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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
Wed Mar 15 2023
Journal Name
Al-academy
The dramatic necessities of the Obligatory Scene in the feature film
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 Drama is one of the means of transmitting human experiences, as it presents within it the life ideas and visions of the spectator, who is subject to their influence on him, robbed of the will in front of its charm and various display arts, which invade him with its dimensions and affect his references, and this art form is based on stories revolving around personalities involved in events that have grown As a result of the struggle of two conflicting opponents, or two opposing forces or emotions generated as a result of a voluntary conflict, as this dramatic conflict represents the most important elements of those events, as it is embodied in an inevitable scene that emerges from other scenes, and this scene is sometimes subject to the

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Publication Date
Mon Jun 01 2015
Journal Name
Journal Of The College Of Languages (jcl)
THE PARTICLES OF GRAMATICAL IN The Semitic Languages THE FARM (WAW)
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The Semitic Languages have    her its  Articulatory   That  what  we  attend  to  discuss  In  this  Research  to  Represent the  Relation  Between  them  and  the Light  Of  Semitics   a Comparative Studies  where  ever  It's  Exists   The Semitic languages by comparing the words whish most Semitic languages share with each other. We call such Words the Semitic denominator. We have adopted a comparative framework in our Research, which is based on comparing an Arabic word with its Semitic counterpart in Order to identify the forms that control grammatical  change in both language

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Publication Date
Mon Jan 02 2017
Journal Name
Al-academy
The Pluralism In The Interior Spaces Design Of The Baghdadi House
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Since his first existence on earth, human had formed a connecting link for a regressive, kinetic and developed relationship that comes from a semi-complicated interaction between natural environment and constructed environment, and this resulted in the survival of human and his existence continuance. Constructed environment enabled human to survive the natural environment inconstancies and enemies as predators, also it helped him to feel safe, comfortable and to practice his everyday life activities...etc. This alternative interaction resulted in creating a civilized legacy for a group of landmarks that tell about the development of this relationship by elemental output that reached us either by documents and manuscripts or as an existed

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Publication Date
Thu Jun 09 2022
Journal Name
2022 International Congress On Human-computer Interaction, Optimization And Robotic Applications (hora)
Study of Inelastic Coulomb Form Factors in 18O using the Radial Wave functions of Transformed Harmonic-Oscillator
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Publication Date
Wed Oct 16 2019
Journal Name
Journal Of Research In Medical And Dental Science
Evaluation of the Antibacterial Efficacy of Silver Nanoparticles as an Irrigant against Enterococcus faecalis In vitro Study
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Background: Successful root canal therapy depends on thorough chemo mechanical debridement of pulpal tissue, dentin debris and infective microorganisms. Objective: This study aimed to investigate the antibacterial effect of silver nanoparticles, sodium hypochlorite and chlorhexidine in reducing the bacterial infection of the root canals. Materials and Methods: The root canals of 55 single-rooted teeth were cleaned, shaped, and sterilized. All the teeth samples were inoculated with Enterococcus faecalis and incubated at 37°C for 2 weeks. Then, the teeth were divided into four groups. Group I (n=15): 100 ppm silver nanoparticles, Group II (n=15): 2.5 sodium hypochlorite, Group III (n=15): 2% chlorhexidine, IV (n=10): Normal saline as a contr

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Publication Date
Sun Aug 01 2021
Journal Name
The Journal Of Asian Finance, Economics And Business (jafeb)
The Effect of Social Marketing on Customer Behavior: An Empirical Study of Tourism Companies in Baghdad, Iraq
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Social marketing seeks to develop and integrate marketing concepts with other approaches to social change and aims to influence behaviors that benefit individuals and societies for the social good. The study investigates the type and level of influence of social marketing on customer behavior in tourism companies in Baghdad (Iraq). The sample size of the study is 135 people comprising directors, assistant directors, and marketing staff in tourism companies in Baghdad. A questionnaire was used as a tool to collect data and information, and was prepared by the researcher after it underwent validity, stability, and arbitration tests. The data was analyzed using the statistical program (SPSS v. 25, AMOS v. 23) and statistical methods have been

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
Features of Modernity in the Works of Saleh Al-Jami (An Analytical Study): رؤى قحطان عبد الله
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Since the beginning of the twentieth century, the art of composition has witnessed major transformations that accompanied the transformations that occurred in the cognitive field. The plastic artists rejected the prevailing artistic line, and sought to create a new artistic format that accommodates the new social and cultural problems. So was the announcement of the era of modernity in the late nineteenth century, with the birth of the impressionism movement that gave a place to challenge all that is familiar. . And he drew the attention of the researcher, and for that he chose the research title (Characteristics of Modernity in the Works of Saleh Al-Jumayyi (Analytical Study)) The researcher divided the research as follows:
Methodolo

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Evaluation of Risk Management among Managers of the Primary Health Care Centers in Baghdad City: Comparative Study
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Background: Several risk managem-ent standards had been developed including the Project Management Institute, the National Institute of Standards and Technology, actuarial societies, and ISO standards.

Objective: The study aimed at evaluating risk management among managers of model and ordinary primary health care centers in Baghdad City and comparing the risk management among these centers.

Methods: A descriptive comparative des

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Publication Date
Sun Dec 06 2009
Journal Name
Baghdad Science Journal
Study of the Porosity of Certain pharmaceutical Tablets using Mercury Intrusion Porosimeter
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Porosity and pore structure are important characteristics of pharmaceutical tablets, since they influence the physical properties, such as mechanical strength, density and disintegration time. This paper is an attempt to investigate the pore structure of four different paracetamol tablets based on mercury porosimetry. The intrusion volumes of mercury were used to calculate the pore diameter, pore volume and pore size distribution. The result obtained indicate that the variation of the pore volume in the tablets followed the sequence:- S.D.I. Iraq? Pharmacare,Dubai-U.A.E.? Bron and Burk(UK) London?Lark Laboratories(India), while the variation of surface area followed the sequence:- S.D.I. Iraq? Lark Laboratories(India)? Pharmacare,Dubai-U.A

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Publication Date
Mon Jan 01 2018
Journal Name
Aip Conference Proceedings
Study the effect of nano SiO2 on dielectric strength property of zirconia
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