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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
Fri Nov 01 2013
Journal Name
International Journal Of Advanced Research
The effects of alkaloid extracted of Solanum nigrum leaves on the biological performance of Dialerodus citri
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Publication Date
Sun Jun 06 2010
Journal Name
Baghdad Science Journal
The effect of Sunn bug Eurygaster intgriceps infection of wheat on the Capability of bread making
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The present study aims to identifying the effect of Eurygaster integriceps infection on the quality features of the local wheat varity IBA 99. The result revealed significant decrease in the percentage of protein of infected wheat at (4, 5)% compared to sound wheat values for the sound wheat were (10.9%) whereas those for the infected wheat were(9.0, 8.4 )% also the result revealed significant increased in the percentage of ash in the infected wheat flour. The result showed significant decrease in the percentage of wet and dry gluten in the infected wheat by sun bug at the rate of (2, 3, 4, 5)% compared to sound wheat value (27, 9% and 25, 23, 22, 22, 20%) for wet gluten and (8.2, 7.8, 7, 7.2, 6%) for dry glutin . The value of sedimentati

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Publication Date
Wed Sep 29 2021
Journal Name
College Of Islamic Sciences
The position of Al-Jassas (D. 370 AH) of the verses of "As-Sifat Al-Khbriya"
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This research aims at know the position of Al-Jassas Al- Hanafi (D. 370 AH) of  "As-Sifat Al- Khbriya", through his interpretation: (the provisions of Qur'an), by studying his interpretation of the verses related to this issue.

The most significant results of this study that Al-Jassas did not consider the words that called: "As-Sifat Al- Khbriya" as adjectives to Allah almighty, but he consider them contained an inappropriate meaning to Allah almighty, thus it must be referred to the perfect arbitrator, so he was believe in opinion of interpretation. and interpretations of Al-Jassas for the related of the Qur'an verses relat

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Publication Date
Sun Sep 06 2015
Journal Name
Baghdad Science Journal
The Effect of nano particles of TiO2-Al2O3 on the Mechanical properties of epoxy Hybrid nanocomposites
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Preparation of epoxy/ TiO2 and epoxy/ Al2O3 nanocomposites is studed and investigated in this paper. The nano composites are processed by different nano fillers concentrations (0, 0.01, 0.02 ,0.03, 0.04 ,0.05 ,0.07 and 0.1 wt%). The particles sized of TiO2,Al2O3 are about 20–50 nm.Epoxy resin and nano composites containing different shape nano fillers of (TiO2:Al2O3 composites),are shear mixing with ratio 1 to 1,with different nano hybrid fillers concentrations( 0.025 ,0.0 5 ,0.15 ,0.2, and 0.25 wt%) to Preparation of epoxy/ TiO2- Al2O3 hybrid composites. The mechanical properties of nanocomposites such as bending ,wearing, and fatigue are investigated as mechanical properties.

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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Academic Accreditation From The point Of view The Teaching Staff Of Iraqi Expatriates And Its Impact On Strategic Performance Of Institutions Of Higher Education - Field Research
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Abstract

       The Research Includes Two Variables : First , Academic Accreditation with his dimensions ( Educational Context , Educational Inputs , Educational Process , Educational Outputs , Feedback ) , And The Second : Strategic Performance With His dimensions ( Financing , Satisfaction Stakeholders , Internal Processes , Learning And Growth ) , The Research Highlights On The Academic Accreditation System Which Is Considered A Major And Important Systems Can Through Which Administration Of Activities And Programs Institutions Of Higher Education , As This research aims to determine his relationship And The Extent Of Its Effect In The Strategic Performance , And It Includes The Research C

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Publication Date
Fri Feb 01 2013
Journal Name
Ijbpas
THE POSSIBLE RELATIONSHIP BETWEEN SERUM TUMOR NECROSIS FACTOR ALPHA LEVEL AND THE RECOVERY OF PATIENTS WITH PULMONARY TUBERCULOSIS
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Mycobacterium tuberculosis is the cause of the major world health issue, tuberculosis (TB). The cytokine, tumor necrosis factor alpha (TNF-α) has been implicated in protection against TB in the early stages of the disease. TNF-α is an effective cytokine in the killing of intracellular M. tuberculosis. This study inducted to investigate whether there is any relationship between levels of TNF-α in sera of TB patients and their recovery, and is there any difference in the level of this cytokine in sera of female and male TB patients. This study included 29 patients with pulmonary TB (18 female and 11 male), their ages ranging from 37 to 59 years. All of them received first line TB therapy. They were consulted at Pasture Center during Septem

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Publication Date
Fri Jul 01 2022
Journal Name
Iop Conference Series: Earth And Environmental Science
Studying Some Technical Indicators of the Local Manufactured Machine and Its Effect on the Wheat Crop “Tamuz cultivar”
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Abstract<p>The effect of compound machine on wheat "Tamuz cultivar" was studied based on some technical indicators which were tested under three practical speed (PS) of 2.015, 3.143, and 4.216 km.hr-1 and three tillage depth (TD) of 11, 13, and 15cm. The split-split plot arrangement in RCBD with three replications was used. The results showed that the PS of 2.015km.hr-1 was major best than other two speed in all studied conditions, physical properties (SBD and TSP), mechanical parameters (FD, (DP and LAS), and yield and growth parameters (PVI, BY and HI). The TD of 11cm was major effect to the other two levels TD of 13 and TD of 15cm in all studied conditions. All interactions were significant, </p> ... Show More
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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The mediating effect of organizational innovation climate on enhancing the relationship between talent development practices and organizational performance
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The current, research, aims, to, verify, the relationship between talent development practices and organizational performance through a mediating role of creative organizational climate at the Institution of Industrial Development and Research- the Iraqi Industry Ministry. The descriptive and analytic approach was adopted as a research design. The research sample was represented by a number of managers and employees who work at the middle management level. The researchers used the questionnaire as the main method for collecting data to achieve the main research objective. It was distributed 162 questionnaires, of which 146 received; and then all of those were used on the final statistical analysis. The sample response-rate rate w

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Publication Date
Mon Nov 11 2024
Journal Name
International Journal Of Dynamics And Control
The modified predator–prey model response to the effects of global warming, wind flow, fear, and hunting cooperation
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Global warming has a serious impact on the survival of organisms. Very few studies have considered the effect of global warming as a mathematical model. The effect of global warming on the carrying capacity of prey and predators has not been studied before. In this article, an ecological model describing the relationship between prey and predator and the effect of global warming on the carrying capacity of prey was studied. Moreover, the wind speed was considered an influencing factor in the predation process after developing the function that describes it. From a biological perspective, the nonnegativity and uniform bounded of all solutions for the model are proven. The existence of equilibria for the model and its local stability is inves

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Publication Date
Sat Oct 24 2020
Journal Name
Pramana
The neutron halo structure of 14B, 22N, 23O and 24F nuclei studied via the generalised Woods–Saxon potential
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The radial wave functions of the generalise dWoods–Saxon (GWS) potential within the two-body model of (Core + n) have been used to study the ground-state density distributions of protons, neutrons and matter and the associated root mean square (rms) radii of neutron-rich 14B, 22N, 23O and 24F halo nuclei. The calculated results show that the radial wave functions of the generalised Woods–Saxon potential within the two-body model succeed in reproducing neutron halo in these exotic nuclei. Elastic electron scattering form factors for these nuclei are studied by combining the charge density distributions with the plane-wave Born approximation (PWBA).

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