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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 Oct 20 2021
Journal Name
Journal Of Engineering Research
Effect of several patterns of floating stone columns on the bearing capacity and porewater pressure in saturated soft soil
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One of the common geotechnical problems is the construction on soft soil and the improvement of its geotechnical properties to meet the design requirements. A stone column is one of the well-known techniques used to improve the geotechnical properties of soft soils. Sometimes thick layers of soft soil imposed the designer to use floating stone columns for improvement of such soil; in this case, the designer will be lost the end bearing of the stone column. In this study, the effects of several patterns of floating stone columns distribution under footing on the bearing capacity of soil and the distribution of excess porewater pressure are investigated. The soft soil used in this study has a very low undrained shear strength (cu) of

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Publication Date
Sun Jan 01 2023
Journal Name
Sport Tk - Revista Euro Americana De Ciencias Del Deporte
Analysis of the amount of lost fluids, some blood components and mineral salts in volleyball under hot weather conditions
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Publication Date
Tue Apr 30 2024
Journal Name
International Review Of Electrical Engineering (iree)
Enhancing Efficiency in Distribution Power Networks by Power Factor Controlling of Renewable Energy Generators: a Case Study of Iraqi Wasit Network
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Integrating Renewable Energy (RE) into Distribution Power Networks (DPNs) is a choice for efficient and sustainable electricity. Controlling the power factor of these sources is one of the techniques employed to manage the power loss of the grid. Capacitor banks have been employed to control phantom power, improving voltage and reducing power losses for several decades. The voltage sag and the significant power losses in the Iraqi DPN make it good evidence to be a case study proving the efficiency enhancement by adjusting the RE power factor. Therefore, this paper studies a part of the Iraqi network in a windy and sunny region, the Badra-Zurbatya-11 kV feeder, in the Wasit governorate. A substation of hybrid RE sources is connected to this

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Publication Date
Sat Feb 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Distribution of Municipal Services and Some Factors Affecting Them (A survey in a sample of districts from Rushed municipal in Baghdad)
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s The study aims to identify the fairness in the distribution of municipal services between  municipal districts and areas, from point of view  of municipal chamber staff and from the point of view of the citizen. It also aims to identify factors affecting the fairness of the distribution of municipal services. Municipal services were being studied : hygiene and waste, water supply, sewer, creating gardens,  and street paving .Factors which  examined its impact on municipal services are: resources available to municipal chamber, the managerial  process at municipal chamber,  and factors in the external environment surrounding  municipal chamber.The results of the study showed that level of the e

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Publication Date
Thu Dec 01 2011
Journal Name
International Review Of Physics (e-journal) (irephy)
Red shift band enhancement of the nanostructure ZnO100-xAlx thin films as a function of Al concentration for optoelectronic applications
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Publication Date
Tue Dec 13 2022
Journal Name
Frontiers In Chemistry
Numerical analysis of the energy-storage performance of a PCM-based triplex-tube containment system equipped with arc-shaped fins
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This study numerically intends to evaluate the effects of arc-shaped fins on the melting capability of a triplex-tube confinement system filled with phase-change materials (PCMs). In contrast to situations with no fins, where PCM exhibits relatively poor heat response, in this study, the thermal performance is modified using novel arc-shaped fins with various circular angles and orientations compared with traditional rectangular fins. Several inline and staggered layouts are also assessed to maximize the fin’s efficacy. The effect of the nearby natural convection is further investigated by adding a fin to the bottom of the heat-storage domain. Additionally, the Reynolds number and temperature of the heat-transfer fluid (HTF) are e

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Publication Date
Fri Oct 20 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Application of the Canadian Water Quality Index (CCME-WQI) for Aquatic Life to Assess the Effect of Tharthar Water upon the Quality of the Tigris Water, Northern Baghdad City,Iraq
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The present study aims to assess the effect of the Tharthar Canal as an outlet canal that feeds back from the Tharthar Lake on the quality of the Tigris water. Utilizing a Canadian Water Quality Index (CCME-WQI) for the protection of aquatic life Water samples were obtained every month from January to December of 2020. Six different sites were selected: four along the Tigris River and two on the Tharthar Canal. Seven ecological parameters were used to assess water quality depending on importance and availability: water temperature, Water Temperature, Turbidity, Dissolved Oxygen (DO), Total Dissolved Solids (TDS), pH, Nitrate (NO3-) and Phosphate ( . The study demonstrated that the water quality of the Tharthr canal ranked as a

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
The passive As a grammatical phenomenon in four selected textbooks: Das Passiv Als grammatisches Phӓnomen in vier ausgewӓhlten Lehrwerken
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The research work is "The passive voice as a grammatical phenomenon in four selected textbooks". The research deals with the grammatical phenomenon passive in German. The research consists of two parts, the theoretical and the empirical part. The present research work is divided into 3 sections:

The first section includes the definition of passive, passive types, process passive, state passive, passive with modal verbs, and other types of passive. The second section provides illustrations of the four selected textbooks. The third chapter presents the passive voice in textbooks, namely German language teaching for foreigners by Dora Schulz and Heinz Griesbach, Delfin von Aufderstrasse H. and others, Em von Balme, M. and others and

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Publication Date
Mon Mar 15 2021
Journal Name
Al-academy
Aesthetic Levels in Shape Variables in Spectacular Films the Indian Film (Main Tera Hero) a Model: غسان محسن حمد
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The spectacular film is a type of feature films which has specific elements that contribute in increasing the aesthetics of the shape in its structure. The researcher started studying this type of films by researching the spectacular film concept, the history of its development, who are its most important stars and then tackling the Indian cinema represented by Bollywood, which is considered a school for this type of film. The researcher addressed the most important influential elements that entre in its production as well as studying these elements that contribute to building the shape including the configuration, movements of cameras, lenses, the lighting, colors, costumes etc. and what influence they have in forming a special aestheti

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Publication Date
Wed Mar 01 2023
Journal Name
Human Gene
The deubiquitylase-ubiquitin-specific protease 4 absence in HeLa cells leads to a reduction in Semliki Forest virus replication
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