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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
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
The impact of a typical student achievement teams use and integration of fragmented information in the collection of history students at the fifth grade literary
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The goal of this research is to find the effects of both the studying students groupwhich has various educational levels and the integration of the fragmented information through or during the study of history subjects for the female students of the fifth secondary literary section.
To achieve this study or case the researcher has chosen an experimental design or test by studying three groups: two are as mentioned above and the third is just ordinary team. In addition to that, there is a test after the experiment. The researcher chose on purpose female students of the literal section from two different secondary school Al Asil and Wahran both are secondary school for girls, and both are from directorate of education- Al Karkh 2nd dist

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Publication Date
Thu May 14 2020
Journal Name
Journal Of Planner And Development
Property ownership and its implications for urban development The Case study (the development project of the Rashid camp for housing in Baghdad)
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        Of the importance of the concept of ownership of real estate as the basic basis from which various projects are launched in various economic, tourism, and urban areas .... The need to research the diagnosis of real estate reality went astray in the difficulties, which played a decisive role in the process of urban development.

 

 This leads us to the research problem of the difficulty of implementing urban development plans in many cases due to the absence of a clear methodology for organizing and modernizing the ownership of real estate and its coordination with the management of urban land and to achieve the objective

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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Static Performance Characteristics Of Vortex Rate Sensor
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The vortex rate sensor is a fluidic gyroscope with no moving parts and can be used in very difficult conditions like radiation, high temperature and noise with minimum cost of manufacturing and maintenance. A vortex rate sensor made of wood has been designed and manufactured to study theoretically and experimentally its static performance .A rig has been built to carry out the study,
the test carried out with three different air flow rates (100, 150, and 200 l/min).The results show that the relation between the differential pressure taken from the sensor pickoff points and the angular velocity of the sensor was linear.The present work involved theoretical and experimental study of vortex rate sensor static characteristics .Vortex rat

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Publication Date
Sat Oct 01 2011
Journal Name
Journal Of Engineering
STATIC PERFORMANCE CHARACTERISTICS OF VORTEX RATE SENSOR
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The vortex rate sensor is a fluidic gyroscope with no moving parts and can be used in very difficult
conditions like radiation, high temperature and noise with minimum cost of manufacturing and
maintenance. A vortex rate sensor made of wood has been designed and manufactured to study
theoretically and experimentally its static performance .A rig has been built to carry out the study,
the test carried out with three different air flow rates (100, 150, and 200 l/min).The results show that
the relation between the differential pressure taken from the sensor pickoff points and the angular
velocity of the sensor was linear.The present work involved theoretical and experimental study of
vortex rate sensor static characteri

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Publication Date
Thu Jan 24 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Over the awareness of managers strategic importance of vigilance: "Exploratory study in the National Insurance Company"
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The rapid reality of events in the information era, and the enormous pressure of forces market, competition, permanent movement of the markets and consumers and the large development unprecedented of technology in all areas make a lot of organizations find it difficult to keep up with this rapid developments .Here was the role of strategic vigilance closer organization to their environment ,and play an active role in providing the necessary information to make decisions and insurance companies are not far from those changes .On this basis the researcher offered studied(Over the awareness of managers of insurance companies for strategic vigilance).Choosing sample of 35 managers in the National Insurance Company to test th

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Publication Date
Mon May 29 2023
Journal Name
Russian Law Journal
LEGAL RULES GOVERNING THE DURATION OF THE CONTRACT IN ITS PERIOD OF FORMATION (COMPARATIVE LEGAL STUDY)
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The duration of the contract is a legal term first provided for in French Amendment Decree No. 131/2016, and given the increasing importance of time in contracts, we have chosen to study the legal rules governing time at the formative stage by drawing on changes in French law compared to both Iraqi and Egyptian laws. Article 1102 of French Amendment Decree No. 131/2016 stipulates that: "Everyone is free to contract or not to contract, to choose the person with whom he contracts, and to determine the content and form of the contract within the limits established by law." Contractual freedom does not permit a breach of the rules relating to public order), as well as article 1104, which provides for (contracts must be nego

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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of the cleaning efficiency of the isthmus using different rotary instrumentation techniques (In vitro study)
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Background: The aims of the study were to evaluate the unclean/clean root canal surface areas with a histopathological cross section view of the root canal and the isthmus and to evaluate the efficiency of instrumentation to the isthmus using different rotary instrumentation techniques. Materials and Methods:The mesial roots of thirty human mandibular molars were divided into six groups, each group was composed of five roots (10 root canals)which prepared and irrigated as: Group one A: Protaper system to size F2 and hypodermic syringe, Group one B: Protaper system to size F2 and endoactivator system, Group two A:Wave One small then primary file and hypodermic syringe, Group two B:Wave One small then primary file and endoactivator system, Gr

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Publication Date
Thu Jan 01 2015
Journal Name
International Journal Of Pharmacy And Pharmaceutical Sciences
Study the sustain release effect of different polymers used in the formulation of aspirin-rosuvastatin tablets
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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
An analytical study of the reality of chemical industries in Iraq for the period (1995-2007)
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Is the chemical industries of great importance for the economy of any country, through what is borne by these industries is an important part of the changes contained in the industrial output of transfer and, moreover, that these industries are overlaps and intricacies of sector-wide with the rest of the manufacturing sectors, with agriculture and services , through the offering of these industries produce Production requirements intervention such as chemical fertilizer used in the production of agricultural crops, in addition to the various areas for the use of phosphorus in the food industry, to the extent that it is difficult to find material Food preparation is not included i

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Total quality management of the environment in flexible manufacturing / exploratory study in cement factory Badush
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Abstract

  Nowadays, the world adopts a philosophy that relates to environmental conservation. This philosophy can be achieved through providing environmentally friendly products while satisfying customers' needs as well. To attain that, a new systems and programs need to be applied in a scientific manner, and total quality environmental management (TQEM) is among these concepts. The research aimed to analyze the Relationship between (TQEM) Practices and its effect on Flexible Manufacturing in Badush factory. The research sample includes managers and head of divisions at top, middle and front line management levels which were (27) working in Badush factory. To achieve the objectives of the study, the descriptive anal

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