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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
Sat Jan 05 2019
Journal Name
Iraqi Journal Of Physics
The study of the bending property of the epoxy (Ep / MgO) and (Ep/SiO2) composites in natural conditions and after immersion in chemical solution
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In this paper, a polymer-based composite material was prepared by hand Lay-up method consisting of epoxy resin as a base material reinforced by magnesium oxide powder once and silicon dioxide powder again and with different weight ratios (3, 6, 9 and 12) wt %. The three-point bending test was performed in normal conditions and after immersion in sulfuric acid. The results showed that the bending value decreased with the increase of the weighted ratio of the reinforcement material (MgO, SiO2). The Bending of samples reinforced by SiO2 was found to be less than the bending of samples reinforced by particles (MgO). For example, the bending of the SiO2 sample (0.32 mm) at the weighted ratio (3%) and for the MgO (0.18mm) sample at the weight

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Publication Date
Sun Jun 11 2017
Journal Name
Al-academy
Performance difficulties of Sharif Muhiyddin Haider’s musical works among Oud students
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This research focuses on the difficulties that face Oud's students' in the performance of Sharif Muheyddin Haider musical works. In addition, this research suggests solutions to overcome these difficulties for make it easier to play Haider's musical works. This research also addressed important topics of great relevance the title, problem and the research's aims. Moreover, Procedures of this research adopted the descriptive approach (content analysis) to attain the research's aims. Furthermore, results and discussions where covered, and conclusions of the appropriate academic solutions were achieved to overcome the performance difficulties of Haider's musical works among Oud's students'. At the end, the research presents a set of recomme

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Publication Date
Thu May 18 2023
Journal Name
Journal Of Engineering
The Effect of Tool Path Strategy on Mechanical Properties of Brass (65-35) in Single Point Incremental Sheet Metal Forming (SPIF)
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In this paper, three tool paths strategies; iso-planar, helical and adaptive have been implemented to investigates their effect on the mechanical properties of Brass 65-35 formed by single point incremental sheet metal forming process. To response this task, a fully digital integrated system from CAD modeling to finished part (CAD/CAM) for SPIF process has been developed in this paper.
The photo-micrographs shows an identical grain formation due to the plastic deformation of the incremental forming process, change in the grain shape and size was observed. It's found that the adaptive tool path play a significant role to increase the hardness of the formed specimen from (48 to 90 HV) and the grain texture of the formed specimen found a

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Publication Date
Thu Nov 03 2022
Journal Name
Res Militaris
Prose of Sons of Imam Ali Al-Rida (Peace Be Upon Them): A Study Regarding the Structure of the Image and Its Implications - Simile as a Model
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Praise be to God, Lord of the Worlds, and prayers and peace be upon the most honorable of creation, Muhammad, whom God sent as a mercy to the worlds, and his pure God and his faithful companions. The Islamic heritage was replete with texts issued from among the pure infallibility, which constituted a prominent teacher that takes the student to stop there in search of its goals, purposes and beauty. The choice was made from those texts that were issued by the imams of Muslims in the Abbasid era, namely Imam Muhammad al-Jawad, his son Imam Ali al-Hadi and his grandson Imam Hassan Zaki al-Askari. (Peace be upon them), and scholars have called them (sons of satisfaction), and researchers have shed light on these texts from rhetorical, artistic

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Publication Date
Thu Dec 15 2022
Journal Name
Al-academy
The art of adornment and make-up in the ancient civilizations of Mesopotamia and the old country of Yemen as a model
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This research sheds light on those discrepancies in the use of ornaments, adornment and perfumes, as well as the art of cosmetics, in two important civilizations, namely, the Mesopotamian civilization as the earlier civilization, and the civilization of Yemen, which represents the first Arab civilization. Through the foregoing, our research includes two topics, the first topic included the history of the use of decorations, ornaments and perfumes in the civilization of Mesopotamia, while the second topic included the study of ornaments, adornment and cosmetic art in the ancient civilization of Yemen. And then the research came out with a number of conclusions that the researcher considers very important to highlight the differences and f

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Publication Date
Fri Oct 25 2024
Journal Name
The Review Of Contemporary Scientific And Academic Studies
The Representation of Men and Women in the Black and White Streams of the Second Wave of Feminism: A Corpus Stylistic Analysis
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Publication Date
Wed Oct 25 2017
Journal Name
European Journal Of Environmental And Civil Engineering
Effect of saturation on response of a single pile embedded in saturated sandy soil to vertical vibration
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Publication Date
Wed Jun 30 2021
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
RATE CONSTANT OF SOME AMINO DERIVATIVES DISSOCIATION: RATE CONSTANT OF SOME AMINO DERIVATIVES DISSOCIATION
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Amino glycoside derivation including, Neomycin, Streptomycin, Kanamycin and Gentamycin with special reagents, which  are  benzoylchloride; benzene sulfonyl chloride and phthalic anhydride were made to enhance Uv-detectability for HPLC analysis. But there are many problems facing pre column derivation and in order to solve this, the conductivity of antibiotic derivatives were used to calculate the dissociation constant and the hydrolysis rate which determined concern type reaction. In addition the  characteristics those controlling the hydrolysis of antibiotic-derivatives were investigated.

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Publication Date
Sun Mar 02 2014
Journal Name
Baghdad Science Journal
We study the effect of Ultra violet rays (A-B) in treatment of Vitiligo (applied Therapy)
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This research evaluated the effect of (UV)(400-320A)Hz(320-220B)Hz on the patient with vitiligo , using it with our new combing therapy that include the oral (Psorlene ) topical , meladinine solution applied on the Vitiligiousns Lesions , In edition to the instralesnional injection in the Vitiligiousns Lesions by long acting steroid (kenacort-A ) by aprecentage of (5%) , after that we expose the patient to UV . The ruslets of this way of treatment more effective by using of the UV rays in the treatment of vitiligo , while the previous treatment that used the UV ray with or with out the psorlene , the results were not effective on controlling of the Vitiligio diseases comparing by the treatment used in this research as it stop’s the sp

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Publication Date
Mon Dec 18 2017
Journal Name
Agronomy
A Case Study of Potential Reasons of Increased Soil Phosphorus Levels in the Northeast United States
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Recent phosphorus (P) pollution in the United States, mainly in Maine, has raised some severe concerns over the use of P fertilizer application rates in agriculture. Phosphorus is the second most limiting nutrient after nitrogen and has damaging impacts on crop yield if found to be deficient. Therefore, farmers tend to apply more P than is required to satisfy any P loss after its application at planting. Several important questions were raised in this study to improve P efficiency and reduce its pollution. The objective of this study was to find potential reasons for P pollution in water bodies despite a decrease in potato acreage. Historically, the potato was found to be responsible for P water contamination due to its high P sensitivity a

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