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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
Tue Feb 12 2019
Journal Name
Iraqi Journal Of Physics
A study of the structural and electrical properties of Ni1-x Cox Fe2O4 ferrites
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Ferrite with general formula Ni1-x Cox Fe2O4(where x=0.0.1,0.3,0.5,0.7, and 0.9), were prepared by standard ceramic technique. The main cubic spinel structure phase for all samples was confirmed by x-ray diffraction patterns. The lattice parameter results were (8.256-8.299 °A). Generally, x -ray density increased with the addition of Cobalt and showed value between (5.452-5.538gm/cm3). Atomic Force Microscopy (AFM) showed that the average grain size and surface roughness was decreasing with the increasing cobalt concentration. Scanning Electron Microscopy images show that grains had an irregular distribution and irregular shape. The A.C conductivity was found to increase with the frequency and the addition of Cobal

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
A study of the Effect of Air Inlet and Exit on Indoor Air Movement
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This work consists of a numerical simulation to predict the velocity and temperature distributions, and an experimental work to visualize the air flow in a room model. The numerical work is based on non-isothermal, incompressible, three dimensional, k turbulence model, and solved using a computational fluid dynamic (CFD) approach, involving finite volume technique to solve continuity, momentum and energy equations, that governs the room’s turbulent flow domain. The experimental study was performed using (1/5) scaled room model of the actual dimensions of the room to simulate room air flow and visualize the flow pattern using smoke generated  from burnt herbs and collected in a smoke generator to delivered through

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Prepare a plan for the Total Productive Maintenance in the light of the concurrent engineering A Field Study in AL-Askandria General Company Machanical Industries and AL-Musaib Electric Power Station
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           Strives Total Productive Maintenance  to increase the overall effectiveness of the equipment through the early involvement in the design and manufacture of equipment productivity. It also operates in an environment of simultaneous engineering work on the synchronization of activities to take advantage of early information by maintenance engineers, design, operation, and that helps to reduce the faults and facilitate future maintenance tasks.

    Has adopted a search in the theoretical concept of the total maintenance productivity and concurrent engineering activities carried out during which the conjunction a

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Publication Date
Wed Jul 01 2015
Journal Name
Arabian Journal Of Geosciences
Mishrif carbonates facies and diagenesis glossary, South Iraq microfacies investigation technique: types, classification, and related diagenetic impacts
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Publication Date
Mon Dec 27 2021
Journal Name
Palarch's Journal Of Archaeology Of Egypt/egyptology
The social and artistic connotations of the mural paintings of the Iraqi woman in the popular movement-an analytical study
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In the contemporary political history of Iraq, a unique protest broke out on October 1st, 2019. This protest reappeared on October 25th and lasted up to the following weeks making this protest as the most comprehensive and deepest one. It has the possibility of lengthening and the diversification of methods among all the social protesting movements during the century for Iraq. This desperate youth movement presents various images and methods to highlight the image of the protesting movement. The role of the Iraqi woman was clear, which was embodied through the mural paintings expressing her artistic and social role in conveying and expressing the goal of the protest. The aim of the current research is to identify the social artistic implica

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Publication Date
Wed Mar 18 2020
Journal Name
Baghdad Science Journal
The A Comparative Study of the Adsorption of Crystal Violet Dye from Aqueous Solution on Rice Husk and Charcoal
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n this work, the adsorption of crystal violet dye from aqueous solution on charcoal and rice husk has been investigated, where the impact of variable factors (contact time; the dosage of adsorbent, pH, temperature, and ionic strength) have been studied. It has been found that charcoal and rice husk have an appropriate adsorption limit with regards to the expulsion of crystal violet dye from fluid arrangements. The harmony adsorption is for all intents and purposes accomplished in 45 min for charcoal and 60 min for rice husk. The amount of crystal violet dye adsorbed (0.4 g of charcoal and 0.5 g of rice husk) increased with an increasing pH and the value of 11 is the best. The effect of temperature on the adsorption process was studied

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Publication Date
Wed Mar 18 2020
Journal Name
Baghdad Science Journal
The A Comparative Study of the Adsorption of Crystal Violet Dye from Aqueous Solution on Rice Husk and Charcoal
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            In this work, the adsorption of crystal violet dye from aqueous solution on charcoal and rice husk has been investigated, where the impact of variable factors (contact time; the dosage of adsorbent, pH, temperature, and ionic strength) have been studied. It has been found that charcoal and rice husk have an appropriate adsorption limit with regards to the expulsion of crystal violet dye from fluid arrangements. The harmony adsorption is for all intents and purposes accomplished in 45 min for charcoal and 60 min for rice husk. The amount of crystal violet dye adsorbed (0.4 g of charcoal and 0.5 g of rice husk) increased with an increasing pH and the value of 11 is the best

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Publication Date
Fri Dec 02 2022
Journal Name
Nankai Business Review International
Evaluating the dimensions of strategic intent according to the Hamel and Prahalad model/a case study in Oil Projects SCOP Company
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Purpose

The purpose of this study is to examine the dimensions of strategic intent (SI; see Appendix 1) according to the Hamel and Prahalad model as a building for the future, relying on today’s knowledge-based and proactive strategic directions of management as long-term and deep-perspective creative directions, objective vision and rational analysis, integrative in work, survival structure and comprehensiveness in perception.

Design/methodology/approach

The quantitative approach was used based on research, detection and proof, as data were collected from leader

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Publication Date
Mon Jun 07 2021
Journal Name
Journal Of Molecular Histology
Structural and functional relations between the connective tissue and epithelium of enamel organ and their role during enamel maturation
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Publication Date
Fri Dec 30 2022
Journal Name
Journal Of The College Of Education For Women
The Exploratory and Confirmatory Factorial Structure of Test-Wiseness Scale: A Field Study on a Sample of Students in Hama University
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The current research aims to recognize the exploratory and confirmatory factorial structure of the test-wiseness scale on a sample of Hama University students, using the descriptive method. Thus, the sample consists of (472) male and female students from the faculties of the University of Hama. Besides, Abu Hashem’s 50 item test-wiseness scale (2008) has been used. The validity and reliability of the items of the scale have also been verified, and six items have been deleted accordingly. The results of the exploratory factor analysis of the first degree have shown the presence of the following five acceptable factors: (exam preparation, test time management, question paper handling, answer sheet handling, and revision).  Moreover,

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