypes and the dimensions of organizational clarity and their role in achieving the planned organizational behavior Analytical study on a sample of workers in some departments of the Faculties of Engineering, University of
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The current research examines the employment of indicators of stereotypes and the dimensions of organizational clarification to achieve planned organizational behaviour on a sample of employees in a number of departments of the Faculties of Engineering, University of Kufa, for a sample of (122) teaching staff. This research proposes the use of positive indicators of stereotypes for both the organization and employees and their awareness of what they want to obtain and what should be done for both parties and the removal of organizational clarity represented by the functional dimension that explores to what degree the employee's understanding of the internal strategy of the organization and the strategic dimension that searches fo

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Tax Exemptions and their impact in reducing the phenomenon of tax evasion: A field study
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The research aims to verifying the tax exemptions granted in accordance with the Iraqi tax legislations, showing their suitability for basic tax rules, and identifying their role to reduce the tax evasion phenomenon and the negative effects resulting therefrom, which arerepresented by a decrease in the proceeds of tax revenue and therefore leadings to a reduction of public revenues of the state. Also, the research tries to identify the ways to reduce cases of tax evasion due to their reflection positively on the public budgetof the state. The data of the research was collected through two models of questionnaires distributed to a sample of taxpayers from some professions and a sample of the tax administration staff. The research has reac

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