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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 Jun 30 2024
Journal Name
Iraqi Journal Of Science
Gray-Scale Image Compression Method Based on a Pixel-Based Adaptive Technique
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     Today in the digital realm, where images constitute the massive resource of the social media base but unfortunately suffer from two issues of size and transmission, compression is the ideal solution. Pixel base techniques are one of the modern spatially optimized modeling techniques of deterministic and probabilistic bases that imply mean, index, and residual. This paper introduces adaptive pixel-based coding techniques for the probabilistic part of a lossy scheme by incorporating the MMSA of the C321 base along with the utilization of the deterministic part losslessly. The tested results achieved higher size reduction performance compared to the traditional pixel-based techniques and the standard JPEG by about 40% and 50%,

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Towards Perceptions building a descriptive and procedural for the knowledge assets at the center of learning and growth for the techniques of Balanced Score card in the light of the strategic map concepts to achieve the strategic and operational: requirements of the contemporary business
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Abstract:

   Witness the current business environment changes rapidly reflected on the performance of the facility wishing to stay , which is no longer style reaction enough to handle installations with their environment , and quickly began to lose its luster with the emergence of a message and the vision of contemporary business environment from a set of parts interacting with each other and the concept of behavioral includes all dimensions of performance, it is imperative to adopt a system installations influence variables and positive interaction through the development of strategic plans and the use of implementation and follow-up strategies to ensure the effectiveness of the method for meas

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Publication Date
Mon Dec 31 2018
Journal Name
International Journal Of English Linguistics
Iraqi EFL Students’ Difficulties in Writing Composition: An Experimental Study (University of Baghdad)
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Iraqi EFL students face difficulties in writing composition, especially academic writing, which affects negatively their exam results. This study has been conducted in the Department of English at College of Education for Women, University of Baghdad, in order to identify first year EFL students&rsquo; incompetence in writing. This may enhance their achievement by some weekly writing activities. It deals with Iraqi EFL students&rsquo; difficulties in writing paragraphs such as descriptive, process, opinion, and factual paragraphs. The study aims to identify these difficulties and to suggest suitable solutions for them. The researcher perceives that it is necessary to enhance students&rsquo; skills in writing because it i

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Publication Date
Thu Jan 01 2015
Journal Name
Al–bahith Al–a'alami
Public confidence in the content of satellite channels during crises
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Most studies combine that it is important to determine the extent of the public's trust TV for two reasons. First of knowing the impact of satellite TV audience ranges and the second determining public outlets for Information Find regard to the extent of the public's confidence in knowing the contents of the satellite during the occupation of Mosul crisis by organizing the Islamic state in Iraq and the Levant And the researcher developed a questionnaire to find out the public's confidence statement satellite contents provided by the questions related to exposandscale.

 

     The researcher audience chose the city of Baghdad to the suitabil

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Publication Date
Wed Dec 13 2017
Journal Name
Al-khwarizmi Engineering Journal
Large Eddy Simulation in Duct Flow
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In this paper, the problem of developing turbulent flow in rectangular duct is investigated by obtaining numerical results of the velocity profiles in duct by using large eddy simulation model in two dimensions with different Reynolds numbers, filter equations and mesh sizes. Reynolds numbers range from (11,000) to (110,000) for velocities (1 m/sec) to (50 m/sec) with (56×56), (76×76) and (96×96) mesh sizes with different filter equations. The numerical results of the large eddy simulation model are compared with k-ε model and analytic velocity distribution and validated with experimental data of other researcher. The large eddy simulation model has a good agreement with experimental data for high Reynolds number with the first, seco

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The Enneagram Personality Types (The feeling center) and Academic Self Among the distinguished Students
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The current study aims to

1) identify the prevalent Enneagram personality types and the academic self among the sixth-grade students of the distinguished secondary schools; 2) the differences of relationship between the Enneagram personality types and the academic self-concept based on gender; 3) identify the correlation between the Enneagram personality types and the academic self-concept; and 4) identify the contribution of each type of personality types to the academic self-concept. To this end, two instrument were used to collect the data: Riso-Hudson’s scale,1995 was administered to measure enneagram types which had translated to the Arabic language by ( al-yassery,2004), the other instrument was

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Publication Date
Fri May 10 2019
Journal Name
Research Journal Of Chemistry And Environment
Solid Phase Extraction of Theophylline in Aqueous Solutions by Modified Magnetic Iron Oxide Nanoparticles as an Extractor Material and Spectrophotometry Technique for the Determination
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new, simple and fast solid-phase extraction method for separation and preconcentration of trace theophylline in aqueous solutions was developed using magnetite nanoparticles (MIONPs) coated with aluminium oxide (AMIONPs) and modified with palmitate (P) as an extractor (P@AMIONPs). It has shown that the developed method has a fast absorbent rate of the theophylline at room temperature. The parameters that affect the absorbent of theophylline in the aqueous solutions have been investigated such as the amount of magnetite nanoparticle, pH, standing time and the volume, concentration of desorption solution. The linear range, limit of quantification (LOQ) and limit of detection (LOD) for the determination of theophylline were 0.05-2.450 μg mL-

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Publication Date
Thu Aug 31 2017
Journal Name
Available At Ssrn 3030385
Synthesis, Spectral Studies And Antimicrobial Activity Of Mixed Ligand Complexes Of Cephalexin And Dimethylglyoxime With Some First Row Transition Metal Ions
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In this paper ,six new mixed metal ligand complexes are reported with Cephalexin (Ceph.H)as a primary ligand and Dimethylglyoxime (DMG) as secondary ligand with metal Chloride [MCl2 .nH2O. M=Mn(II),Co(II),Cu(II),Ni(II) and Zn(II),n=0-6] ,CrCl3.6H2O.The complexes are of (1:1:1)(Metal:Ligand: Ligand) Stoichiometry.The structures of these complexes are confirmed by using FT-IR and UV- electronic spectroscopies, magnetic moments, melting points, molar conductivity measurements and the metal % analysis revealed that the complexes analyze indicates a four coordinated as (A)=[M(HDMG) (Ceph)] .M=[Ni(II)and Zn(II).Six coordinated as (B) = K2[M(DMG)(CePh)(H2O)]. M= Mn (II),Co(II) and Cu(II) and (C)=[Cr(DMG)(Ceph)]Cl2. Interestingly, the in-vitro anti

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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Laboratory Investigation on Roller Compaction Technique in Concrete Construction
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Roller compacted concrete (RCC) is a concrete compacted by roller compaction. The concrete mixture in its unhardened state must support a roller while being compacted. The aim of this research work was to investigate the behavior and properties of roller compacted concrete when constructed in the laboratory using roller compactor manufactured in local market to simulate the field conditions. The roller compaction was conducts in three stages; each stage has different loading and number of passes of the roller. For the first stage, a load of (24) kg and (5) passes in each direction had been employed. For the second stage, a load of (104) kg and (10) passes in each direction were conducted. Finally, at the third stage, a load of (183) kg a

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Publication Date
Wed Oct 06 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Image segmentation by using thresholding technique in two stages
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