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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 May 11 2020
Journal Name
Baghdad Science Journal
The Jacobson Radical of the Endomorphism Semiring of P.Q.- Principal Injective Semimodules
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 In this work, we introduced the Jacobson radical (shortly Rad (Ș)) of the endomorphism semiring Ș =  ( ), provided that  is principal P.Q.- injective semimodule and some related concepts, we studied some properties and added conditions that we needed. The most prominent result is obtained in section three

-If   is a principal self-generator semimodule, then (ȘȘ) = W(Ș).

Subject Classification: 16y60

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Publication Date
Sun Mar 06 2011
Journal Name
Baghdad Science Journal
The effect of additives metal on the D.C conductivity of epoxy resin
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The present studies are focused on the modification of the properties of epoxy resin with different additives namely aluminum, copper by preparing of composites systems with percentage (20%, 40% and 50%) of the above additives. The experimental results show that the D.C of conductivity on wt% filler content at ( 293-413 ) K electrical conductivity of all above composites increased with temperature for composites with filler contact and find the excellent electrical conductivity of copper and lie between (2.6*10-10 - 2.1*10-10)?.cm . The activation energy of the electrical conductivity is determined and found to decrease with increasing the filler concentration.

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Effect of the professional skepticism characteristics of the auditor on audit qualit
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The professional skepticism is one of the fundamental concepts necessary for practicing the audit profession, without which the auditor can not reach a reasonable assurance as to the correctness of the evidence and the information obtained by the auditing department. The auditor's possession of the characteristics of professional skepticism and his practice of professional skepticism during the audit process lead to an increase The quality of audit and thus raise the confidence of the financial community in the audit profession again after the exposure of several crises led to the loss of financial society confidence in the audit profession.

The aim of the study is to measure the impact of professional sk

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of Some Methods for Estimating the Scheff'e Model of the Mixture
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Because of the experience of the mixture problem of high correlation and the existence of linear MultiCollinearity between the explanatory variables, because of the constraint of the unit and the interactions between them in the model, which increases the existence of links between the explanatory variables and this is illustrated by the variance inflation vector (VIF), L-Pseudo component to reduce the bond between the components of the mixture.

    To estimate the parameters of the mixture model, we used in our research the use of methods that increase bias and reduce variance, such as the Ridge Regression Method and the Least Absolute Shrinkage and Selection Operator (LASSO) method a

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Publication Date
Tue Jul 11 2023
Journal Name
Journal Of Educational And Psychological Researches
The Relationship of Digital Skills with the Professional Competence of Kindergarten Teachers
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The current research aims to identify the level of digital skills of kindergarten teachers, identify the level of professional competence of kindergarten teachers, as well as to identify the relationship between digital skills and the professional competence of kindergarten teachers. The current research was determined by kindergarten teachers in the second Baghdad / Karkh Education Directorate for the academic year (2021-2022). The research sample consisted of (100) teachers chosen in a simple random way. To achieve the objectives of the research, the researcher developed a digital skills scale of (20) items and a scale of professional competence consisting of (22) items. The results revealed that kindergarten teachers have a high level

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The Effect of Preservation on the Shelf Life of Laboratory Processed Biscuit
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This study has been conducted to investigate the influence of preservatives(sodium propionate and potassium sorbate) at different levels to extend the storage life of laboratory processed biscuit.The results have shown that When%0.10 sodium propionate was added bacteria and fungi was not found for three months while found in the fourth month of storage.However bacteria and mold didnot grow until the sixth month of storage as %0.20 and %0.30 concentration was used. On the other side as %0.03 potassium sorbate was used,the growth of bacteria was cheched for 3 months and 4 months for molds..When %0.06 potassium sorbate was used no growth of bacterial or mold was found until the sixth month of storage . Three types of bacteria have been appeare

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The reflection of environmental quality costs on the evaluation of environmental performance
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Abstract:

               The research aims to achieve defining the concept of environmental quality and associated costs. Studying the impact of environmental quality costs on the performance of economic units. Measuring the relationship between environmental quality and environmental performance of the units. Where the research problem is represented in the weak awareness of some economic units of the importance of environmental quality costs and their impact on evaluating environmental performance, and this leads to neglecting environmental considerations and not improving environmental performance effectively, which negatively affects the en

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Publication Date
Sat May 11 2024
Journal Name
Journal Of Optics
The effect of increasing temperature on the sensitivity of photonic crystal fiber
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Photonic Crystal Fiber Fabry–Perot Interferometers (FPI) based on Surface Plasmon Resonance (SPR) was investigated in this paper in order to detect changes in photonic crystal fiber sensitivity with increasing temperature. FPI is composed of a PCF (ESM-12) solid core spliced with a single-mode fiber (SMF) on one side and a 40nm thick gold Nano film on the other. In order to obtain the SPR curve, the end of PCF can be spliced with the side of SMF before covering the gold film on the PCF. SPR results are included in the suggested sensor, based on the conclusions of the investigations. Resolution (R) is 0.0871, Signal-to-Noise Ratio (SNR) is 0.1867, a figure of merit (FOM) is 0.0069, and sensitivity (S) is 1.1481 . This sensor proposed is s

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Publication Date
Thu Aug 31 2017
Journal Name
Journal Of Engineering
Urban agriculture as one of the ecological applications of the regenerative city
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Recently, several concepts and expressions have emerged that have often preoccupied the world . around the concept of environment and sustainability. This is due to the negative and irresponsible impact of man and his innovations in various industrial and technological fieldsthat have damaged the natural environment. Architecture and cities at the broader level are some of the man made components that caused these negative impacts and in the same time affected by them. What distinguishes architectural and urban projects is the consumption of large . quantities of natural resources and production larger amounts of waste and pollution, along the life of these projects. At the end of the twentieth century and the beginning of the twenty-fir

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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Influence of Eggshell Particle Sizes on the Adsorption of Organic Dye
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This work aimed to use effective, low-cost, available, and natural adsorbents like eggshells for removal of  hazardous organic dye result from widely number of  industries and study the influence of different eggshell particle size (75, 150) Mm.  The adsorbent was characterized by SEM, EDX, BET and FTIR . The initial pH of dye solutions  varying from 4 to 10 , the initial concentrations of methyl violet (MV) 2B range (20-80) mg/L, dosage range (0.5-10) g, contact time (30-180) min, and particles size of the adsorbent (75, 150) Mm were selected to be studied. Two adsorption isotherms models have been used to fit the experimental data. Langmuir and Freunlich models were found to more represent the experiments with high

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