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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 Jan 01 2019
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees19gr
I-V characteristics of n-Si /ZnO/Se/MWCNTs nanocomposite solar cell fabricated by solvothermal technique
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Publication Date
Fri Aug 20 2021
Journal Name
Iraqi Journal Of Laser
Permeability of Radicular Dentine after Using Different Irrigant Activation Techniques Including Photo Induce Photoacoustic Streaming Technique
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Background: preparation of root canals is an important step in root canal treatment. Mechanical instrumentation of root canals cause an irregular layer of debris, known as the smear layer. As a result, several studies reported that preferring the removal of the smear layer. Objective: To study the influence of the energy (100 mJ) of Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser at short pulse duration (60 μs)  on smear layer removal of apical third after using Photon induced photoacoustic streaming technique. Materials and methods: Eighteen straight single-rooted mandibular premolars were used. The roots length were uniform to 14mm from the anatomic apex and

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Publication Date
Tue Nov 24 2015
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
The role of e-commerce in the insurance industry and its impacts on consumer rights (In the case of the National Insurance Company study): The role of e-commerce in the insurance industry and its impacts on consumer rights (In the case of the National Insurance Company study)
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The e-commerce is one of the best achievements of the twentieth century, since the conduct commercial transactions via the Internet may be the consumer easy selection process and purchase convenient manner different from traditional methods, and with the beginnings of the new millennium impose the emergence of e-commerce term significant challenges to the insurance industry as an important economic sectors Generally, and insurance companies in particular as a result of scientific development, which has led to a reduction in costs and innovation in the production, which led to intense competition on both levels local or global. The insurance industry is a vital part of the economy and it has a varied impact to the community and individual

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Publication Date
Thu Jun 27 2019
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIRST RECORD OF SOLOSTAMENIDES PAUCITESTICULATUS KRITSKY & ÖKTENER, 2015 (MONOGENOIDEA, MICROCOTYLIDAE) FROM GILLS OF ABU MULLET PLANILIZA ABU (HECKEL, 1843) FROM EUPHRATES RIVER OF SAMAWA CITY, SOUTHERN IRAQ
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    A total of 54 abu mullet Planiliza abu (Heckel, 1843) were collected from two stations (north and south stations) along the Euphrates River near Samawa City, Al-Muthanna province and were examined during the period from October 2016 till September 2017 for parasites. Six out of 35 examined fishes from the north station (17.1%) and one out of 19 examined fishes (5.3%) from south station were infected with the microcotylid Solostamenides paucitesticulatus Kritsky & Öktener, 2015. The parasite was illustrated and described, and it is considered as a new record for the parasitic fauna of fishes of Iraq.

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Publication Date
Fri Jun 01 2007
Journal Name
Journal Of The College Of Languages (jcl)
TECHNIQES OF SURREALISM: A STUDY IN TWO NOVELS BY THOMAS PYNCHON, V. AND THE CRYING OF LOT 49
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Surrealism is a twentieth-century literary and artistic movement oriented toward the liberation of the mind. Surrealism is a reaction to the philosophy of rationalism which was believed to be the cause of the disaster of World War I. It emphasizes the expression of the imagination as revealed in dreams and presented without conscious control, the unexpected juxtapositions of objects, the withdrawal of the self, and the exploitation of chance effects.
Surrealism began in Paris in the early 1920s, as Europe emerged from the devastation of World War I. A group of writers, artists, and filmmakers, led by the poet André Breton, adopted the word surréaliste (meaning, roughly, "super-real") as a label for their artistic activities. Influen

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Qualification Of Human Resources To Apply Electronic Management A case study In The Ministry Of Science And Technology
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     This research aims to shed light on the reality of the process of rehabilitation of human resources for the implementation of electronic management practice in the ministry, and availability requirements of the application of electronic management and diagnosis of the most important stages and steps that can be followed in the process of transition towards electronic management to keep abreast of developments in the field of information technology, has been the application of this research in the Ministry of science and technology on a group of heads of departments and directors of the people in the departments of the Ministry through the use of case study method, which includes cohabitation field intervi

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Publication Date
Wed Dec 11 2019
Journal Name
Journal Of The College Of Education For Women
A Comparative Study in the (myth of Pygmalion) between Bernard Shaw and Sadik Hidayat: University of Ferdowsi - Iran
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  In our time, not too long ago, the universities of the world have been fast to take care of the study of an innovative type of technical and human studies, called the science of "comparative literature". Comparative research studies have grown and flourished rapidly in response to the demands of both mental and artistic life. This shows the increasing awareness at both the modern national and the international levels in order to develop through connecting with the international intellectual, nental and artistic currents to nurture ethics and originality. Comparative studies show that the beginning of the comparative literature goes back to the time when the Latin literature was connected to the Greek literature and th

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Publication Date
Sat May 14 2022
Journal Name
Oral And Maxillofacial Surgery
Evaluation of crestal sinus floor elevations using versah burs with simultaneous implant placement, at residual bone height ≥ 2.0 _ &lt; 6.0 mm. A prospective clinical study
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Publication Date
Mon May 15 2017
Journal Name
Journal Of Theoretical And Applied Information Technology
Anomaly detection in text data that represented as a graph using dbscan algorithm
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Anomaly detection is still a difficult task. To address this problem, we propose to strengthen DBSCAN algorithm for the data by converting all data to the graph concept frame (CFG). As is well known that the work DBSCAN method used to compile the data set belong to the same species in a while it will be considered in the external behavior of the cluster as a noise or anomalies. It can detect anomalies by DBSCAN algorithm can detect abnormal points that are far from certain set threshold (extremism). However, the abnormalities are not those cases, abnormal and unusual or far from a specific group, There is a type of data that is do not happen repeatedly, but are considered abnormal for the group of known. The analysis showed DBSCAN using the

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Publication Date
Sun Nov 25 2018
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Numerical Study of Solid Core Photonic Crystal Fibres with Endlessly Single Mode
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       In this work, a solid core photonic crystal fibre (SC-PCF) has been designed with endlessly single mode of which both centerd core and holes in the cladding are organized by circles. The designed SC-PCF has a single solid centerd core which is ringed by a six rings hexagonal cladding. The computation of  SC-PCF is  achieved by using the finite element method (FEM) with perfectly matched layer (PML) boundary condition. All the designed factors like dimensions and distance of both core and cladding areas have varied with an optimized structure. After ending the numerical calculation, the results shows that there are a link between the air hols in the cladding ,  and the different normaliz

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