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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
Fri Dec 01 2023
Journal Name
Al-khwarizmi Engineering Journal
Working Memory Classification Enhancement of EEG Activity in Dementia: A Comparative Study
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The purpose of the current investigation is to distinguish between working memory ( ) in five patients with vascular dementia ( ), fifteen post-stroke patients with mild cognitive impairment ( ), and fifteen healthy control individuals ( ) based on background electroencephalography (EEG) activity. The elimination of EEG artifacts using wavelet (WT) pre-processing denoising is demonstrated in this study. In the current study, spectral entropy ( ), permutation entropy ( ), and approximation entropy ( ) were all explored. To improve the  classification using the k-nearest neighbors ( NN) classifier scheme, a comparative study of using fuzzy neighbourhood preserving analysis with -decomposition ( ) as a dimensionality reduction technique an

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Publication Date
Sun Sep 01 2024
Journal Name
Green Analytical Chemistry
Green methods for determination of paracetamol in drug samples: A comparative study
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Publication Date
Wed Jan 01 2025
Journal Name
Veterinary World
Comparison of the sequences of the viral capsid protein 1 and viral capsid protein 2 encoded genes in symptomatic and asymptomatic cases of canine parvovirus 2 in dogs
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Background and Aim: Canine parvovirus 2 (CPV-2) is a highly contagious virus that infects wild and domestic canines. Despite the use of a routine vaccination protocol, it is endemic in Iraq. The genetic drift of CPV-2 is a major issue worldwide because it abrogates virus control. In Iraq, there is a knowledge gap regarding the genetic sequences of asymptomatic and symptomatic CPV-2 cases. Therefore, this study aimed to perform a genetic analysis of viral capsid protein 1 (VP1) and viral capsid protein 2 (VP2), two major capsid-encoding genes, to demonstrate the possible role of certain mutations in triggering infection. Materials and Methods: Symptomatic and asymptomatic cases (n = 100/each) were tested by a polymerase chain reacti

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Publication Date
Tue Aug 02 2022
Journal Name
Journal Of Legal Sciences
Expropriation of foreign investments - a comparative study
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The right to property is one of the most prominent and most important of the fundamental rights that the individual enjoys, whether national or foreign, both of them have their own private property that may not be affected except for the requirements of the country's economic development or what is known as the public benefit, and the Iraqi legislator did not specify what is meant by the removal of foreign investment. Of the bilateral international agreements (BITS), as it determined its terms and methods, the properties of foreign investors may be expropriated in a direct and indirect way.

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
A Pragmatic Study of English Honorific Forms
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         It is axiomatic that languages mirror  the world view of their users. Manipulating honorific forms  among people inevitably reflects this truth . Honorifics are conventionalized forms or expressions  manifested in all the world's languages and  are used to  express the social status of the participants in the verbal interaction and to convey indications like politeness and respect  . English is no exception. However the question is what exactly creates these forms and their meanings. Although  honorifics have been extensively researched from a grammatical and semantic  angle  , yet they haven’t received that significant  attention  i

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Publication Date
Mon Jan 02 2023
Journal Name
Pakistan Heart Jornal
The Effect of the Strategy of Differentiated Education According to the Auditory Learning Style by Using Assistance in Learning the Back Kick (T-Chagi) for the Young Players of …
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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Views of Amadi and Gorgani In the metaphor in their books budget and mediation
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The research revolves around the views of Al-Amadi and Al-Jurjani in the metaphors in their books, balancing Abu Tammam and Al-Bohtari, and mediation between Mutanabi and his opponents. And others whose poems were cited. One of the most important things we have reached is: the critics release the term metaphor to take sometimes and mean to take the meaning or steal it, and analyzed the evidence of metaphor as a rhetorical art in the light of what he heard about the former Arab poets, rejected the unusual metaphor out of use, and reclaimed the familiar metaphor. The research after submitted to the topics are: the first: Al-Amadi and his budget book, the second: Al-Jurjani and his book of mediation, and the third is divided into three dema

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Publication Date
Wed Jan 01 2025
Journal Name
Journal Of The Indian Chemical Society
Inspection the impact of mixing and external resistance on the Microbial Desalination Cell for electricity generation and desalination efficiency by using Macroalgae as a bio-cathode
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Publication Date
Wed Jun 01 2022
Journal Name
Canadian Journal Of Chemistry
Hydrogenation of pyridine and hydrogenolysis of piperidine over $γ$-Mo2N catalyst: a DFT study
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Increasing demands on producing environmentally friendly products are becoming a driving force for designing highly active catalysts. Thus, surfaces that efficiently catalyse the nitrogen reduction reactions are greatly sought in moderating air-pollutant emissions. This contribution aims to computationally investigate the hydrodenitrogenation (HDN) networks of pyridine over the γ-Mo2N(111) surface using a density functional theory (DFT) approach. Various adsorption configurations have been considered for the molecularly adsorbed pyridine. Findings indicate that pyridine can be adsorbed via side-on and end-on modes in six geometries in which one adsorption site is revealed to have the lowest adsorption energy (–45.3 kcal/mol). Over a nitr

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Publication Date
Wed Oct 03 2012
Journal Name
Journal Of Kufa For Chemical Science
A study of Adsorption of Acetone and 2- Butanone on Iraqi Siliceouns Rocks Powder
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Adsorption of Acetone and 2-Butanone on Iraqi siliceouns rocks powder have been investigated. UV technique has been used to determine the adsorption isotherms. The results showed that the adsorption isotherms obeyed Freundlich adsorption equation. The results showed that the adsorption increases with increasing acidity of solutions. The adsorption was exothermic process, increasing temperature leads to decreasing adsorption. H,  S, G were calculated