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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
Fri Jan 01 2021
Journal Name
Plant Archives
STUDY OF THE EFFECT OF SPEED, DEPTH OF THE CULTIVATION AND THE NUMBER OF TIMES THE SPRING – LOADED CULTIVATOR PASSES ON SOME TECHNICAL PARAMETERS OF THE CULTIVATOR AND ON WEED CONTROL
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Publication Date
Mon Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
Prediction of Surface Roughness and Material Removal Rate in Electrochemical Machining Using Taguchi Method
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Electrochemical machining is one of the widely used non-conventional machining processes to machine complex and difficult shapes for electrically conducting materials, such as super alloys, Ti-alloys, alloy steel, tool steel and stainless steel.  Use of optimal ECM process conditions can significantly reduce the ECM operating, tooling, and maintenance cost and can produce components with higher accuracy. This paper studies the effect of process parameters on surface roughness (Ra) and material removal rate (MRR), and the optimization of process conditions in ECM. Experiments were conducted based on Taguchi’s L9 orthogonal array (OA) with three process parameters viz. current, electrolyte concentration, and inter-electrode gap. Sig

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Publication Date
Wed Feb 22 2012
Journal Name
مجلة تكريت للعلوم الصرفة
Study the activity of ALT and AST in serum of diabetic patients type II
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Publication Date
Wed Jan 01 2020
Journal Name
Biochem. Cell. Arch.
ANATOMICAL AND CHEMICAL STUDY OF ALTHEAE OFFICINALIS L. SPREAD IN THE NORTH OF IRAQ
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Publication Date
Sun Jun 04 2017
Journal Name
Baghdad Science Journal
Analysis and Study of the Effect of Atmospheric Turbulence on Laser weapon in Iraq
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One of the most important challenges facing the development of laser weapons is represented by the attenuation of the laser beam as it passed through the layers of atmosphere.This paper presents a theoretical study to simulate the effect of turbulence attenuation and calculates the decrease of laser power in Iraq. The refractive index structure C_n^2 is very important parameter to measure the strength of the atmospheric turbulence, which is affected by microclimate conditions, propagation path, season and time in the day. The results of measurements and predictions are based on the Kolmogorov turbulence theory. It was demonstrated by simulations that the laser weapons in Iraq were severely affected due to the large change in temperatures,

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Publication Date
Wed May 09 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STRATEGIC VIGILANCE AND ITS IMPACT ON THE QUALITY OF MANAGEMENT DECISION SURVEY STUDY IN THE SUPREME JUDICIAL COUNCIL (DEPARTMENT OF FINANCE & ADMINISTRATION): STRATEGIC VIGILANCE AND ITS IMPACT ON THE QUALITY OF MANAGEMENT DECISION SURVEY STUDY IN THE SUPREME JUDICIAL COUNCIL (DEPARTMENT OF FINANCE & ADMINISTRATION)
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The Objective of the research is to identify the Strategic Vigilance and effect in the Managerial Decision Quality, by knowing the interest of the organization influence the Strategic Vigilance in the Managerial Decision Quality, adopted four dimensions of the Strategic Vigilance is (Environmental Vigilance, Commercial, Competitiveness & Technology) to indicate the extent individually and collectively impact in the Managerial Decision Quality, The questionnaire was used as a main tool to survey the views of a sample of 45 managers, was named Supreme Judicial Council society for research, and the statistical program SPSS, and research found a clear positive impact dimensions Strategic Vigilance in the Manageri

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of Engineering
The The Use of Copper and Aluminum Electrodes for Energy Production in a Microbial Fuel Cell
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Microbial fuel cell is a device that uses the microorganism metabolism for the production of electricity under specific operating conditions. Double chamber microbial fuel cell was tested for the use of two cheap electrode materials copper and aluminum for the production of electricity under different operating conditions. The investigated conditions were concentration of microorganism (yeast) (0.5- 2 g/l), solutions temperature (33-45 oC) and concentration of glucose as a substrate (1.5- 6 g/l). The results demonstrated that copper electrode exhibit good performance while the performance of aluminum is poor. The electricity is generated with and without the addition of substrate. Addition of glucose substrate

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Publication Date
Sat Dec 15 2018
Journal Name
Journal Of The College Of Education For Women
The Lingual Criticism and Explication of the Narrative Syntax A reading in Roger Fawler’s Critical Attempt
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الخلاصة

يجمع المختصون أن ليس من نقد إلا وكان مُرحِّلا لنظرية لسانية إلى فضائه، فكان أثر اللسانيات السوسيرية، ومن ثم اللسانيات التوليدية التحويلية معروفا، ولم يكن هذا الأثر محدودا باللسانيين أو نقاد الأدب فحسب، بل امتد إلى الشعراء والجماليين أيضا. وفي هذا البحث سنتوقف عند أثر اللسانيات الوظيفية، وهو ما لم يتوقف عنده إلا قلة من المختصين. ولن نقف عند نقد الوظيفيين للشعر، بل سنقف عند نقدهم للرواية، بقراءة

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Publication Date
Mon Dec 30 2019
Journal Name
College Of Islamic Sciences
Among the hadiths of righteous deeds mentioned in the expiation of sins -An analytical study-
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The almighty Al-Bari imposed on Muslims easy and accessible worshipers for every individual who is eligible to commission, so whoever performed it rightfully, God rewarded it with the best reward. From the Muslim, the Almighty made the Almighty to the types of acts of worship and acts of righteousness as a reason for the remission of sins that were advanced and late, so I chose a topic (from the hadiths of righteous deeds mentioned in the atonement of sins) as a research drawn from the master’s thesis called (the hadiths of the atoners of sins that were presented and delayed - An analytical study- ), And collect in this research kinds of acts of righteousness that bring the mercy of God Almighty to His servants and be a reason for the

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Study for evidence of bacteria contamination in the southern part of the Diyala River / Iraq
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Were studied some bacteria evidence of pollution as well as the total number of live bacteria in the waters of the Diyala river and selected five stations within the 17 km final Diyala River before its mouth in the Tigris River was the first before the new bridge of the Diyala River about 4 km and the second after the mouth of the water purification plant Rustumiya suit inverselywith temperatures

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