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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 Mar 31 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study of the Performance of Paraffin Wax as a Phase Change Material in Packed Bed Thermal Energy Storage System
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The present work deals with an experimental investigation of charging and discharging processes in thermal storage system using a phase change material PCM. Paraffin wax was used as the PCM which is formed in spherical capsules and packed in a cylindrical packed column which acted as an energy storage system. Air was used as the heat transfer fluid HTF in thermal storage unit. The effect of flow rate and inlet temperature of HTF on the time of charging and discharging process were studied. The results showed that the faster storage of thermal energy can be made by high flow rate of heat transfer fluid HTF and high inlet temperature of heat transfer fluid. It was found that at 65°C HTF inlet temperature, the melting and solidification pr

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Publication Date
Sun Aug 20 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Study on the Physiological Function of a - Tocopherol, Vitamin (E) on Lipoproteins Levels in Serum of Apparantly Healthy Individuals
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The  role  of  free  radicals  generation  and  Lipid  Peroxidation

during the course of ischemic heart disease is well establshed as a basic for Pthogenesis and subsequent tissue damage consequenes . In an attempt to shed a light on the possible relationship between lipid peroxidation and some antioxidant.

The effect of vitamine E  (as a potent antioxidant free radical scavenger) . On the serum levels of the Lipoproteins, (HDLc) High Density Lipoprotein , (LDLc) Low Density Lipoprotein and (VLDLc) very Low Density Lipoprotein in healthy donors.

The  study  includes  (50) healthy  donors  from  males  and  females  ,

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Publication Date
Fri Oct 20 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
An Analytical Study of the Convergence and Stability of the New Four-Step Iterative Schemes
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Based on the needs of the scientific community, researchers tended to find new iterative schemes or develop previous iterative schemes that would help researchers reach the fixed point with fewer steps and with stability, will be define in this paper the multi_implicit four-step iterative (MIFSI) which is development to four-step implicit fixed point iterative, to develop the aforementioned iterative scheme, we will use a finite set of projective functions ,nonexpansive function and finite set from a new functions called generalized quasi like contractive which is an amalgamation of quasi contractive function and contractive like function , by the last function and a set of sequential organized steps, we will be able to prove the existen

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Publication Date
Wed Jan 01 2020
Journal Name
Biochemical & Cellular Archives
MORPHOLOGICAL STUDY OF THE BRAIN AND SPINAL CORD OF THE IRAQI FROG, RANA RIDIBUNDA RIDIBUNDA
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The frog has a highly developed nervous system. It consists of a brain, a spinal cord and nerves. The brain is the only center for the control of all vital activities as it receives impulses from different parts of the body through sensory nerves and issues orders through motor fibers to different parts of the body for appropriate action. The Aims of studyis general morphological structural of the brain and spinal cord in the Iraqi frog Rana ridibunda ridibunda. The brains of twenty of frogs belonging to class Amphibia were studied using conventional techniques of dissecting microscopy. All samples were sacrificed and anesthetized and then they were removed completely from the neurocranium, cranial, sensory nerves and the meninges and trans

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Publication Date
Mon Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
Optimization and Prediction of Process Parameters in SPIF that Affecting on Surface Quality Using Simulated Annealing Algorithm
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Incremental sheet metal forming is a modern technique of sheet metal forming in which a uniform sheet is locally deformed during the progressive action of a forming tool. The tool movement is governed by a CNC milling machine. The tool locally deforms by this way the sheet with pure deformation stretching. In SPIF process, the research is concentrate on the development of predict models for estimate the product quality. Using simulated annealing algorithm (SAA), Surface quality in SPIF has been modeled. In the development of this predictive model, spindle speed, feed rate and step depth have been considered as model parameters. Maximum peak height (Rz) and Arithmetic mean surface roughness (Ra) are used as response parameter to assess th

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Publication Date
Mon Jul 27 2015
Journal Name
Iranian Journal Of Parasitology
Abnormalities of endocytosis, phagocytosis, and development process in Dictyostelium cells that over-express Acanthamoeba castellanii metacaspase protein
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Publication Date
Mon Jan 08 2024
Journal Name
Al-academy
Designing a module in light of cognitive learning theories and their impact on the achievement of students of the Department of Art Education and their motivation in learning the subject of aesthetics.
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This research aims to:
1 – Make a proposed module for (aesthetics) for the second stage - Department of Art Education under education theories.
2 - Verification from the effect of the proposed module on student achievement and motivation towards learning aesthetics material.
To verification the second goal we wording these two hypotheses:
1- There are no individual differences with statistically significant at level (0.05) between the student's scores average. (Experimental group ) who studied according to the proposed module and the average student's scores (control group) who studied in the usual way for the achievement test for the Aesthetics material.
2- There are no individual differences with statistically signifi

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Publication Date
Tue Mar 15 2022
Journal Name
Al-academy
The semiotics of the visual image of women in the discourse of empowerment, Saudi Arabia Kingdom as a model
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We studied, in this paper, the semiotics of the visual image of women in the discourse of empowerment, through three models of advertising images expressing the particularities of the Saudi Arabian environment.

We aim to know how the mark operates and how it is interpreted, as a semantic process in which the meaning ranges from description to interpretation, and we studied two hypotheses:

-The advertising image is a structure in which the mark corresponds to the reality and the discourse to the context.

-The significance is not found in the visual sign or in the textual sign of the advertising image, but in the creative event that opens up to the social, cultural, and psychological context, and creates a field of dia

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Publication Date
Tue Jun 17 2025
Journal Name
Journal Of Sport Sciences
The school system and its relationship to the evolution of some indicators of physical and functional skills in a lesson and basketball
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Publication Date
Tue Jan 01 2019
Journal Name
Aip Conference Proceedings
Study the effect of addition of Ar to N2 gas on the EEDF and the correspondent coefficients of electron transport
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