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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
Gsc Biological And Pharmaceutical Sciences
Taxonomic study of a cultivated plant of genus Zanthoxylum l. 1753 (Rutaceae) in Iraq
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Zanthoxylum L. 1753 belongs to the family Rutaceae. The plant, with its forest green color and with its distinctive fragrance attracted the attention of the study, specially it was an exotic to the environment of Iraq. Zanthoxylum is an exotic plant produced to Iraq and planted in gardens as an ever-green aromatic plant named (BUKHUR HINDI), as it is known among sellers and farmers in Iraq, because of the aromatic smell that emanated from the leaves and resembles Indian incense. The plant adapted to environmental conditions and succeeded in growing and blooming. It was examined and diagnosed for the first time in Iraq as Zanthoxylum beechyanum K. Koch. (Chinese pepper tree). Morphological characteristics and anatomical characteristi

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Publication Date
Sat Dec 01 2018
Journal Name
Political Sciences Journal
The Patterns of the Strategic Environment and its Role in Determining Strategies for Dealing with Conflict and Peace Situations
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Abstract

The decision maker needs to understand the strategic environment to be addressed through different means and methods. It is obvious that there is a difference between the three strategic environments (conflict environment, peace environment, post- peace environment) in terms of inputs and strategies to deal with each one of them. There is an urgent need to understand each pattern separately, analyze its inputs, and identify the factors and variables that affect the continuity of this situation (conflict, peace, post-peace). It is not appropriate to identify treatment without diagnosis of the condition, so it is very important to understand the type of strategic environment to be dealt with it.

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Publication Date
Fri Dec 01 2023
Journal Name
Agbioforum
The Role of the Digital Economy, Business Synergy, and Trade Policies on Global Economic Prosperity in India and China
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The necessity of addressing global economic prosperity has garnered significant attention from recent studies and policymakers. This article analyses the effects of the digital economy, business synergies, and trade policies on the economic prosperity of China and India. The study examines the impact of political support on the digital economy, business synergies, trade policies, and global economic prosperity in China and India. The study collects data from prominent economists in India and China using questionnaires. The article utilised the SPSS-AMOS software to analyse the relationship between variables. The results showed that the digital economy, business synergies, and trade policies are positively linked to global economic prosperit

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Relationship between ABO Blood Group Distribution and the incidence of Upper Gastric and Duodenal Ulcer in Iraqi Patients
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The relationship between blood group antigens and peptic ulcer disease has been widely evaluated in the past, but only one study relating H pylori seroprevalence to ABO blood groups among Iraqi patients with peptic ulcer disease is available. We aimed to evaluate the frequency of peptic ulcer disease among different ABO blood groups in Iraqi patients, and we thought it was worthwhile to try to determine whether these components take some part in disease etiology. One hundred and six patients with peptic ulcer disease (PUD) (43 male and 63 female; mean  age: 48 ± 18 years) who attended Baghdad teaching hospital and Al- Yarmouk teaching hospital endoscopy centers were enrolled , and 238 control Subjects.  Fing

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Publication Date
Wed Apr 06 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role Talents Management in Consolidating Organizational Learning Process: An Applied Study at the Yemeni General Telecommunications Corporation
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This study aimed at accounting for the role of talents management in consolidating organizational learning process at the Yemeni General Corporation For telecommunication. To achieve the objective of the study, the researcher designed a questionnaire and administered it. The sample of the study consisted of (166) employees (General Manager, Manager and Department Head). They were selected randomly out of a total Population of (291) employees during the Year 2019. The descriptive analytic approach was used t reach conclusions.

The finding of the study revealed existence of effect of talents management dimensions, all together and alone, (talents polarization, talents development, talents maintenance and ma

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Publication Date
Tue Mar 08 2022
Journal Name
Multimedia Tools And Applications
Comparison study on the performance of the multi classifiers with hybrid optimal features selection method for medical data diagnosis
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Publication Date
Thu Sep 03 2020
Journal Name
Al-kindy College Medical Journal
Unusual Location of Giant Cell Tumor of the Tendon Sheath .. A Case Report
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Locking of the knee is a one of the commonest orthopedic outpatient presentation. This patient usually need magnetic resonance imaging (MRI) when there is suspected lesion in the soft tissue clinically. Meniscal tears is the first differential diagnosis when accompany with painful knee. (1, 2)Giant cell tumor (GCT) is benign a localized nodular tenosynovitis often occur in the tendon sheath , Mostly involve the hand tendons in middle age group between 30 and 50 years old , female affect more than male.(3,4) The WHO defines two well-known kinds of giant cell tumor: (1) pigmented villonodular synovitis ( generalized type), which mainly involve the joints of the lower limb and (2) giant cell tumor of the tendon sheath ( localized type)

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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
A Comparison of Bayes Estimators for the parameter of Rayleigh Distribution with Simulation
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   A comparison of double informative and non- informative priors assumed for the parameter of Rayleigh distribution is considered. Three different sets of double priors are included, for a single unknown parameter of Rayleigh distribution. We have assumed three double priors: the square root inverted gamma (SRIG) - the natural conjugate family of priors distribution, the square root inverted gamma – the non-informative distribution, and the natural conjugate family of priors - the non-informative distribution as double priors .The data is generating form three cases from Rayleigh distribution for different samples sizes (small, medium, and large). And Bayes estimators for the parameter is derived under a squared erro

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Publication Date
Tue Oct 08 2002
Journal Name
Iraqi Journal Of Laser
Effect of Gas Mixture on the Output Characteristics of a CW CO2 Laser
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In this work, the effect of partial amounts of gases in gas mixture of a CW CO2 laser on the output power was investigated. Also their effect on the condition determining the glow-discharge self-sustaining required for pumping the active medium was studied. Two fit relations were derived to predict the output laser power and the electric field to unit pressure ratio as functions to the partial amounts of gases. Results presented in this work could be used fruitfully to determine some of the optimum operational conditions of glow-discharge low-power CW CO2 lasers.

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Publication Date
Sat Jan 25 2020
Journal Name
International Journal Of Research In Pharmaceutical Sciences
Determination of the Dissociation Constants of Metformin from a Second Derivative UV Spectrum
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An environmentally begnin second derivative spectrometric approach was developed for the estimation of the dissociation constants pKa(s) of metformin, a common anti-diabetic drug.  The ultraviolet spectra of the aqueous solution of metformin were measured at different acidities, then the second derivative of each spectrum was graphed. The overlaid second derivative graphs exhibited two isobestic points at 225.5 nm and 244 nm pointing out to the presence of two dissociation constants for metformin pKa1 and pKa2, respectively. The method was validated by evaluating the reproducibility of the acquired results by comparing the estimated values of the dissociation constants of two different strategies that show excellent matching. As we

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