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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
Thu Jun 01 2023
Journal Name
مجلة اداب المستنصرية
The Concept of dialogue, it's importance, it's goals and it's character A descriptive Study
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Dialogue is one of the most important means of calling to the Creator, as it is one of the scientific and verbal activities carried out by a group of interlocutors to present ideas they believe in, and evidence and proofs that express their views and demonstrate the reason for their belief in them, In order to arrive at the truth or a radical solution to a specific problem, so the interlocutor should pay attention to this science, study it and its etiquette, because the purposeful dialogue requires that the funniest of them be the most knowledgeable and knowledgeable about the axis of the hadith, and the funniest must also be able to be convinced of the rule of difference of opinion that does not spoil the issue of friendly They must also c

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Publication Date
Sat Oct 01 2022
Journal Name
Journal Of Engineering
Parameters Affecting the Strength and Behavior of RC Dapped-End Beams: A Numerical Study
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The finite element method has been used in this paper to investigate the behavior of precast reinforced concrete dapped-ends beams (DEBs) numerically. A parametric investigation was performed on an experimental specimen tested by a previous researcher to show the effect of numerous parameters on the strength and behavior of RC dapped-end beams. Reinforcement details and steel arrangement, the influence of concrete compressive strength, the effect of inclined load, and the effect of support settlement on the strength of dapped-ends beams are examples of such parameters. The results revealed that the dapped-end reinforcement arrangement greatly affects the behavior of dapped end beam. The failure load decreases by 25% when

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Communications
SDN Implementation in Data Center Network
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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of The Faculty Of Languages
A Psychological Reading of The Problem of the Black in John Steinbeck’s Of Mice and Men
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Publication Date
Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
A Psychological Reading of The Problem of the Black in John Steinbeck’s Of (Mice and Men)
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The present paper applies Fanon Psychological reading of the problem of the Black introduced in his book Black Skin White Mask to Crooks, The black Character in John Steinbeck’s  Of Mice and Men. The analysis of this character infers three essential points regarding the artistic achievement of the author. First, he uses a fictional character that offers a psychological interpretation of the black problem of alienation and loneliness in a way that does not disgrace the black. Second, he applies Fanon’s way of showing the various attitudes that the black adopts in contact with the white society. Third, he affirms that the black inferiority complex comes as a result of double proc

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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
Tue Apr 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Organizational citizenship behaviors under theory of servant leadership: A exploratory study in a sample of faculties of the University of Alqadisiya
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This study aimed to identify the role of servant leadership in promoting organizational citizenship behaviors in a sample of faculties of the University of Alqadisiya .It tried to answer several questions represented its problem.

 

 The most important questions are the followings:

1- Is there enough perception among administrative leaders in the aforementioned faculties toward the concept of servant leadership? And under what level?                                    &

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Publication Date
Wed May 10 2023
Journal Name
Journal Of Planner And Development
The impact of population density in sustainable housing - An applied study in the city of Baghdad (Mahalla 817), Al-Bayaa as a model
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Population density represents an important indicator for determining the growth of the size of urban areas. Population density has a direct impact on the quality of life, and its excessive rise may lead to the deterioration of basic service facilities. The problem of the research is that the increase in the total population densities of the residential neighborhood may reflect negatively on the nature of the services provided to the residents in these shops, and thus the failure to achieve sustainability in the residential locality. The research assumes that the increase in population densities negatively affects the achievement of sustainability in the residential neighborhood.

 

      

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Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The role of intellectual capital in promoting financial performance an applied study on a sample of the companies listed in Iraq stock exchange
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The interest in the intellectual capital and its development is a civilized necessity imposed by the requirements of the times and cannot imagine an advanced society in its potential productivity in poor efficiency of human capital, and features the work environment change permanently, putting the management of financial companies against a constant challenge toward coping with new developments in this changing environment and this is not taken unless owned by these companies qualified human resources and the provision of Culture organizers have, which manifested itself with the research problem by the following two questions:

  1. Did the intellectual capital value specific financial and

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Publication Date
Thu Oct 18 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY OF THE TEMPORAL EFFECT OF THE LEVEL OF THE CREATINE KINASE ENZYME CK-MB AND SOME BIOMARKERS IN PATIENTS WITH MYOCARDIAL INFARCTION AND HEART FAILURE IN RAMADI CITY: STUDY OF THE TEMPORAL EFFECT OF THE LEVEL OF THE CREATINE KINASE ENZYME CK-MB AND SOME BIOMARKERS IN PATIENTS WITH MYOCARDIAL INFARCTION AND HEART FAILURE IN RAMADI CITY
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The current study is designed to achieve the goal of early detection of heart disease because it is the main risk of death. Some biomarkers were measured as well as the percentage of the effect of certain risk factors in people with myocardial infarction and heart failure. The study included 40 serum samples from people with heart disease. The effectiveness of the creatine kinase (CK-MB), as well as its temporal and albumin effects, as well as sodium ions in people with myocardial infarction and heart failure, were compared with the control group. as shown below:

-The first group consisted of 25 blood samples from people with myocardial infarction and 15 serum samples from people with heart failure. Blood

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