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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 Dec 11 2019
Journal Name
Journal Of The College Of Education For Women
Investigating Difficulties Faced by Iraqi EFL Learners in Identifying the Illocutionary Force of the Reduplicative Words
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A reduplicative word is an important phenomenon in all language studies because it reflects many functions in language communication such as plurality, emphasis, contrast, imitation.  The various instances of reduplicative words in a particular language reflect the richness and uniqueness of that language. Moreover, such variation gives insights into both culture and thought. A reduplicative word is a linguistic phenomenon found in the syntactic, morphological, phonological and semantic levels. The current study aims at investigating the illocutionary force of English reduplicative words in some selected English colloquial utterances. To achieve this aim, an analytical -pragmatic approach has been used by adopting Searle’s (1979)

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of real estate investment projects with framework theory of real options: A case study in the shopping center project (Baghdad Mall)
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Focused research aims to provide a framework cognitive analytical nature of real estate investments and how they evaluated in the light of the assessment tools of modern theory of real options, and the possibility to rely on that theory in the detection of the true value of projects, real estate investments that would maximize the value of the investment decision taken, and the analysis of those projects that arise in the real estate markets and environments is the organization, which she was to make sure cases and high-risk, compared with entrances techniques, discounted cash flow (net present value). Based on the assumption lies in the possibility of the application of the implic

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Publication Date
Tue Sep 28 2021
Journal Name
Journal Of The College Of Education For Women
Forced Displacement during the Syrian Forced Displacement during the Syrian Crisis, and its Impact on Jaramana’s Children's Education: A Field Study , and its Impact on Jaramana’s Children's Education: A Field Study: نهال ريحاوي جلب , قاسم الربداوي
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The study aims to examine the problem of forced displacement and its social and economic problems in light of the Syrian crisis. Such an aim helps to know the difficulties and challenges facing the children of displaced families in learning, and the reasons for their lack of enrolment. It also clarifies whether there are significant statistical differences at  among the attitudes of the children of the displaced families towards education regarding the following variables: (the work of the head of the family, the economic level of the family, and the work of the children). The study has adopted the descriptive-analytical approach;  a questionnaire was adopted as a tool to collect information. The study was applied to a sample o

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Publication Date
Mon Mar 27 2023
Journal Name
Iranian Journal Of Materials Science And Engineering
First-Principles Analysis of Cr-Doped SrTiO 3 Perovskite as Optoelectronic Materials
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The influence of Cr3+ doping on the ground state properties of SrTiO 3 perovskite was evaluated using GGA-PBE approximation. Computational modeling results infered an agreement with the previously published literature. The modification of electronic structure and optical properties due to Cr3+ introducing into SrTiO 3 were investigated. Structural parameters assumed that Cr3+ doping alters the electronic structures of SrTiO 3 by shifting the conduction band through lower energies for the Sr and Ti sites. Besides, results showed that the band gap was reduced by approximately 50% when presenting one Cr3+ atom into the SrTiO 3 system and particularly positioned at Sr sites. Interestingly, substituting Ti site by Cr3+ led to eliminating the ban

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Publication Date
Thu Sep 01 2005
Journal Name
Journal Of Sport Sciences
Comparison study in some kinematics variables in (100) meter butterfly swimming to first and second ranking in world swimming championship Espana 2003
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The aim of study was making comparison in some kinematics variables in (100) meter butterfly swimming to first and second ranking in championship 2003 Espana, so noticed there is no such like this study in our country in comparison study for international champions therefore not specific and scientific discovering to these advanced levels, also the researchers depend on group of kinematics variables when the comparison making and it was included (50 meter the first, 50 meter the second, the differences between the first (50) meter and the second , more over basic variables in (100) meter butterfly , after having the results and treat it statistically the researchers reaches to two conclusions which was: • Success the first rank in startin

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Publication Date
Mon Nov 27 2023
Journal Name
Journal Of Periodontal Research
Ability of gingival crevicular fluid volume, E‐cadherin, and total antioxidant capacity levels for predicting outcomes of nonsurgical periodontal therapy for periodontitis patients
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Abstract<sec><title>Objectives

To determine the potential of gingival crevicular fluid (GCF) volume, E‐cadherin and total antioxidant capacity (TAC) levels to predict the outcomes of nonsurgical periodontal therapy (NSPT) for periodontitis patients.

Background

NSPT is the gold‐standard treatment for periodontal pockets < 6 mm in depth, however, successful outcomes are not always guaranteed due to several factors. Periodontitis‐associated tissue destruction is evidenced by the increased level of soluble E‐cadherin and reduced antioxidants in oral fluids which could be used as predictors for success/failure of N

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Publication Date
Thu Jan 06 2022
Journal Name
Chemical Papers
A solvent collection technique using dispersive liquid–liquid microextraction coupled with spectrophotometry for the trace determination of folic acid in pure, dosage forms and flaxseed
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A simple, rapid and environmentally friendly dispersive liquid–liquid microextraction method-based spectrophotometric method for the trace determination of folic acid has been developed. The proposed method is based on the formation of a deep yellow product via reaction of folic acid and 1,2-naphthoquine-4-sulfonate at pH = 9. The formed complex was extracted using a mixture of chloroform and ethanol. Then, the tiny organic droplets were measured at λ = 520 nm. At the optimum conditions, linearity was ranged from 0.05 to 1.5 μg/mL for the standard and samples, with a linear correlation coefficient of 0.9996. The detection limits were 0.02, 0.027, 0.03, 0.02 and 0.04 μg/mL for standard, tablet (5 mg), tablet (1 mg), syrup and fl

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Publication Date
Fri Mar 28 2025
Journal Name
Journal Of Physical Education
Standard scores and levels for certain legal situations among first-class basketball referees
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The significance of the research lies in the fact that electronic technologies represent an important step in evaluating legal situations, and the research problem centered on the lack of attention to visual requirements and the absence of a clear image of legal situations that may be difficult for the referee to apply correctly in addition to the lack of focus on visual requirements and the unclear depiction of some legal cases which make it difficult for the referee to interpret them correctly This is because the referee's main tool is visual perception, which interprets live situations such as violations, fouls, and other cases that arise during a game Moreover, there are numerous responses and challenges in evaluating legal situ

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Publication Date
Sat Jan 05 2019
Journal Name
Iraqi Journal Of Physics
Study of nuclear structure for carbon isotopes using local scale transformation technique in shell model
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This work is devoted to study the properties of the ground states such as the root-mean square ( ) proton, charge, neutron and matter radii, nuclear density distributions and elastic electron scattering charge form factors for Carbon Isotopes (9C, 12C, 13C, 15C, 16C, 17C, 19C and 22C). The calculations are based on two approaches; the first is by applying the transformed harmonic-oscillator (THO) wavefunctions in local scale transformation (LST) to all nuclear subshells for only 9C, 12C, 13C and 22C. In the second approach, the 9C, 15C, 16C, 17C and 19C isotopes are studied by dividing the whole nuclear system into two parts; the first is the compact core part and the second is the halo part. The core and halo parts are studied using the

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Publication Date
Thu Jun 01 2023
Journal Name
Australian Dental Journal
Debonding of LDSVs utilising Er,Cr:YSGG laser irradiation with fractional technique: an in vitro study
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