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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
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
The Inner Wasteland in Selected Later Plays of Samuel Beckett
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The inner wasteland can be observed in Samuel Beckett’s early and later plays. His characters suffer from loss of identity, emotions, and sense of time. They lead a life of failure, repetition, inaction, loneliness, doubt, suffering, and nothingness. The inner wasteland includes many aspects, such as the multi and split identity, the habitual repetitive element of life, the dark sorrowful life the characters lead, lack of communication and relations among them, their unfree, inactive condition, their foggy terrible recollections, loneliness, dryness of love, and uncertainty. The analysis and the illustration of each aspect will show how the inner wasteland is intensified in the selected later plays of Beckett.

 

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Publication Date
Thu Sep 15 2022
Journal Name
Al-academy
Role Of the Interactive Public Sculpture in Increasing Physical Activity
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The study investigates the possibility of utilizing public interactive sculptures to enhance physical activity in Saudi Arabia. The paper uses a descriptive-analytical methodology to identify the characteristics of interactive sculptures promoting physical activity in public areas as follows: The size and space of the work area are appropriate to the type of physical activity that is achieved, and the importance of the work site in the city and its relation to the surrounding space, identifying participants at the same time and their relationship to ensure safe interaction, as well as the relationship between the esthetic and intellectual concept of working in the community. The study concludes that three technical proposals were present

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Publication Date
Fri Jul 05 2013
Journal Name
Hemoglobin
The Spectrum of β-Thalassemia Mutations in Baghdad, Central Iraq
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Publication Date
Mon Jan 01 2024
Journal Name
Aip Conference Proceedings
Assessment of water quality in the shatt Al-Hillah river
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Publication Date
Thu Aug 01 2013
Journal Name
Journal Of The College Of Basic Education
A laboratory assessment on the effect of powder from Foeniculum vulgare and Eruca sativa against saw-toothed grain beetle Oryzaephilus surinamensis (L.)
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Publication Date
Thu Jan 25 2024
Journal Name
Biomedical Materials
Enhancing the therapeutic potential of curcumin: a novel nanoformulation for targeted anticancer therapy to colorectal cancer with reduced miR20a and miR21 expression
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Abstract<p>Curcumin (Cur) possesses remarkable pharmacological properties, including cardioprotective, neuroprotective, antimicrobial, and anticancer activities. However, the utilization of Cur in pharmaceuticals faces constraints owing to its inadequate water solubility and limited bioavailability. To overcome these hurdles, there has been notable focus on exploring innovative formulations, with nanobiotechnology emerging as a promising avenue to enhance the therapeutic effectiveness of these complex compounds. We report a novel safe, effective method for improving the incorporation of anticancer curcumin to induce apoptosis by reducing the expression levels of miR20a and miR21. The established</p> ... Show More
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Publication Date
Tue May 06 2025
Journal Name
Aip Conference Proceedings
Enhance the performance of the wind turbine blade based on the blade element momentum theory
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In order to improve the effectiveness, increase the life cycle, and avoid the blade structural failure of wind turbines, the blades need to be perfectly designed. Knowing the flow angle and the geometric characteristics of the blade is necessary to calculate the values of the induction factors (axial and tangential), which are the basis of the Blade Element Momentum theory (BEM). The aforementioned equations form an implicit and nonlinear system. Consequently, a straightforward iterative solution process can be used to solve this problem. A theoretical study of the aerodynamic performance of a horizontal-axis wind turbine blade was introduced using the BEM. The main objective of the current work is to examine the wind turbine blade’s perf

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Publication Date
Tue Jul 11 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of SPAWN Strategy on the Life Skills among the Second Grade Intermediate Students
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The aim of the research is to find out the effect of the SPAWN strategy on the life skills of second-intermediate-grade students. This study stage represented the research community within the intermediate and secondary governmental daytime schools affiliated with the Directorate of Education of Diwaniyah. The experiment was applied in Al-Razai Intermediate School on a sample of second-grade intermediate students, including 66 students distributed into two groups: (32) students within the experimental group and (34) students within the control group. The two groups were equivalent with a number of variables (chronological age, intelligence test, previous information test, life skills scale). The results indicated that the two groups were

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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
US-Russian Interventions in the Caspian-Caucasus Basin Countries after 2001: (Strategies to Re-Impose Control and Influence as a Model)
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Today, the five Caspian riparian states on the shores of the Caspian Sea (Kazakhstan, Turkmenistan, Azerbaijan, Russia, and Iran) have become a front for ambitions and international and regional competition, especially in light of the features and characteristics that natural geography has endowed them with and their enjoyment of a group of economic and mineral wealth that are not optimally exploited so far which made it a strategic attraction area for international trends and interventions, especially Western ones. It is a battleground for major international companies aiming to monopolize promising industrial investments in order to impose control and influence on the region’s resources and economic wealth and thus impose their forei

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Publication Date
Wed Dec 25 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
THE ROLE OF FINANCIAL INCLUSION IN PROVIDING FINANCIAL SUPPORT WOMEN IN IRAQ
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 This study dealt with the basics of financial inclusion in terms of concept, importance and objectives, The empowerment of women financially and bank,and then the relationship between financial inclusion and women, and determine the requirements of inclusion Financial resources for women. The analytical descriptive method was used for data, which included reviewing and analyzing information And data in economic and financial literature. The study: reached a number of conclusions, the most important of which are Financial inclusion contributes to women's financial and banking support, as there is a positive relationship between financial institutions Banking and women's access to financial and banking services, thus playing a role i

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