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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 Apr 30 2021
Journal Name
Onkologia I Radioterapia
The prevalence of lymph proliferative disorders in a group of Iraqi patients and its relation to blood indices parameters
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Abstract: Lymphoproliferative Disorders (LPDs) are a group of neoplasms affecting various cells within lymphoid system. Each type has different treatment a..70619

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Publication Date
Tue Feb 01 2022
Journal Name
Current Pharmaceutical Analysis
Analytical Methods for the Identification of Pigments in Tattoo Inks and Some of Their Physiological Side Effects: A Review
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In this review, numerous analytical methods to distinguish pigments in tattoo, paint, and ink items are discussed. The selection of a method was dependent upon the purpose, e.g., quantification or identification of pigments. The introductory part of this review focuses on describing the importance of setting up a pigment-associated safety profile. The formation of different degradation chemical substances as well as impurity trends can be indicated through the chemical investigation of pigments in tattoo products. It is noteworthy that pigment recognition in tattoo inks can work as a preliminary method to identify the pigments in a patient's tattoo before being removed by laser therapy. Contrary to the stud

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Publication Date
Tue Feb 01 2022
Journal Name
Current Pharmaceutical Analysis
Analytical Methods for the Identification of Pigments in Tattoo Inks and Some of Their Physiological Side Effects: A Review
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In this review, numerous analytical methods to distinguish pigments in tattoo, paint, and ink items are discussed. The selection of a method was dependent upon the purpose, e.g., quantification or identification of pigments. The introductory part of this review focuses on describing the importance of setting up a pigment-associated safety profile. The formation of different degradation chemical substances as well as impurity trends can be indicated through the chemical investigation of pigments in tattoo products. It is noteworthy that pigment recognition in tattoo inks can work as a preliminary method to identify the pigments in a patient's tattoo before being removed by laser therapy. Contrary to the stud

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Publication Date
Tue Dec 21 2021
Journal Name
Journal Of Engineering Mathematics
Fluid inflow from a source on the base of a channel
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Publication Date
Tue Jun 30 2020
Journal Name
Dialogo
The Problems of Applying Psychological, Educational and Political Measurement Instruments in light of the Prevalence of the Corona virus (Covid-19)
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Publication Date
Mon Apr 01 2019
Journal Name
Plant Archive
EFFECT OF SOME GROWTH REGULATORS ON THE MULTIPLICATION AND STIMULATING THE PRODUCTION OF THE VOLATILE OIL OF ROSEMARY OFFICINALIS IN VITRO
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The experiment was conducted at the plant tissue culture laboratory of the Department of Horticulture and Garden Engineering College of Agricultural Engineering Sciences, University of Baghdad, in order to study the effect of some growth regulators on propagation an stimulation production of volatile oil compounds of rosemary plant Rosmarinus officinlis using two vegetative parts (apical and lateral buds). Factorial experiment was implemented in completely randomized design with twenty replications. The results indicated that culturing the apical meristem on the medium Murashige and Skoog (MS) media with 0.5 mg.l-1 (BA) with 0.1 mg.l-1 of NAA gave the highest response rate of 100%. As for the doubling stage, the levels of BAA and IAA (Indol

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Publication Date
Thu Jan 17 2019
Journal Name
Energy Procedia
Irradiation of the thin films of MnS with fast neutrons and the possibility of using the new characteristics in optical detector
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The optical detectors which had been used in medical applications, and especially in radioactive treatments, need to be modified studied for the effects of radiations on them. This study included preparation of the MnS thin films in a way that vacuum thermal evaporation process at room temperature 27°C with thickness (400+-10nm) nm and a sedimentation rate of 0.39nm/sec on glass floors. The thin films prepared as a detector and had to be treated with neutron irradiation to examine the results gained from this process. The results decay X-ray (XRD) showed that all the prepared thin films have a multi-crystalline structure with the dominance of the direction (111), the two samples were irradiated with a neutron irradiation source (241Am-9Be)

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The effectiveness of teaching the theory of TRIZ in expressive performance and the development of creative thinking among preparatory school students
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The current research aims to find out (the effectiveness of teaching TRIZ theory in the expressive performance and the development of creative thinking among preparatory school students)
To achieve this, the researcher adopted on an experimental design is located in women with partial seizure experimental designs field in order to achieve the goals of the research, has sample consisted of two divisions seminars Mentzmtin in junior high school Diyala for Boys, and divided the sample of (60) called on the two groups, the first pilot of ( 30) student, and the other officer and number (30), student, and studied researchers experimental group theory TRIZ, while he studied the officer in the traditional manner, the researcher conducted a pa

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Effectiveness Of the Poetic Text Between the Presence and Absence in Abu Firas al_Hamdani Romyate
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Abu Firas al- Hamdani is one of the most prominent abbasid poets Who characterized their poetry with high artistic quality especially in his Romyate which blended the quality of feelings of grief, sorrow, longing and nostalgia that makes sensitive self conflict that stems with time from one hand and with place on the other hand. Because we are dealing with a poet lived west spatial coercive which it has been hurt him within a time conflict swinging between despair and some times patience and hope other times between the present and his painful reality also between the past and the beautiful times.
This researcher is to stand on this Romyat by monitoring effectiveness of the poetic text based on conflict between the presenc

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The history of rational thought for the investment by human capital and the investing in it.
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The investment however "was its description and meaning, it remains a resident" in the composition of capital assets located in the forefront of the creation of productive assets, and this means that the investment in the productive sectors is a priority in achieving capital accumulation, on any other investment that takes place with the stages of advanced development of formation , not forgetting "to humans and investment humans as head of real money product, the source of the economic surplus and accumulation, and the source of producing values, and if human labor was the source of value, and the human was the source of work, therefore humanitarian work on different levels and skills presents capital", so the investment in huma

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