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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
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Kinetics of the Saponification of Mixed Fats Consisting of Olein and Stearin
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This research presents the kinetics of the saponification reaction using mixed fats of olein and stearin [in the ratio (3:1)] with NaOH solution. In this reaction, excess solution of NaOH was used to ensure the reaction being irreversible. Three parameters were varied to show their effects on the reaction rate .They are: percentage excess of NaOH solution (10 % - 100 %) , temperature (100-150)oC , and stirring speed (400-1100) rpm. It was noticed that increasing the percentage excess of NaOH solution enhances the rate of reaction while increasing temperature decreases the reaction rate since it is exothermic reaction.    Increasing stirring speed also improves the reaction rate because it is mass transfer controlled .Calcu

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Publication Date
Mon May 01 2023
Journal Name
Journal Of Molecular Liquids
On the influence of hydrocarbons solvents on the inhibition efficiency of some organic corrosion inhibitors: Theoretical and validation studies
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Publication Date
Fri Nov 11 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The initiative of the Central Bank of Iraq and its impact on some banking activities provided by specialized banks
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Specialized banks provide their banking activities to their customers at interest rates that are determined according to the approved bank policy, which is almost similar to most or most banks. To satisfy the financial desires of customers and at the same time it is a source of the bank's profits, However, these banks have been introduced to new services that they provide with the funds of the Central Bank initiative launched at the beginning of (2016) to address the economic stagnation that befell the country due to the (financial security) crisis that the country faced in 2014. To put forward initiatives amounting to nearly (15) trillion dinars, which were put forward through private commercial and Islamic banks and specialized

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Publication Date
Mon Mar 12 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of Crystallization Time and Acid Type on the Synthesis of Nano-Gamma Alumina Using Double Hydrothermal Method
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Double hydrothermal method was used to prepare nano gamma alumina   using aluminum nitrate nano hydrate and sodium aluminate as an aluminum source, CTAB (cetyltrimethylammonium bromide) as surfactant, and variable acids: weak acids like; citric, and acitic acids, and strong acids like; hydrochloric and nitric acids as a bridge between aluminum salts and surfactant. Different crystallization times  12, 24, 48, and 72 hrs were applied. All the batches were prepared at pH equals to 9. XRD diffraction technique was used to investigate the crystalline nano gamma alumina pure from surfactant. N2 adsorption-desorption (BET) was used to measure the surface area and pore volume of the prepared nano alumina, the average p

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Publication Date
Sun May 28 2023
Journal Name
Brazilian Journal Of Physics
An Analysis of the Tensor Force and Pairing Correlation on the Disappearance of Nuclear Magicity at N = 28 Region
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The effect of the tensor term in the Skyrme interaction has been estimated in calculating the static and dynamic nuclear properties in sd and fp-shell model spaces nuclei. The nuclear shell gaps have been studied with different Skyrme parameterizations; Skxta and Skxtb with tensor interaction, SkX, SkM, and SLy4 without tensor interaction, and Skxcsb with consideration of the effect of charge symmetry breaking. We have examined the stability of N = 28 for 42Si and 48Ca. The results showed that the disappearance of the magicity occurs in the shell closure of 42Si. Furthermore, excitation energy, quadrupole deformation, neutron separation energy, pairing energy, and density profile have also been calculated. Quadrupole deformation indicates a

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Publication Date
Sun Feb 05 2023
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Past Myocardial Infarctions and Gender Predict the LVEF Regardless of the Status of Coronary Collaterals: An AI-Informed Research
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BACKGROUND: The degree of the development of coronary collaterals is long considered an alternate – that is, a collateral – source of blood supply to an area of the myocardium threatened with vascular ischemia or insufficiency. Hence, the coronary collaterals are beneficial but can also promote harmful (adverse) effects. For instance, the coronary steal effect during the myocardial hyperemia phase and that of restenosis following coronary angioplasty. OBJECTIVES: Our study explores the contribution of coronary collaterals – if any exist – while considering other potential predictors, including demographics and medical history, toward the left ventricular (LV) dysfunction measured through the LV ejection fraction (LVEF). METH

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Publication Date
Fri Oct 01 2010
Journal Name
Iraqi Journal Of Physics
Effect of the Thickness and Annealing Temperature on the Structural Properties of Thin CdS Films Prepared by Thermal Evaporation
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A thin CdS Films have been evaporated by thermal evaporation technique with different thicknesses (500, 1000, 1500 and 2000Å) and different duration times of annealing (60, 120 180 minutes) under 573 K annealing temperature, the vacuum was about 8 × 10-5 mbar and substrate temperature was 423 K. The structural properties of the films have been studied by X- ray diffraction technique (XRD). The crystal growth became stronger and more oriented as the film thickness (T) and duration time of annealing ( Ta) increases.

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
The Effect of Annealing on The Structural and Optical Properties of Copper Oxide Thin Films Prepared by SILAR Method
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Copper oxide thin films were deposited on glass substrate using Successive Ionic Layer Adsorption and Reaction (SILAR) method at room temperature. The thickness of the thin films was around 0.43?m.Copper oxide thin films were annealed in air at (200, 300 and 400°C for 45min.The film structure properties were characterized by x-ray diffraction (XRD). XRD patterns indicated the presence of polycrystalline CuO. The average grain size is calculated from the X-rays pattern, it is found that the grain size increased with increasing annealing temperature. Optical transmitter microscope (OTM) and atomic force microscope (AFM) was also used. Direct band gap values of 2.2 eV for an annealed sample and (2, 1.5, 1.4) eV at 200, 300,400oC respect

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Publication Date
Wed May 18 2016
Journal Name
Al-academy
The reality of religious tourism publications design and ways of developing The upper threshold model: صادق هاشم حسن الموسوي
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Tourism is one of the most important sources of income of economic key countries in the world so are imports of tourism for some countries a source of income is not significant of the total revenues of States. Making those countries, and those countries a destination for visitors, and here should be interest in the Wealth and cultural heritage that distinguishes Islamic countries in general, and Iraq in particular, must be placed specialist studies in all areas for the development of this area of tourism, especially religious tourism to achieve a desired and desired of such research.It is the most important ways to develop tourism in general and religious tourism is of particular publications, advertising, and is important for us in this

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Publication Date
Sat Dec 15 2012
Journal Name
International Journal Of Applied Biology And Pharmaceutical Technology
EFFECT OF THE SUPPLEMENTATION OF THE LAYING QUAILS RATION WITHSESAME (SESAMUM INDICUM) SEEDS AND OIL ON EGG QUALITY TRAITS
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The aim of this study was to determine the influence of feeding diets containing different levels of sesame seeds and oil on the egg quality of laying quail. A total of 120, 10 weeks old, were randomly assigned to 1 of 5 dietary groups and fed for 12 weeks diets containing 0% sesame seeds + 0% sesame oil (control group; C) or 0.5% sesame oil (T1), 1% sesame oil (T2), 1% sesame seeds (T3), and 2% sesame seeds (T4).The study was terminated when the birds were 22 weeks of age. Egg quality characteristics involved in the present study were egg weight, yolk diameter, yolk height, yolk weight, albumen height, albumen weight,Haugh unit, shell weight, shell thickness, shell percentage, yolk percentage, and albumen percentage. The addition of sesame

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