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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.

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 Apr 26 2024
Journal Name
Mathematical Modelling Of Engineering Problems
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Wed Mar 02 2022
Journal Name
International Journal Of Early Childhood Special Education
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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Estimating the impact of tax exemptions on achieving economic development in Iraq for the period (2015-2021): An Applied research in the General Authority for Taxes

Abstract

          The research aims to identify tax exemptions, their objectives and types, as well as to shed light on the concept of sustainable development, its objectives, dimensions and indicators (economic, social and environmental), as well as to analyze the relationship between tax exemptions and economic development, in addition to measuring and analyzing the impact of tax exemptions on economic development in Iraq for the period ( 2015 - 2021) using the NARDL model. The research problem centers on the fact that failure to employ financial policy tools correctly led to a weakness in achieving economic justice, which leads to a failure to improve social welfar

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Publication Date
Thu Mar 18 2021
Journal Name
Egyptian Journal Of Chemistry
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Publication Date
Tue Dec 30 2008
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of TCE Addition on the Performance of Catalytic Isomerization of n-Hexane

n-Hexane conversion enhancement was studied by adding TCE (Trichloro-ethylene) on feed stream using 0.3%Pt/HY zeolite catalyst. All experiments were achieved at atmospheric pressure and on a continuous laboratory unit with a fixed bed reactor at a temperature range 240-270◦C, LHSV 1-3h-1, H2/nC6 mole ratio 1-4.
By adding 435 ppm of TCE, 49.5 mole% conversion was achieved at LHSV 1h-1, temperature of 270ºC and H2/nC6 mole ratio of 4, while the conversion was 18.3 mol% on the same catalyst without adding TCE at the same conditions. The activation energy decreased from 98.18 for pure Pt/HY zeolite to 82.83 kJ/mole by adding TCE. Beside enhancement the activity, selectivity and product distribution enhanced by providing DMB (Dimethyl b

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Publication Date
Sun Dec 07 2008
Journal Name
Baghdad Science Journal
The effect of doping ratio of Cu on the structural properties of CdSe Films

Films of CdSe have been prepared by evaporation technique with thickness 1µm. Doping with Cu was achieved using annealing under argon atmosphere . The Structure properties of these films are investigated by X-ray diffraction analysis. The effect of Cu doping on the orientation , relative intensity, grain size and the lattice constant has been studied. The pure CdSe films have been found consist of amorphous structure with very small peak at (002) plane. The films were polycrystalline for doped CdSe with (1&2wt%) Cu contents and with lattice constant (a=3.741,c=7.096)A°, and it has better crystallinty as the Cu contents increased to (3&5wt%) Cu. The reflections from [(002), (102). (110), (112), and (201)]planes are more prominen

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Publication Date
Sat Mar 01 2008
Journal Name
Iraqi Journal Of Physics
The effect of Cu concentration on some of the electrical properties of CdSe films

The CdSe pure films and doping with Cu (0.5, 1.5, 2.5, 4.0wt%) of thickness 0.9μm have been prepared by thermal evaporation technique on glass substrate. Annealing for all the prepared films have been achieved at 523K in vacuum to get good properties of the films. The effect of Cu concentration on some of the electrical properties such as D.C conductivity and Hall effect has been studied.
It has been found that the increase in Cu concentration caused increase in d.c conductivity for pure CdSe 3.75×10-4(Ω.cm)-1 at room temperatures to maximum value of 0.769(Ω.cm)-1 for 4wt%Cu.All films have shown two activation energies, where these value decreases with increasing doping ratio. The maximum value of activation energy was (0.319)eV f

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Engineering
Formal Characteristics of the Architectural Type of contemporary Mosques within the concept of Topology

Mosques could be considered as one of the most powerful architectural types throughout historical ages. With their highly symbolic formal legacy, Mosques  play an essential role in providing the Islamic city with its special identity. Nevertheless, the advent of digital technology and its ubiquity at different levels of architectural design marked the emergence of new tendencies in the Architecture of Mosques, represented by various models added to the storage of this architectural type. Consequently a review of these tendencies would be needed, aiming at pointing out the formal transformations and new suggested characteristics.

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Publication Date
Fri Apr 30 2021
Journal Name
Iraqi Journal Of Science
A Numerical Study on Cross Diffusion Cattaneo-Christov Impacts of MHD Micropolar Fluid Across a Paraboloid

Analyzing the impacts of Cattaneo-Christov flux, bioconvective Raleigh number and cross diffusion effects in electrically conducting micropolar fluid through a paraboloid revolution is assessed in this work. Non-dimensional equations are solved numerically using shooting technique with an aid of Matlab software. The impact of various parameters on velocity, temperature and concentration are discussed in detail and presented graphically. Harman number and micro rotation parameters are found and have an increasing influence on shear stress. The vertical velocity increases at free stream and the horizontal velocity increases near the surface when Grb increases, which follows the opposite trend for accumulation of Rb. T

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Publication Date
Wed Mar 02 2022
Journal Name
Remittances Review
Analyzing the Influence of Information and Communication Technologies (ICT) on the Per Capita GDP of Iraq from 2004 to 2021

The study aims to identify the theoretical literature for all the variables of the study (ICT, GDP) as well as to identify the practical side of the impact of ICT on the per capita GDP in Iraq for the period (2004-2021). The study was based on the hypothesis that ICT impacts per capita GDP in Iraq. The problem of the study was to answer the question: does ICT contribute to per capita GDP? The study concluded that an increase in the rate of internet users per 100 people by one unit would increase. Increasing the landline telephone rate per 100 people by one unit will increase GDP per capita. In addition, increasing the mobile phone rate per 100 people by one unit will increase GDP per capita. The study recommended adopting rational poli

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