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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 16 2022
Journal Name
Journal Of Educational And Psychological Researches
Psychological counseling skills and their relation to the power of the ego in educational counselors
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The study aimed to identify the psychological counseling skills and the strength of the ego in the educational counselors, and to identify the relationship of statistical significance between the psychological counseling skills and the strength of the ego in the educational counselors, and to identify the differences of statistical significance in the relationship between psychological counseling skills and the strength of the ego in the guides according to the gender variable(male, Females), the number of sample (100) guides, including (50) males and (50) females from the area of ​​Atifiya and Qadissiya and Ameriya in the Directorate of Education Karkh / 1, the researcher adopted a scale of psychological counseling skills prepared b

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Publication Date
Sun Jun 06 2010
Journal Name
Baghdad Science Journal
The effect of wastewater disposal on the water quality and phytoplankton in Erbil wastewater channel.
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In this study, phytoplankton density, chlorophyll-a, and selected physico- chemical parameters were investigated in Erbil wastewater channel. The surveys were carried out monthly from May 2003 to April 2004. Samplings were established on three sites from headwaters to the mouth. The results showed that pH was in alkaline side of neutrality, with significant differences (P<0.05) between sites 1 and 3. TSS concentration decreased from site 1 toward site 2 (mean value, 80.15 to 25.79 mg.l-1). A clear gradual increase in mineral content (TDS) observed from site one of the channel towards the mouthpart. Soluble reactive phosphate has a concentration maximum mean value reached 48.4 µg.l-1 which is recorded in site 2. A high positive relat

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Publication Date
Wed Oct 12 2022
Journal Name
College Of Islamic Sciences
The semantic research of Al-Maarri in his book the ulna feel and its ablution
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Abu Al-Ala Al-Ma’arri is a linguist and writer who showed his prowess in poetry, so he had poetry collections, including “The ulna fell,” which is one of the books that attracted the attention of scholars such as (Tabrizi, Al-Khwarizmi, Al-Bateliusi and Al-Zamakhshari) .

 

To explain his language in it, the investigators’ hands finally revealed an explanation of this book, which was the work of Abu Al-Ala Al-Ma’arri himself. Those who studied the Divan (The Zind) and its explanations or the character and language of Al-Ma’arri did not pay any attention to it. Therefore, I made this research a continuation of those efforts, using semantic research as a means of revealing Al-Maarri's ef

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Publication Date
Thu Oct 01 2020
Journal Name
Biochemical And Cellular Archives
MORPHOLOGICAL DESCRIPTION AND HISTOLOGICAL STRUCTURE OF THE JEJUNUM IN THE IRAQI BLACK PARTRIDGE (FRANCOLINUS FRANCOLINUS)
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Publication Date
Sun Jun 11 2017
Journal Name
Al-academy
The Theory of knowledge And Their Repercussions On the Journalistic Image In Electronic Designs Websites
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represent websites link support of human communicate and cohesion of cultures different depending on their languages and their environments around, it was the evolution of one of the most important means of communication of services for electronic networks, the Internet active role in containing the world Bbodqh science and knowledge to Taatlaqah cultures from which derives its intellectual and cognitive cupboards continuity and as a link language for each those environmental Altdadat, linguistic, religious, political, economic . We all know that these electronic means difficult promise ring intellectual and mental connectivity for the masses polarized without being of the image as an element Kravekaa supporter of the electronic media an

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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Southwest Jiaotong University
The Dynamics of an Eco-Epidemiological Model with Allee Effect and Harvesting in the Predator
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The aim of this study was to propose and evaluate an eco-epidemiological model with Allee effect and nonlinear harvesting in predators. It was assumed that there is an SI-type of disease in prey, and only portion of the prey would be attacked by the predator due to the fleeing of the remainder of the prey to a safe area. It was also assumed that the predator consumed the prey according to modified Holling type-II functional response. All possible equilibrium points were determined, and the local and global stabilities were investigated. The possibility of occurrence of local bifurcation was also studied. Numerical simulation was used to further evaluate the global dynamics and the effects of varying parameters on the asymptotic behavior of

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Publication Date
Sun Jun 05 2022
Journal Name
Sport Tk-revista Euroamericana De Ciencias Del Deporte
Visual spatial attention and its impact on the accuracy of the diagonal spike in volleyball
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The primary aim of this research was to study visual spatial attention and its impact on the accuracy of the diagonal spike in volleyball. A total of 20 volleyball players of Baghdad participated in this study. The sample was homogeneous in terms of height, weight and age of the players. The tests used in the present study were: 1) Visual Spatial Attention Test. 2) Volleyball Spike Test. Based on the findings of the study, the researcher concluded that visual spatial attention has a significant impact on the accuracy of the diagonal spike in volleyball.

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Publication Date
Thu Oct 01 2020
Journal Name
Biochemical And Cellular Archives
MORPHOLOGICAL DESCRIPTION AND HISTOLOGICAL STRUCTURE OF THE JEJUNUM IN THE IRAQI BLACK PARTRIDGE (FRANCOLINUS FRANCOLINUS)
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Scopus
Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Disclosure and Transparency Criteria In Saudi Banks on The Financial Ratios Indicators
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The study aimed to measure the effect of applying the disclosure and transparency standards criteria adopted by the Saudi Arabian Monetary Authority on improving performance indicators in the Saudi banking sector, by measuring the extent of the impact of the bank's financial indicators represented by liquidity, profitability and return on assets in Saudi banks by applying the criteria of disclosure and transparency, which is one of the Main principles in the list of governance, which was approved by the Saudi Arabian Monetary Authority. The analytical approach was followed to achieve the goal of the study, as the financial statements of Saudi banks were analyzed during a period of 8-year to test four hypotheses related to measuri

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Publication Date
Sun Mar 04 2018
Journal Name
مجلة الباحث
"The Pinkerton Agency" and its security activities in the United States of America 1850-1899
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Fast economical developments in the US. in second half of nineteenth century contained many social results, such as increasing of stealing and killing crimes and expand of Labor strikes, which resulted in violence actions, and presented acceptable reason for emergence specialist security agencies, first of them "Pinkerton Agency". which played important role in all of that, besides that .. its role in American Civil War such as discovering an attempt to kill elected republican president Abraham Lincoln. This research studied all that aspects, focused on period of 1850 - 1899 of agency's history.

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