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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 15 2024
Journal Name
Journal Of Legal Sciences
The period for challenging the unconstitutionality of the medium-term general budget law In light of the decision of the Federal Supreme Court No. 155 and its unified No. 163 / Federal / 2022
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يتعرض قانون الموازنة العامة الاتحادية للطعن بعدم الدستورية كغيره من القوانين، بل أن الطعن فيه يكاد يكون سنوياً حال نشره في الجريدة الرسمية ، وتوجه إليه المطاعن بعدم الدستورية إما عن إجراءات تشريعه أو لمضامينه المتعارضة مع الدستور نصاً أو روحاً ، ولكنّه إذا كانت مدة الطعن بعدم دستورية القوانين كافة متاحة دون قيد زمني محدد ولا تتطلب سوى إجراءات إقامة الدعوى العامة وأخصها قيام شرط المصلحة في حالة الدعوى ال

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Publication Date
Wed Jun 10 2009
Journal Name
Iraqi Journal Of Laser
Real Time Quantum Bit Error Rate Performance Test for a Quantum Cryptography System Based on BB84 protocol
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In this work, the performance of the receiver in a quantum cryptography system based on BB84 protocol is scaled by calculating the Quantum Bit Error Rate (QBER) of the receiver. To apply this performance test, an optical setup was arranged and a circuit was designed and implemented to calculate the QBER. This electronic circuit is used to calculate the number of counts per second generated by the avalanche photodiodes set in the receiver. The calculated counts per second are used to calculate the QBER for the receiver that gives an indication for the performance of the receiver. Minimum QBER, 6%, was obtained with avalanche photodiode excess voltage equals to 2V and laser diode power of 3.16 nW at avalanche photodiode temperature of -10

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Publication Date
Mon Jun 15 2020
Journal Name
Al-academy
The narrative and dramatic construction between the vision of the script and the director: بان جبار خلف
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  The relationship between the vision of the scenario and the director is represented in the second search for new mechanisms and possibilities that possess the direct effect and synonyms of the vision of the scenario, so he works on investing them in achieving his ideas and visions with more effectiveness and flexibility to achieve creative potentials, without resorting to the installations and expressive structures themselves that have exhausted their meaning, and lost their luster due to Its prevalence and familiarity on the one hand, and its activation on the other hand to achieve modernity at the level of aromas, after the director takes a method or approach that has privacy and exclusivity, and based on the foregoing, getting

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Publication Date
Wed Apr 01 2020
Journal Name
Iop Conference Series: Earth And Environmental Science
Study for the Informal Settlement Supposed to Be Distributed by the Iraq Government for Poor People in Baghdad City - Republic of Iraq
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This paper set forth the spatial suitability of the informal settlement supposed to be distributed by the Iraqis government to poor people. The Iraqi government identified 9 locations of informal settlement in Baghdad city and acceptance it as a reality as a help for them to getting home. In this paper I discovered the suitability of those locations which one will be suitable more than others for living. The analysis process was applied using the GIS environment – spatial analysis. According to the results, It has been identified as the most important measures to identify which one of these areas suitable for development for housing by using some criteria (Distance from the city center, Proximity from transport routes, Proximity of high v

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Publication Date
Fri Nov 07 2014
Journal Name
Chemistry And Materials Research
Synthesis and Charactrization of New Schiff Base Derived from PVA and Erythroascorbic Acid Derivative and Study Its Effect on the Activity of ACh Enzyme (In Vitro)
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Schiff base derived from PVA and Erythroascorbic acid derivative (pentulosono-ɣ-lactone-2, 3-enedianisoate) was synthesized and characterized by Thin Layer Chromatography (TLC) and FTIR spectra, aldehyde was also characterized by (U.V-Vis), 1HNMR, 13CNMR and mass spectra. The inhibitory effect of prepared polymer on the activity of human serum Cholinesrerase has been studied in vitro. The polymer showed a remarkable activity at low concentration (4.5*10-3 – 4.5*10-8 M).

Publication Date
Fri Jun 30 2023
Journal Name
College Of Islamic Sciences
Belief in the Last Day and its impact on building a Muslim's personality
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Research Summary

        The doctrine of belief in the Last Day is one of the pillars of faith, and the doctrine of resurrection and reckoning are part of this day.

 Belief in the Last Day puts a person in constant control over himself, as this control creates in this person happiness and a decent life, and he renounces the world and turns away from all vices and adorns all virtues.

        On the other hand, we find that the person who does not believe in this day does not stand before his eyes anything that prevents him from doing injustices and corruption in the land. The doctrine of belief in the Last Day alone is

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Publication Date
Sun Oct 01 2023
Journal Name
Fuel
Matrix acidizing in carbonate rocks and the impact on geomechanical properties: A review
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Acid treatment is a widely used stimulation technique in the petroleum industry. Matrix acidizing is regarded as an effective and efficient acidizing technique for carbonate formations that leads to increase the fracture propagation, repair formation damage, and increase the permeability of carbonate rocks. Generally, the injected acid dissolves into the rock minerals and generates wormholes that modify the rock structure and enhance hydrocarbon production. However, one of the key issues is the associated degradation in the mechanical properties of carbonate rocks caused by the generated wormholes, which may significantly reduce the elastic properties and hardness of rocks. There have been several experimental and simulation studies regardi

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Publication Date
Sun Jan 25 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of the Efficiency of Three Different Obturation Techniques to Obturate the Isthmus Area of Roots Canals Prepared by Two Different Instrumentation Techniques (An In Vitro Study)
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Background: The isthmus is a difficult area in the root canal complex to manage. The research aimed to evaluate the efficiency of three different obturation techniques (lateral condensation, EandQ (thermoplasticized gutta percha system) and Soft Core (thermoplasticized core carrier gutta percha system)) to obturate the isthmus area of roots prepared by two different instrumentation techniques (rotary ProTaper universal and ProTaper Next systems). Material and method: Sixty freshly extracted teeth were randomly divided into two main groups (A and B) of 30 teeth each. Group A was prepared by rotary ProTaper Universal whereas group B was prepared by ProTaper Next system. Each main group was then randomly subdivided into three subgroups of 10 t

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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Educational And Psychological Researches
Developing Undergraduate Students' Geography Learning Skills during Fieldwork and Their Attitude toward It: Developing Undergraduate Students' Geography Learning Skills during Fieldwork and Their Attitude toward It
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Abstract

This study identified the developing of a range of students' geography learning skills and the change in their attitudes toward fieldwork as a consequence of leaning experiences that occurred within a field trip. The sample of the study consisted of (27) students within a special topic course enrolled in Geography Department at Umm Al-Qura University in Saudi Arabia in semester 2, 2018. A range of students' geography learning skills were measured by the skills questionnaire that consisted of 12 geography skills after completing field work. Changes in students' at

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Publication Date
Tue Jul 11 2023
Journal Name
Journal Of Educational And Psychological Researches
Developing the Social Studies Curriculum at the Primary Stage in View of the Standards of the Next Generation
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The aim of the current research is to develop the social studies curriculum at the primary stage in light of the standards of the next generation, which was represented in three main dimensions (pivotal ideas, scientific practices, and comprehensive concepts). The researcher designed a tool for the study, which is a content analysis card in the light of (NGSS) standards, based on the previous main dimensions. The descriptive analytical approach was adopted in analyzing the social studies curriculum for the primary stage to determine the degree to which the standards of the next generation are available, as well as to establish the theoretical framework related to the research variables. To develop the social studies curriculum in light o

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