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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
Mon Oct 12 2020
Journal Name
Molecules
Phase Change Process in a Zigzag Plate Latent Heat Storage System during Melting and Solidification
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Applying a well-performing heat exchanger is an efficient way to fortify the relatively low thermal response of phase-change materials (PCMs), which have broad application prospects in the fields of thermal management and energy storage. In this study, an improved PCM melting and solidification in corrugated (zigzag) plate heat exchanger are numerically examined compared with smooth (flat) plate heat exchanger in both horizontal and vertical positions. The effects of the channel width (0.5 W, W, and 2 W) and the airflow temperature (318 K, 323 K, and 328 K) are exclusively studied and reported. The results reveal the much better performance of the horizontal corrugated configuration compared with the smooth channel during both melti

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of fraud detection skills in the settlement of Compensatory claims for the fire and accident insurance portfolio: An applied study in the national and Iraqi insurance companies
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The research seeks to identify the impact of fraud detection skills in the settlement of compensatory claims for the fire and accident insurance portfolio and the reflection of these skills in preventing and reducing the payment of undue compensation to some who seek profit and enrichment at the expense of the insurance contract. And compensatory claims in the portfolio of fire and accident insurance in the two research companies, which show the effect and positive return of the detection skills and settlement of the compensation on the amount of actual compensation against the claims inflated by some of the insured, The research sample consisted of (70) respondents from a community size (85) individuals between the director and assistan

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Publication Date
Wed May 17 2023
Journal Name
College Of Islamic Sciences
A stylistic vision of the objection in the Quranic discourse
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The modern stylistic lesson has become more committed to the scientific limits in which it believed, and more confident in itself, and it is no longer just a scientific procedure that helps other curricula and sciences that preceded it.

Based on this, our modest research ((a stylistic vision of the objection in the Quranic discourse)) arose to explore an artistic rhetorical phenomenon that was included in the Holy Quran text. ; Because analysis is a situation that allows us to see a lot and absorb the stranger more clearly.

And since the horizontal arrangement of the linguistic elements in which stylistically undistinguished elements meet with distinct ones, the other trend has emerged that believes that the stylistic dis

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
Federated states of monks in the holy Quran (Study and analysis)
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Thank God also taught us that thanks . thank meets the blessings and rewards mazidk glory we have no knowledge except what you have taught you Alim hakim , not counted praise you as yourself praised and pray and to recognize the envoy mercy to the worlds , prophet Mohammed and his family and companions and guided to the day of judgment .
But after :
Aware of the interpretation of the most important science needed by Muslims because God Almighty sent down the Quraan to be a way of the life for Muslims is subject to a healing for what is in the breasts and it slaham and flaham and has spared the nation from crisisThe stats of the monks , like other verses talking about Christians and Jews and what they have invented in the religion o

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Timings of people and their significance in the Koran: (Objective study)
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We try through this research to show the relationship between the crescent and the month in the Koran, and then their importance and their relationship to timing, and the timing of this relationship with people, and the significance of these timings, so we gathered verses that spoke about the family and the month, and we tried to study them in a detailed objective study, so this came The research of five subjects was the first topic introductory research and the time and month, while the remaining four detectives on the verses that talked about the timing of the month, and we have explained the relationship of this timing with people and the significance of these times.

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Publication Date
Mon Jul 04 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of agricultural insurance in the prevention of financing risks in the form of slam : "An Empirical Study on Shikan Insurance and Reinsurance Company
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The aim of this research is to introduce agricultural insurance, to define financing in the form of salam and the role of agricultural insurance in the prevention of risks to agricultural finance operations in the form of salam by verifying the hypotheses through which to reach the results, including the imposition of risks for agricultural finance in the form of salam, The study of agricultural finance in the form of salm, the deductive approach to the development of the problem of research and hypotheses, and the inductive method to extrapolate the results through analysis and brother The researcher concluded that agricultural insurance works to bridge the risks facing agricultural finance in the form of the ladder in cases of

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Publication Date
Mon Jul 01 2024
Journal Name
Iop Conference Series: Earth And Environmental Science
An Economic Study of the Margins and Profits of Middlemen in the Marketing of Chicken Meat Marketing Channels in Baghdad Province for the Season 2023
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Abstract<p>Marketing studies are important to researchers and policy makers. The study of marketing margins and efficiency is important to understand the marketing problems that face parties of the marketing process. The aim of the research is to measure the efficiency margins and the most important marketing channels for marketing chicken meat in the province of Baghdad and to identify the most important marketing problems facing marketers of the commodity. The absolute marketing margins were (0, 1360, 1570, 1545) for the four channels respectively, while the price paid by the consumer was variable according to the marketing channel (3150, 3790, 3920, 4065) for the four channels respectively. T</p> ... Show More
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Publication Date
Sun Dec 01 2019
Journal Name
Al-ustath Journal For Human And Social Sciences
Landscape as History: A Postcolonial Ecopoetic Study of the Poetry of Derek Walcott
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Abstract: As human history is implicated in landscape or the natural history, it can be stated that the origins of the Caribbean writers' conflict, in general, are the colonial history of West India. That history which tells the story behind not only their fragmented identity, but also the problems connected to their language as well. Building on the arguments of the prominent Postcolonial ecoccritics such as Elizabeth DeLoughrey, George Handley, Helen Tiffin, and Graham Huggan, this research analyzes selected poems by Derek Walcott's which are bounded in his volume, Collected Poems. It shows how the Caribbean history has been erased due to the brutality of colonization offering landscape as a reliable source which has recorded that history

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Publication Date
Sun Feb 17 2019
Journal Name
Iraqi Journal Of Physics
A Study of the electronic structure of CdS Nanocrystals using density functional theory
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Density Functional Theory at the generalized-gradient approximation level coupled with large unit cell method is used to simulate the electronic structure of (II-VI) zinc-blende cadmium sulfide nanocrystals that have dimensions 2-2.5 nm. The calculated properties include lattice constant, conduction and valence bands width, energy of the highest occupied orbital, energy of the lowest unoccupied orbital, energy gap, density of states etc. Results show that lattice constant and energy gap converge to definite values. However, highest occupied orbital, lowest unoccupied orbital fluctuates indefinitely depending on the shape of the nanocrystal.

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Crossref
Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Study of Traffic on The Roads The Governorate Of Karbala
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The study of traffic on the roads the governorate of Karbala, Where is the study of traffic on the roads measure is necessary to determine the extent of the road and highlighting the importance of its role in the transfer of individuals from original to destination as well as the importance of the region that attracted its movement. This research aims to analyze the traffic in the governorate of Karbala through the study and analysis of surveys of traffic that were made in the governorate. Based on this analysis, it has been reached to identify volumes of the traffic and its density and how the roads are efficient and accommodating these volumes, the results of the traffic survey of the studied roads in the area of the study have shown t

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