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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
Mon Dec 30 2024
Journal Name
Journal Of The College Of Education For Women
The Effect of Dictogloss Technique on University EFL Students' Collocation Knowledge
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تتمثل مشكلة الدراسة في الصعوبات التي يواجهها طلاب اللغة الإنجليزية كلغة أجنبية في تعلم وإتقان المتلازمات اللفظية. تهدف هذا الدراسة تهدف إلى تحديد أثر استخدام تقنية المسرد الاملائي على معرفة المتلازمات اللفظية لدى الطلاب. ولتحقيق أهداف هذا البحث والتحقق من فرضياته تم اختيار عينة عشوائية مكونة من (60) طالبة من كلية اللغة الإنجليزية للسنة الثانية باستخدام كتاب الفهم القرائي المقرر للمستوى الثاني في قسم الل

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Publication Date
Sun May 12 2019
Journal Name
Oral And Maxillofacial Surgery
Lingual anesthesia of the lower anterior teeth, which technique is better?
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Purpose To extract the lower anterior teeth, the oral surgeon needs to anesthetize the pulpal tissue of the accused tooth and the surrounding tissues. The lingual nerve innervates the lingual soft tissue to the lower teeth, this nerve usually anesthetized alongside the inferior alveolar nerve by a block technique. However, the lingual tissue of the lower anterior teeth usually anesthetized by either infiltration or periodontal ligament injection (PDL) techniques. This study was intended to compare between these two techniques. Methods Forty-eight teeth were extracted from 24 patients. Non-adjacent two lower anterior teeth in the same patient were selected. The lingual soft tissue in one of them was anesthetized by PDL injection technique wh

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Publication Date
Mon Oct 03 2022
Journal Name
Optik
Enhancement the photosensitivity of PVA NFs/Si prepared by electrospinning technique
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This work aimed PVA nanofibers in a range of concentrations were successfully manufactured via electrospinning. PVA NFs/Si was effectively prepared using the electrospinning process. The structural, morphological, optical and electrical properties of the prepared PVA were studied using XRD, FE-SEM, UV-Vis spectrophotometer and I-V characteristics, respectively. The amorphous structure of PVA nanofibers was observed. The optical energy gap from ultraviolet to visible was between (2.75 and 2.41) eV, making this compound highly sensitive to visible orange light at 610 nm, with a photosensitivity of 66%. The optical energy gap of PVA/Si heterojunction was utilized to modify this film from the UV to the visible spectrum. As show in the results,

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Publication Date
Sat Mar 30 2002
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
A Study of Absorption Column with Single Bubble Cap Tray in the Production of Sodium Bicarbonate
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Publication Date
Sat Mar 04 2023
Journal Name
Baghdad Science Journal
Nordhaus-Gaddum Type Relations on Open Support Independence Number of Some Path Related Graphs Under Addition and Multiplication
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In this paper, Nordhaus-Gaddum type relations on open support independence number of some derived graphs of path related graphs under addition and multiplication are studied.

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
term of the first difference between the Imam of the Two Holy Mosques, Imam Taj Al-Din al-Subki and its impact on the doctrine of Al-Shafeiyah
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Praise be to Allah, the Lord of the Worlds, the best prayer and the best prayer, on our master Muhammad, and on his pure God, and his companions and the faithful, and who followed them by charity to the day of religion. This relationship between emphasis, is a sincere, and this harmony, such as the relationship between water, and the green, but it is good, but, with greenery, it is better, and as well as alone, is a beautiful view, but the most beautiful, with the most beautiful. From here he was starting on myself in writing the fundamentalist research of jurisprudence, to show the depth of this interconnection. The doctrine as a new term, then the taj al-Din al-Suobki came after three centuries, and a

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Publication Date
Wed Sep 16 2020
Journal Name
Route Educational & Social Journal
Effect of applying the QR-Code system for acquisition chemistry and creative thinking in of first class female student at intermediate schools.
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This research aims at identifying the system of applying the QRcode system for acquisition of chemistry by first class female students studying at intermediate schools knowledge and its effect on creative thinking. The research sample consisted of (63) female students in one of the intermediate schools in Baghdad/Iraq using two equivalents experimental and control groups. The scientific context used was based on the chemistry text book related to the periodic table, (Metals) for the first group of students and Alkaline metals,Nonmetals, Metalloides) for the second group. The research methodology employed consisted of the followings :Measuring students acquisition using (35) issues. The results were verified for their face validity and obtai

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Study the Effect of Annealing on Optical and Electrical Properties of ZnS Thin Film Prepared by CO2 Laser Deposition Technique
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In this work, ZnS thin films have been deposited by developed laser deposition technique on glass substrates at room temperature. After deposition process, the films were annealed at different temperatures (200ºC , 300 ºC and 400ºC ) using thermal furnace.The developed technique was used to obtain homogeneous thin films of ZnS depending on vaporization of this semiconductor material by continuous CO2 laser with a simple fan to ensure obtaining homogeneous films. ZnS thin films were annealed at temperature 200ºC, 300 ºC and 400ºC for (20) minute in vacuum environment. Optical properties of ZnS thin film such as absorbance, transmittance, reflectance, optical band gap, refractive index extinction coefficient and absorption coefficien

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Publication Date
Sun Mar 03 2013
Journal Name
Baghdad Science Journal
Study the Spectral reflectance and factor affecting they for the dominate land cover by using remote sensing technique in Abu-Gharib projection.
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Image of landsate-7 taken by thematic mapper was used and classified using supervised method. Results of supervised classification indicated presence of nine land cover classes. Salt-soils class shows the highest reflectance value while water bodies' class shows the lowest values. Also the results indicated that soil properties show different effects on reflectance. There was a high significant positive relation of carbonate, gypsum, electric conductivity and silt content, while there was a week positive relation with sand and negative relation with organic matter, water content, bulk density and cataion exchange capacity.

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Publication Date
Tue Jan 01 2013
Journal Name
Journal Of The College Of Basic Education
Study the spectral reflectance and factor affecting they for the dominate land cover by using remote sensing technique in Abu-Gharib projection
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Image of landsate-7 taken by thematic mapper was used and classified using supervised method. Results of supervised classification indicated presence of nine land cover classes. Salt-soils class shows the highest reflectance value while water bodies' class shows the lowest values. Also the results indicated that soil properties show different effects on reflectance. There was a high significant positive relation of carbonate, gypsum, electric conductivity and silt content, while there was a week positive relation with sand and negative relation with organic matter, water content, bulk density and cataion exchange capacity.

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