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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
Tue Jul 20 2021
Journal Name
Materials Science Forum
Investigation into the Distribution of Erosion-Corrosion in the Furnace Tubes of Oil Refineries
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Crude oil is one of the most important sources of energy in the world. To extract its multiple components, we need oil refineries. Refineries consist of multiple parts, including heat exchangers, furnaces, and others. It is known that one of the initial operations in the refineries is the process of gradually raising the temperature of crude oil to 370 degrees centigrade or higher. Hence, in this investigation the focus is on the furnaces and the corrosion in their tubes. The investigation was accomplished by reading the thickness of the tubes for the period from 2008 to 2020 with a test in every two year, had passed from their introduction into the work. Where the thickness of more than one point was measured on each tube in the sa

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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Impact beyond the knowledge when students of the Faculty of education in teaching methods
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Research aims to know the impact beyond the defined in the collection. The research community is the second school students at Baghdad University and a research sample (63) students, the number of experimental group (27) students and a control group (30) students.  The researcher was rewarded in variable lifetime for students and educational attainment and educational level of the parents and the educational level of mothers. The researcher has developed a test took the number of paragraphs (20).  A test was true after it has been submitted to the Group of arbitrators. The test was consistent with test method used and the reliability coefficient (0, 88). Either the statistical methods used by the researcher are: Pearson correla

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Publication Date
Tue Dec 15 2020
Journal Name
Al-academy
Diversity of Temporal Workings in the Narrative of the Feature Film: عباس فاضل عبد
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  Time represented a significant element in building any film story, despite its inability to express itself, but by employing the rest of the elements of the cinematic mediator language to express it. Time factor is present and manifested in all the details of the picture, and the more important is its presence in the event narration process. The narration totally depends on temporal structure in which it appears, which makes time a dominating element in the development of the narrative shapes and patterns. The narrative propositions have come to take new workings that time streams appeared that manipulate the time structure, reversing it, stopping it or making it fluctuate between the three levels of time, or repeating it or make

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Publication Date
Thu Jun 30 2016
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of Asphaltene on the Stability of Iraqi Water in Crude Oil Emulsions
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In the present work, asphaltenes and resins separated from emulsion samples collected from two Iraqi oil wells, Nafut Kana (Nk) and Basrah were used to study the emulsion stability. The effect of oil resins to asphaltene (R/A) ratio, pH of the aqueous phase, addition of paraffinic solvent (n-heptane), aromatic solvent (toluene), and blend of both (heptol) in various proportions on the stability of emulsions had been investigated. The conditions of experiments were specified as an agitation speed of 1000 rpm for 30 minutes, heating at 50 °C, and water content of 30%.  The results showed that as the R/A ratio increases, the emulsion will be unstable and the amount of water separated from emulsion increases. It was noticed that the em

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Publication Date
Sun Jun 30 2013
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of Promoters on the Activity of Prepared Zeolite Catalyst in FCC Process
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Faujasite type NaY zeolite catalyst was prepared from locally available kaolin, then the prepared NaY zeolite have been modified by exchanging of sodium ion with ammonium to produce NH4Y zeolite. NH4Y zeolite was converted to HY zeolite by ion exchanging with oxalic acid. Zinc and nickel promoters have been added to the prepared HY zeolite catalyst, and the effect of these promoters on the catalytic activity of the prepared HY catalyst was studied in fluid catalytic cracking process using light gas oil as a feedstock. The experimental results show that the promoted catalyst gives higher gas oil conversion and gasoline yield than HY zeolite catalyst at the same reaction temperature and WHSV. It was also found that the promoted catalyst gi

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Publication Date
Tue Jun 01 2021
Journal Name
Iraqi Journal Of Physics
Use of zeolite to reduce the radioactivity of cesium -137 in the liquid waste
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 Prepared zeolite type A was used for theremoval of cesium ions from aqueous solution. The experimental data were analyzed by Langmuir, Freundlich isotherms. Various parameters, such as contact time, zeolite weight, pH, and initial concentration, were studied. The results indicated that the highest removal efficiency was95.53% at (2h time, 0.04 g weight, and pH=6.8). The results also showed that the Freundlic model fits well with the experimental results and is better than the Langmuir model.

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Publication Date
Mon Oct 02 2023
Journal Name
Journal Of Engineering
The Applicability of Multiple MCDM Techniques for Implementation in the Priority of Road Maintenance
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Priority of road maintenance can be viewed as a process influenced by decision-makers with varying decision-making power. Each decision-maker may have their view and judgment depending on their function and responsibilities. Therefore, determining the priority of road maintenance can be thought of as a process of MCDM. Regarding the priority of road maintenance, this is a difficult MCDM problem involving uncertainty, qualitative criteria, and possible causal relationships between choice criteria. This paper aims to examine the applicability of multiple MCDM techniques, which are used for assessing the priority of road maintenance, by adapting them to this sector. Priority of road maintenance problems subject to internal

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Publication Date
Tue Apr 01 2025
Journal Name
Sustainable Materials And Technologies
Current developments in the use of nanotechnology to enhance the generation of sustainable bioenergy
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Publication Date
Thu Jan 24 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Accounting For Investments In Joint Projects Accounting to the International Accounting Standard: An applied Study at the General Company for food Stuff Trading
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   As a result of the entry of  multinationals companies in Iraq for investing in the joint projects through conducting agreements and contracts for work on important and strategic projects to get the necessary funds and various experiences which characterize the foreign participant sides that Iraq currently needs them and because of the non-applying the accounting processing stipulated in the unified accounting system in addition to the absence of a local accounting bases as well as the default of the participant contracts on indicating the accounting methods about those projects which are considered one of the bases that enables auditors in the public sector to depend on it, thus the research paper deals with studying an

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Publication Date
Sat Nov 27 2021
Journal Name
Route Educational & Social Science Journal
A STYLISTIC ANALYSIS OF ADVERTISING DISCOURSE: A CASE STUDY OF FACEBOOK COMMERCIAL ADVERTISEMENT
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BN Rashid

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