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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
Mon Jun 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Theoretical Study and calculation The cold Reaction Rate of Deuteron Fusion In Nickel Metal Using Bose–Einstein Condensate Theory
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In this paper, we focused on the investigated and studied the cold fusion reaction rate for D-D using the theory of Bose-Einstein condensation and depending on the quantum mechanics consideration. The quantum theory was based on the concept of single conventional of deuterons in Nickel-metal due to Bose-Einstein condensation, it has supplied a consistent description and explained of the experimental data. The analysis theory model has capable of explaining the physical behaviour of deuteron induced nuclear reactions in Nickel metals upon the five-star matter, it's the most expected for a quantitative predicted of the physical theory. Based on the Bose-Einstein condensation theorem formulation, we calculation the cold fusion reaction rate fo

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Taboo Words Vs. Social Deixis: A sociolinguistic Analysis of La Justice or The Cock that Crew: A Play from the Theatre of Ridiculous
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Linguistic taboos exist in most cultures. Tabooed words are generally being culturespecific
and relating to bodily functions or aspects of a culture that are sacred. Such words are
avoided, considered inappropriate and loaded with affective meaning and failing to adhere to.
Strict rules, often, governing their use and lead to punishment or public shame. These taboo
words can be used as a way of violating social deixis represented by four types of honorifics;
addressee, referent, bystander, and finally setting honorifics. This paper shows how these
taboo words are used in Kenneth Bernard's play La Justice or The Cock that Crew from the
theatre of the Ridiculous as means of violating social deixis in its four types. Th

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Publication Date
Sun Jul 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Teaching Using Adey- Shire Model and its Effect in Achievement and Critical Thinking for first intermediate students in Mathematics
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The aim of this research is to measure the effect of Adey- Shire model in the achievement and critical thinking of first intermediate female students in mathematics. The researcher adopted the experimental method with a post-test, the research of sample consists of (60) female students, divided into two groups with (30) students in the experimental group, that studied with Adey- Shire model, and (30) students in the control group who studied in the usual way. The two groups are equivalent in many variables. The researcher makes two tests of multiple choices, the first one is an achievement test consists (30) items and another test was for a critical thinking test with (25) items. The statistical analysis make to both tests is made with s

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Publication Date
Thu Dec 25 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Management of Independent Middle Mesial Canal in Mandibular First Molar Using Cone Beam Computed Tomography Imaging as an Adjunct – A Case Report
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The primary objective of root canal therapy is adequate biomechanical preparation of root canal system followed by 3D obturation.in clinics we are encountered with several anatomical variations, which we need to manage efficiently. One of the major factors responsible for failure of root canal therapy is missed canals. Recent technological advances have given the clinician opportunity to identify anatomical variations and treat them to satisfaction.

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Publication Date
Thu Dec 01 2022
Journal Name
Caspian Journal Of Environmental Sciences
Histological study of liver in Dhub lizard Uromastyx aegyptius microlepis (Blanford, 1874) during the period of hibernation
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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Bowel Cleansing Quality in Morning Versus Evening Preparation Regimens for colonoscopy; a Prospective Study
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Background :Evening preparation for colonoscopy is often unsatisfactory and inconvenient. This study was performed to compare the efficacy of bowel preparation at two different timings: night before and morning of endoscopy and to compare the cecal intubation rate and disturbance of sleep hours between these two groups.
Methods: In this prospective randomized endoscopist- blinded trial, 150 patients were enrolled between March 2010 and August 2011. Patients aged between 18 to 80 years needing colonoscopy were included. Patients with prior bowel surgery, suspected bowel obstruction or those who didn't completely fulfill the preparation instructions were excluded. Patients received polyethyelen glycol electrolyte preparation in a mornin

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Publication Date
Sat Jul 01 2017
Journal Name
Journal Of Physical Education
Special Exercises According to Refereeing and It's Effect on Developing Some Physical Abilities Of First Class Basketball Referees in Baghdad
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Basketball is one of the most popular and popular games that have a large audience both globally and locally because of the magic it contains in terms of performance. For this sport to be a success, fundamental factors must exist and these factors is the referee. The referee plays a large and important role in the success of the game and the establishment and application of rules.The research aimed at identifying the effect of special on the development of referee's physical abilities. The researcher used the experimental method. The subjects were (12) first class basketball referees. The researcher recommended using special exercises due to their great role in developing the physical abilities of first class basketball referees

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Publication Date
Sun May 15 2016
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Population growth and the culture of consumption A field study in the city of Arbil.: Population growth and the culture of consumption A field study in the city of Arbil.
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research objectives to:
1. identify the social, economic and cultural factors affecting consumption.
2. detect the consumption culture among the population in the city of Erbil.
3. Identify the GATT consumer protection and rights.
The most important results:
1. that there is variation in the answers of respondents about keep up with modernity in the basic consumption (necessary), it swallowed the proportion of yes answers about keep up with modernity in food consumption (72%), and is an indication of growing consumer awareness of the individual in the side of nutrition. The clothing on the side of the proportion of yes answers amounted to (85%), in the health field note that the percentage of yes answers (83%), who are abr

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Economic Conditions of Living in the City of Mosul: Income and Labor Market during the Period 2004-2007
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Abstract

 

This study cares for the economic living conditions in Mosul City. Its importance lies in the critical period that has been covered
(2002-2007), which was dominated by far–reaching events at political economic and social levels.
Among the main results that have been revealed are the following: the rate of economic growth in the City has been the lowest among major urban centers in Iraq. Besides, real income per capita in the City has stayed stagnant during the period of the study. However, the inequality in distribution of income has decreased. The main bulk of the city's population rely on their income from wages and salari

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Publication Date
Thu Jun 05 2014
Journal Name
Arabian Journal Of Geosciences
Applying the cluster analysis technique in logfacies determination for Mishrif Formation, Amara oil field, South Eastern Iraq
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