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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
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of coordination and joint cooperation in raising the quality of auditing in accordance with the INTOSAI standard(9150 (: Applied research in the General Company for Marketing Medicines and Medical Appliances - Kimadia
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The process of coordination and joint cooperation between SAIs and internal auditors in the public sector is considered one of the very important matters in performing efficient audits and are of high quality, especially if this coordination and cooperation is implemented in accordance with international standards, as it leads to avoiding duplication in auditing work. And the distribution of work in a distribution that achieves the objectives of auditing in general and is of general benefit to the economic unit.

The research problem lies in the weakness of the relationship between internal auditing and external auditing as a result of not applying INTOSAI Standard (9150) coordination and joint cooperation

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Publication Date
Sun Dec 31 2017
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study the Effect of Using Microwave Radiation and H-Donors on Improving Heavy Oil
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The present research has investigated the effect of microwave energy on improving the flow properties of heavy crude oil. The fragmentation of crude oil molecules was carried out with and without using 1 and 10 wt. % concentration of various types of H-donors like tetralin, cyclohexane, and naphtha.  Microwave power of 320, 385, and 540 W and radiation time 1-9 min, and temperature were studied. The kinematic viscosity and asphaltene content were measured for evaluation the improving of heavy crude oil.

   Results show that viscosity of crude oil decreased with increase H-donor concentration, a maximum percentage of viscosity reduction was10.63 % for tetralin at 6 min radiation time, while 8.67%, and 7.34% for cycl

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Publication Date
Tue Oct 01 2024
Journal Name
Results In Chemistry
Microwave synthesis, density functional theory study and antiproliferative activity of the novel spiropyrazole derivatives
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Publication Date
Fri May 25 2018
Journal Name
Open Public Health Journal
Comparative Study on the Clinicopathological Profiles of Breast Cancer Among Iraqi and British Patients
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Background: Breast cancer is the most common cancer in Iraq and the United Kingdom. While the disease is frequently diagnosed among middleaged Iraqi women at advanced stages accounting for the second cause of cancer-related deaths, breast cancer often affects elderly British women yielding the highest survival of all registered malignancies in the UK. Objective: To compare the clinical and pathological profiles of breast cancer among Iraqi and British women; correlating age at diagnosis with the tumor characteristics, receptor-defined biomarkers and phenotype patterns. Methods: This comparative retrospective study included the clinical and pathological characteristics of (1,940) consecutive female patients who were diagnosed with invasive b

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Publication Date
Tue Mar 31 2015
Journal Name
Al-khwarizmi Engineering Journal
Experimental Study of the Thermal Diffusivity and Heat Capacity Concerning Some Duplex Stainless Steel
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Abstract

In the present work, thermal diffusivity and heat capacity measurements have been investigated in temperature range between RT and 1473 K for different duplex stainless steel supplied by Outokumpu Stainless AB, Sweden. The purpose of this study is to get a reliable thermophysical data of these alloys and to study the effect of microstructure on the thermal diffusivity and heat capacity value. Results show the ferrite content in the duplex stainless steel increased with temperature at equilibrium state. On the other hand, ferrite content increased with increasing Cr/Ni ratio and there is no significant effect of ferrite content on the thermal diffusivity value at room temperature. Furthermore, the heat capacity of all sam

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
Structural and contextual dimensions For the connection of static T feminization An analytical study
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After looking at the books of the first two grammarians, may God have mercy on them and reward them for what they have provided us with the rules of service to the Book of God and service to Arabic, we must highlight some of the things that the grammarians wanted to clarify, which did not come out of what they proved, but we are working on the statement of the issuance of the passport Provisions from the syntactic industry, and whether it is intended to prove a rule is not very added to the statement of speech, and we know that language, any language was the function of understanding; therefore they said: (speech is a useful word that indicates the benefit improves silence on them), and this concept between Grammatical controls and conte

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Publication Date
Wed Oct 07 2020
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Synthesis and Study the Biological Activity of New Heterocyclic Compounds Derived From Hydrazide Derivatives
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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
Problematic intervention in the new international order and its impact on international relations - the U.S. role a model
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Intervention in International Relations from the concepts that are still highly
controversial among those he considers a breach of international law and the UN Charter and
in violation of the rule , and those who felt that the need provided, however, that this is linked
motives humanity recognized by the international community , because the international
variables proved the inadequacy of the principle of non-interference and the principle of
sovereignty as the traditional variables international , and therefore most of the international
practice came a bus with many of the behaviors that reflect a decline in its entirety to these
principles , and became adapt these principles with international reality is too compl

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Strategic Intelligence on the Process of Green Manufacturing An Explorative Study for the Managers Opinions of Sample of Mineral water factories at Dahuk
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         The studying trying to determine the role of  Strategic Intelligence on the Process of Green Manufacturing  of  Sample of Mineral water factories at Dahuk city.  The study submit a theoretical frame of Strategic Intelligence and Green Manufacturing, a supposed sample, had been set to reverye   the nature of the relations and effect in the study  Varity, the study  depend on group of the main and branch concurring with the relations and effect between the Strategic Intelligence and Green Manufacturing to answer the following questions about research to problems:

 What are the relationships and effects between stra

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Historical Value of Dickens’s A Tale of Two Cities
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In "historical" fiction, characters that never really existed, give expression to the impact of historical events on the people who really did live through them. The result is not history, as an accurate record of actual events, but fiction in which an earlier age is rendered through the personal joys and sufferings of characters. This paper
aims at investigating the historical realities presented in Dickens’s A Tale of Two Cities.

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