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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 Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Organizational Ethnography and its Reflection in the Resonant LeadershipCase study at the University of Kufa
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ABSTRACT

The purpose of this research is to investigate the relationship between organizational ethnography and resonant leadership in the University of Kufa, importance of research includes rare of studies that investigated the relationship between organizational ethnography and resonant leadership. Moreover, it comes as an attempt to reduce or bridge the knowledge gap between the variables of the research. As well as try to put the right foundations and appropriate for industry leaders of various Iraqi organizations aimed at profit or service. Based on the random sampling, 450 questionnaires were distributed to employees at the University of Kufa. Only 392 questionnaires were returned. Out of which 104 questionnaires we

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Publication Date
Wed Jan 01 2020
Journal Name
International Conference Of Numerical Analysis And Applied Mathematics Icnaam 2019
Prevalence of gastrointestinal parasites in Iraq during 2015
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Publication Date
Fri Dec 31 2021
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY OF THE EFFECT OF CHITOSAN EXTRACTED FROM THE MUSHROOM ON THE EXPERIMENTALLY INDUCED HYPERLIPIDEMIA IN MALE RABBITS: STUDY OF THE EFFECT OF CHITOSAN EXTRACTED FROM THE MUSHROOM ON THE EXPERIMENTALLY INDUCED HYPERLIPIDEMIA IN MALE RABBITS
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The present study aimed to identify the therapeutic evaluation of chitosan extracted from the fungus cushroom and pure chitosan on glucose and lipid profile in the blood of 35 male rabbits with hyperlipidemia induced experimentally by cholesterol. The tests included estimation of glucose levels, total cholesterol, triglycerides, high-density lipoproteins, low-density lipoproteins, and very low-density lipoproteins. hyperlipidemia was induced in the male rabbits used in the study which was administered orally with cholesterol 150mg/kg body weight for a week. rabbits were divided into seven groups: control, cholesterol, pure chitosan, mushroom chitosan, cholesterol and pure chitosan, cholesterol and mushroom chitosan and cholestero

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Publication Date
Thu Jun 02 2011
Journal Name
Вестник Воронежского государственного университета. Серия: Лингвистика и межкультурная коммуникация
direct and indirect nomination in single-component characteristics...
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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
The Decisive Answers: A Pragmatic Linguistic Study
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The current research is concerned with studying the decisive answers which are considered quick and conclusive. These answers can effectively interrupt the opponent's argument and close the dialogue.This research is concentrated on deliberative methodology focusing on the decisive answer's activity and ending them through several completing and argument sides. This research consists of an introduction and three parts, the current introduction is focused the light on the concept of decisive answers and its uses in literature and the scarce of speech, and how to consider it with one dialogue description,that dialogue constitute by ? The first part is concerned with those answers through the deliberative methodology and classifying decisive

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of College Of Education For Women
The Decisive Answers: A Pragmatic Linguistic Study
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يهتم هذا البحث بدراسة الأجوبة المسكتة,وهي أجوبة سريعة وحاسمة تقطع حجة الخصم وتفحمه وتغلقالحوار.وقد أرتكز البحث على منهجية تداولية تنظرإلى فاعلية الجواب المسكت في المحاورة وإنهائها من زواياإنجازية و حجاجية.وقد تكون البحث من ديباجة ممهدةوثلاثة مباحث.وسلطتالديباجةالممهدةالضوء علىمفهومالجواب المسكتوشيوعهفي كتب الأدبوالأخبارونوادر الكلاموكيف يمكن النظر لهبوصفه وحدة حوارية تنبنيمنها المحادثة؟أما المبحث ا

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Publication Date
Tue Apr 27 2021
Journal Name
Frontiers In Pharmacology
The Endocannabinoid Anandamide Attenuates Acute Respiratory Distress Syndrome by Downregulating miRNA that Target Inflammatory Pathways
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Acute respiratory distress syndrome (ARDS) is defined as a type of respiratory failure that is caused by a variety of insults such as pneumonia, sepsis, trauma and certain viral infections. In this study, we investigated the effect of an endocannabinoid, anandamide (AEA), on ARDS induced in the mouse byStaphylococcusEnterotoxin B (SEB). Administration of a single intranasal dose of SEB in mice and treated with exogenous AEA at a dose of 40 mg/kg body weight led to the amelioration of ARDS in mice. Clinically, plethysmography results indicated that there was an improvement in lung function after AEA treatment accompanied by a decrease of inflammatory cell infiltrate. There was also a significant decrease i

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Publication Date
Wed Sep 29 2021
Journal Name
College Of Islamic Sciences
The provisions of the epidemic in jurisprudence and its principles The (Covid-19) epidemic is a model
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Abstract

Epidemics that afflict humankind are descending renewed, plaguing them in the place and time they spread.

- The epidemic affects individuals and the movement of societies, and its treatment requires dealing with it according to Sharia, taking into account the current data and developments.

- Integrative jurisprudence: it is intended to know the practical legal rulings deduced from the combination of evidence of two or more sciences related to one topic related to it, and among these calamities is the Corona Covid-19 pandemic.

 - It is permissible to use sterile materials that contain a percentage of alcohol in sterilizing hands and fogging places, including mosques.

T

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The attitude of Arabic - Islamic caliphate toward the A raab in the prophet and rightly guided caliphate
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Publication Date
Thu Nov 01 2007
Journal Name
University Of Baghdad
The Psychic Experience and its Effects on the Creative Process: A Study in Selected Poems By Allen Ginsberg and David Gascoyne
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Evidences indicate that human beings were preoccupied with extreme forms of mental and psychic experiences long before they were recorded in literature. Greek myths and legends appear to include symbolizations of delusions, mania, and other bizarre forms of thought and behaviuor. The figure of the mad man or woman is analogous to the wild man, or the imaginary being who appears in various forms throughout western literature and art. Various studies refer to the notion of the wild man as a response to a persistent psychological urge. This urge gives an external expression and a valid form to the impulses of reckless physical self-assertion which is believed to be hidden in all of us, but is normally kept under control. Such impulses were exp

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