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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 Jun 01 2024
Journal Name
Journal Of Physics: Conference Series
Study of The Effect of Concentration on The Efficiency of The Sensitive N749-TiO2 Solar Cell
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In this research, we studied the effect of concentration carriers on the efficiency of the N749-TiO2 heterogeneous solar cell based on quantum electron transfer theory using a donor-acceptor scenario. The photoelectric properties of the N749-TiO2 interfaces in dye sensitized solar cells DSSCs are calculated using the J-V curves. For the 〖(CH_3)〗_3 COH solvent, the N749-TiO2 heterogeneous solar cell shows that the concentration carrier together with the strength coupling are the main factors affecting the current density, fill factor and efficiency. The current density and current increase as the concentration increases and the strength coupling increases as the N749-TiO2 heterogeneous in solar cell. However, the efficiency is more sens

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Degree of Management Practice of Roaming and Its Role in Achieving Organizational Justice ((An analytical Study of the Opinions of Directors in Anbar Education Directorate))
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Abstract

This Study aimed to investigate the reality of the application of the degree of management practice by Walking Around, namely (discovery of facts, improvement of communication, motivation, development, creativity and feedback) and Its role in achieving organizational justice (procedural justice, distributive justice, Interactional Justice),The availability of the core principles of this system from the point of view of the senior management personnel in the Directorate of Anbar Education, and the importance of research in the philosophical rooting of the nature of the variables as a modern administrative terminology, the research dealt with a problem expressed by a number of intellectual and appl

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Publication Date
Wed Jun 27 2018
Journal Name
Journal Of The College Of Education For Women
Kinds of unknowns and government linkages -empirical study of the application
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It is no secret that the prophets speech is of great importance, as the second source of Islamic legislation after the Holy Quran, and as such we must reserve and verify the authenticity of the novel and the narrators seizure, and all the conditions laid down by the scholars.

The subject of our research here concerns part of this verification, which is the unknown, the subject of the unknown hadith is considered a matter of great interest by the modernists because it relates to the validity of the novel and the narrators, and the methods of the modernists varied in terms of the reasons for this weakness, the fool never entertained them by the reckless narrative.

I chose the subject of my research the types of Mahjail and

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Publication Date
Sun Aug 06 2017
Journal Name
International Journal Of Science And Research
Prevalence Rate of Toxoplasmosis and its Effects on Some Liver Functions in Blood Samples of Volunteers' Students
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Recently, young people have shown a desire to keep cats as pets, despite being threatened with health problems including toxoplasmosis. Therefore, the current study was aimed to detect toxoplasmosis infections among of volunteers students as well as spreading health awareness among students and knowledge about the importance of this disease. Prevalence rate and effects of liver functions were tested by measured levels of Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) enzymes while the OnSiteToxo IgG/IgM combo rapid test was used in the diagnosis of the disease. The blood samples were collected from 76 volunteers (35 male and 41 female). The results showed that, the total percentage of infections was 27.6% and all infect

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Knowledge of marketing and its impact on the performance of the company for the distribution of oil products –an exploratory study of the views of asample in the general company for oil products distribution/ Distribution Authority, Baghdad
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This study seeks to address the impact of marketing knowledge dimensions (product, price, promotion, distribution) on the organizational performance in relation to a number of variables which are (efficiency, effectiveness, market share, customer satisfaction), and seeks to reveal the role of marketing knowledge in organizational performance.

In order to achieve the objective of the study the researcher has adopted a hypothetical model that reflects the logical relationships between the variables of the study. In order to reveal the nature of these relationships, several hypotheses have been presented as tentative solutions and this study seeks to verify the validity of these hypotheses.

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Publication Date
Tue May 16 2023
Journal Name
Political Sciences Journal
(The role of the Security Council in Managing international crises (The Libyan crisis as a model
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The Security Council has an active role in addressing international crises and dealing with their causes. The Libyan crisis is one of the most important real tests of the Security Council and its role in maintaining international peace and security, as the Council has proven so far an ineffective role in resolving the crisis and dealing withtheir causes, which has prolonged its duration and increased its complexities and dangerous repercussions, perhaps the most prominent of which is the threat of the recently achieved cease-fire and the formation of a new transitional government led by Abdel Hamid al-Dabaiba, the growing significant obstacles facing the political process, foremost of which is the continued presence of foreign forces , m

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Publication Date
Sun Dec 16 2018
Journal Name
Al-academy
The Conceptual Representations of the Jewish Personality in the International Cinema (Munich film as a model)
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This study deals with the intellectual representations whose intellectual systems are incarnated in the Jewish personality, which is considered one of the complex intellectual systems that has caused controversy throughout the ages because of the ambiguity due to the religious and psychological factors that were reflected directly and strongly on the intellectual structure of the Jewish community in general and the Jewish - Zionist personality in particular, in an attempt (to create new dimensions embodied by intellectual representations of a human nature embodied by what that - peaceful - religiously oppressed - psychologically and socially isolated character presents, because of the curse of the peoples of the world that was a cause fo

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Publication Date
Thu Jul 01 2004
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
THE HAEMOPROTEIDS OF THE AVIAN FAMILY SCOLOPACIDAE IN IRAQ WITH DESCRIPTION OF A NEW SPECIES
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Three scolopacids out of 150 are found infected with Haemoproteus scolopaci Galli-
Valerio 1929 and H. tringae n. sp. A detailed description of the new taxon is presented along
with a comparison of the diagnostic measurements between the two species.

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Publication Date
Sat Jul 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
A Statistical Analysis of the Effects of Afforestation on the Environment in Iraq (Northern Iraq)
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Abstract<p>The significance of the research conducted in northern Iraq comes despite the expansion of afforestation projects; yet, the suffering of the forests has increased due to their lack of scientific study, unpredictability of the climate, and adverse effects on the spread and growth of plant species Therefore, the goal of the study is to understand the effects of afforestation through a statistical analysis of plant diversity in northern Iraq and its distinctivenessThe analysis revealed that natural groupings had improved qualitatively more than other groups, particularly some dwindling species that are able to compete and occupy new areas. drought-prone vegetation, vegetation, and climat</p> ... Show More
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Publication Date
Fri Sep 01 2023
Journal Name
Iklīl For Humanities Studies
The Decline of Language Loyalty in the Age of Audiovisual Nearness: A Socio-linguistic Approach
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This article investigates the decline of language loyalty in the age of audiovisual nearness. It is a socio-linguistic review of previous literature related to language disloyalty. It reviews the current theoretical efforts on the impact of audiovisual nearness created by social media and language loyalty. The descriptive design is used. The argument behind this review is that the audiovisual nearness provided by social media negatively affects language loyalty. This article concludes that the current theoretical efforts have paid much attention to the relationship between the audiovisual nearness and language loyalty. Such efforts have highlighted the fact that the social media platforms have provided unprecedented nearness that provoke in

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