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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
Thu Mar 19 2015
Journal Name
Al-academy
Aesthetic single-Baghdadi in the works of the ceramists Siham Saudi (analytical study): نعمات محمد رضا حسين
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Baghdad (the capital of the Abbasid Caliphate, and his legacy oldest civilizations in history, with glory ethyl). 1. benediction this city landmarks archaeological evidence of their own Kkabbab mosques and forms gates and (Aelchenachel) 2, which adorn the walls of buildings and Chaababeckha high and palm trees, all these vocabulary inspired artists embody Baghdad warmest dissolved in their artwork and all those who lived and grew up in Baghdad embodied in his memory for the nights Beauties and their lights and Hoa_khasha. Ceramic Arts art one who embodied the most important symbols that represent the beauty and credited with Baghdad. And many Iraqis potters inspired single Baghdadi in their work, notably ceramists late arrows Saudi which

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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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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
Sat Dec 25 2021
Journal Name
International Journal Of Drug Delivery Technology
Study of Main Factors Affecting the Leakage of Aluminum into the Food Wrapped in Aluminum Foil During Cooking
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Different cooking conditions were examined for aluminum content in food cooked while wrapped with aluminum foil. The influence of each anticipated factor (the acidity of the cooking medium, type of acids normally used in cuisines namely acetic and tartaric acids, various cooking temperatures, influence of the presence of sodium chloride salt, the effect of cooking oil, and the length of time of cooking) was studied thoroughly as a function of aluminum degraded out of the aluminum foils to the medium. The experimental samples were digested with nitric acid upon fulfillment of examining each factor separately before quantifying aluminum with the sensitive technique of atomic absorption spectroscopy. The outcomes of the study have shown that t

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Publication Date
Thu Jan 01 2015
Journal Name
The Iraqi Postgraduate Medical Journal
Aesthetic results of superomedial pedicle technique in reduction mammaplasty
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ABSTRACT: BACKGROUND: Breast reduction for mammary hypertrophy is a highly effective procedure with high degree of patient satisfaction. There are many methods of breast reduction which involve removal of excess tissue with reshaping of overlying skin while maintaining a viable nipple areolar complex. OBJECTIVE: The purpose of this study is to evaluate the use of the superomedial technique as an effective method for reduction mammoplasty. PATIENTS AND METHODS: A total of 30 patients underwent reduction mammoplasty by utilizing superomedial pedicle technique between 2010 and 2013. Those patients were evaluated postoperatively in terms of their aesthetic and functional satisfaction, viability of nipple – areolar complex and nipple sensory p

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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
Fri Jul 28 2023
Journal Name
The Journal Of Physical Chemistry A
Tubular Magnetic Shielding Scan (TMSS): A New Technique for Molecular Space Exploration. (i) The Case of Aromaticity of Benzene and [<i>n</i>]Paracyclophanes
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Both traditional and novel techniques were employed in this work for magnetic shielding evaluation to shed new light on the magnetic and aromaticity properties of benzene and 12 [n]paracyclophanes with n = 3–14. Density functional theory (DFT) with the B3LYP functional and all-electron Jorge-ATZP and x2c-TZVPPall-s basis sets was utilized for geometry optimization and magnetic shielding calculations, respectively. Additionally, the 6-311+G(d,p) basis set was incorporated for the purpose of comparing the magnetic shielding results. In addition to traditional evaluations such as NICS/NICSzz-Scan, and 2D-3D σiso(r)/σzz(r) maps, two new techniques were implemented: bendable grids (BGs) and cylindrical grids (CGs) of ghost atoms (Bqs). BGs a

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Publication Date
Tue Apr 02 2024
Journal Name
Advances In Systems Science And Applications
A New Face Swap Detection Technique for Digital Images
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Publication Date
Sat Oct 01 2016
Journal Name
International Journal Of Pure And Apllied Mathematics
A SEMI ANALYTICAL ITERATIVE TECHNIQUE FOR SOLVING DUFFING EQUATIONS
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