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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 Jan 23 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The use of property sampling reduce of the Audit dangerous of auditor judgmentsApplied Research in Board of supreme Audit: Applied Research in Board of supreme Audit Accounts of the State Company for Cotton industries
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This research aims to clarify the advantages of statistical sampling method and provided the scientific basis of the auditor was able to defend the future of any objection to the validity of his opinion on the financial statements of the restrictions of personal rule as much as possible during the stages of the general Company for Cotton industries.Aresearc An applied study in the Board of supreme Audit  (the accounts of the cotton industry), have been used, a researcher at the theoretical side to achieve the objectives of the research methodology descriptive inference in the collection and analysis of financial statements of the circle (sample) for the financial year (2008). To achieve the objectives of the field study was designed

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Publication Date
Tue Jan 01 2019
Journal Name
Plant Archives
The causal relationship between the agricultural exports and agricultural growth in Iraq
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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Recantation By The Al-Zaher People And Its Effects in Derivation
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nouns , because deriving these names will lead to eternity which is impossible, and restrict the derivation only in agent nouns from their verbs, and the adjective names from their adjectives with the condition of truth in derivation.
The derivation of “Allah” names was denied due to a creed thoughts, because saying that “Allah” names is derived will not describe the eternal essence of “Allah”, and if it were derived this will make “Allah” is a Compound from his essence and Attributes.
The Al-Zaher people had recant the derivation of the agent nouns by preventing the derivation of “Allah” names because it will make “Allah” is a Compound from his essence and Attributes.
The Al-Zaher people had recant from

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Publication Date
Tue Aug 15 2023
Journal Name
Alustath Journal For Human And Social Sciences
Autoimmunity and the Terroristic Schemes in Dan Brown's The Da Vinci Code
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From a medical perspective, autoimmunity reflects the abnormal behaviour of a human being. This state is shaped when the defense of an organism betrays its own tissues. Allegedly, the immune system should protect the body against attacking cells. When an autoimmune disease attacks, it results in perilous actions like self-destruction. However, from a psychological perspective, the French philosopher Jacques Derrida (1930-2004) explains that autoimmunity harms both the self and the other. As a result, the organ disarms the betraying cells, as the immune system cannot provide necessary protection. From a literary perspective, Derrida has termed autoimmunity as deconstruction for almost forty years. Autoimmunity starts with the stage of a norm

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Publication Date
Sat Oct 01 2016
Journal Name
Al–bahith Al–a'alami
From Structure to the Signal (Text and Discourse in the Semiotic Analysis)
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Care and attention to the structure in the sixties of the last century replaced the mark, and if the structure of Ms. pampered in research and studies, it has become the mark is also a spoiled lady .. But the relationship between the structure and the mark was not a break and break, but the relationship of integration, His themes are structural analysis, and these are intellectual themes that can not be surpassed in contemporary research, especially since semiotics have emerged from the linguistic inflection.

We have tried to distinguish between text and speech, which is a daunting task, as it seems that whenever the difference between them is clear and clear, we come back to wonder whether the text is the same discourse, and is

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Publication Date
Wed Jan 01 2020
Journal Name
Modern Sport
Special exercises according to the Dynafoot data and its effect on the force index and the performance of the front straight air flip skill on the ground movements mat device
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Publication Date
Tue Dec 31 2013
Journal Name
Al-khwarizmi Engineering Journal
Spectral Study of Pt (II), Cr (II) Polymeric Complexes of the Ligand N- Crotonyl -2- Hydroxy-Phenylazomethine
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 The polymeric complexes were obtained from the reaction of polymeric Schiff base.N-crotonyl-2-hydroxyphenylazomethine (HL), with divalent metals Pt (II), Cr (II). The modes of bonding and overall geometry of the complexes were determine through spectroscopic methods and compared with that reported from analogous monomeric ligand. This study revealed square planer geometry around the metal center for [Pt(L)Cl] and distorted octahedral geometry for Cr complex [Cr(L)Cl(H2O)2].

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Publication Date
Mon Mar 01 2021
Journal Name
Iraqi Journal Of Physics
Study of the Nuclear Structure of some Neutron Rich Si Isotopes Using Shell Model with Skyrme Interaction
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  Abstract

      The nuclear structure of 28-40Si isotopes toward neutron dripline has been investigated in framework of shell model with Skyrme-Hrtree-Fock method using certain Skyrme parameterizations. Moreover, investigations of static properties such as nuclear densities for proton, neutron, mass, and, charge densities with their corresponding rms radii, neutron skin thicknesses, binding energies, separation energies, shell gap, and pairing gap have been performed using the most recent Skyrme parameterization. The calculated results have been compared with available experimental data to identify which of these parameterizations introduced equivalent results with the ex

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Publication Date
Thu Jun 20 2024
Journal Name
Bulletin Of The Iraq Natural History Museum
MORPHO-HISTOLOGICAL STUDY OF THE PROVENTRICULUS OF EURASIAN MARSH HARRIER CIRCUS AERUGINOSUS (LINNAEUS, (1766 (AVES, ACCIPITRIFORMES, ACCIPITRIDAE)
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The study aimed to describe the anatomical, histological, and histochemical structure of the proventriculuc of adult male Eurasian marsh harrier, Circus aeruginosus (Linnaeus, 1766) (Accipitriformes, Accipitridae). Six birds were used for this study. The histological sections of proventriculus were stained with hematoxylin and eosin, periodic acid Schiff, and alcain blue. The proventriculus, representing the upper stomach, appeared as a conical structure with a thick wall connecting the caudal end of the thoracic esophagus to the gizzard. It had a light brown color. Microscopic examination revealed that the proventriculus wall consists of the outer tunica serosa, the tunica muscularis, tunica sub mucosa, and the inner tunica mucosa.

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Publication Date
Sat Jul 01 2017
Journal Name
Al–bahith Al–a'alami
The Digital Presence of Algerian Females via Virtual Satellite Channels: Analytical Study of Women Issues through Facebook
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The platforms of social networking sites, with their distinctive communication and technological features, create a social movement that led to the establishment of a new pattern of communication in a modern context. This allows the users on the internet to carry out many social interactions based on the interests and commonalities among them. Algerian women have a share of this digital presence by representing their views and discussing their issues on several sites like Facebook, for example.
In this research, we have analyzed the pages of Algerian women on Facebook site to find out the most important issues addressed by Algerian women so that we can organize their concerns in the digital channels and discover their different orie

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