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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 Oct 06 2022
Journal Name
Advances In Systems Science And Applications
Stability and Bifurcation of a Delay Cancer Model in the Polluted Environment
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It is well known that the spread of cancer or tumor growth increases in polluted environments. In this paper, the dynamic behavior of the cancer model in the polluted environment is studied taking into consideration the delay in clearance of the environment from their contamination. The set of differential equations that simulates this epidemic model is formulated. The existence, uniqueness, and the bound of the solution are discussed. The local and global stability conditions of disease-free and endemic equilibrium points are investigated. The occurrence of the Hopf bifurcation around the endemic equilibrium point is proved. The stability and direction of the periodic dynamics are studied. Finally, the paper is ended with a numerical simul

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Analytical study on the implications of the GATS Agreement and its implications on the Egyptian banking sector
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International trade in services is becoming increasingly important as it is an economic activity that deals with invisible trade, which has become increasingly important in the balance of international trade. The establishment of the WTO is a starting point in international trade relations. It is responsible for all aspects of international trade, , And in view of the continued increase in international trade in services, the need for more internationally recognized rules has become more urgent, especially as it has been increasingly proven that the traditional framework of public services is inadequate to operate some of the most dynamic and innovative sectors of the economy. (GATS) to be the regulatory framework for this sector

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Publication Date
Thu Dec 31 2015
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Reducing of Corrosion Rate in Boiler Tubes by Using Oxygen Scavengers
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The corrosion behavior of carbon steel at different temperatures 100,120,140 and 160 Cͦ under different pressures 7,10 and 13 bar in pure distilled water and after adding three types of oxygen scavengers Hydroquinone, Ascorbic acid and Monoethanolamine in different concentrations 40,60 and 80 ppm has been investigated using weight loss method. The carbon steel specimens were immersed in water containing 8.2 ppm dissolved oxygen (DO) by using autoclave. It was found that corrosion behavior of carbon steel was greatly influenced by temperature with high pressure. The corrosion rate decreases, when adding any one of oxygen scavengers. The best results were obtained at a concentration of 80 ppm of each scavenger. It was observed that 

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Petroleum Science And Engineering
Operation of a MEG pilot regeneration system for organic acid and alkalinity removal during MDEA to FFCI switchover
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Publication Date
Tue Sep 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Impact of budget on the basis of activities in the implementation of competitive strategiesApplied Study in the General Company for Electrical Industries - Tammuz Laboratory
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The Contemporary Business Environment is Surrounded by many quick and continues variable and changes which has an effect on the economic units. These variables and changes like the high competition which need many tools to help them to continue and achieve The critical success. So to achieve this they have many competitive strategies like cost leadership strategy, differentiation strategy and focus strategy.

Budget is regarded one of main tools to execute objectives polices and programs of the economic units, beside show how the economic units had execute the available economic resources.

Activity based on budgeting is regarded one of the modern technique in the m

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Publication Date
Thu Dec 31 2020
Journal Name
College Of Islamic Sciences
The most important and important rule in the Quranic perspective "An applied study"
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Abstract

    All of us are indispensable for this rule (the most important and important) individuals, whether we were groups of leaders or followers of peoples or countries because the rule provides adequate guarantees for the correct positions and drawing the plan for successful decision-makers matching with the balances of Sharia without incompatibility between religious or worldly interests or legal positions and therefore in the framework of the most important appointment And distinguish it from the important from the interests or the appointment of the most important and distinguish from the important from the evils and through this rule we learn about the scientific and practical solutions t

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Publication Date
Sun Sep 30 2012
Journal Name
Al-hiqouq
The Maintenance Contract – A Comparative Study with Islamic Jurisprudence
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Contemporary life is racing against time in its temptations and variables, and it has become shaped and changed in an amazing way in its various aspects and fields. This was facilitated by intellectual and scientific communication between civilizations, and the rapid progression in successive inventions and discoveries in the fields of science and arts of knowledge. This contributed to a great economic and commercial renaissance. Then, these economic developments entered the world into a very strong competition, which forced producers to calculate all production costs, to reach the highest profits by reducing the price of the produced commodity on the one hand, and achieving quality in appearance (especially) on the other hand. Since the ma

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Publication Date
Thu Dec 30 2021
Journal Name
College Of Islamic Sciences
Controls Scanning on the slippers: a study fiqhiat Comparison
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Controls Scanning on the slippers a study fiqhiat Comparison

The subject of this research is an important topic, which is frequently repeated, and people need to know its wisdom, and has made it in front and the preface and three detectives, showed through discussion the meaning of the survey on the socks, its wisdom, its rules and conditions, and the duration of the survey on it, spoiled and reasoned and compared to the doctrinal doctrines, And the most correct statement of words I have concluded with a number of things, as follows:

  1. The need to ensure that the slippers are clean, visible and inwa

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Publication Date
Sat Nov 22 2025
Journal Name
Tikrit Journal Of Administrative And Economic sciences
Determination of competency levels and auditor evaluation procedures to the international standard (ISO19011: 2018) A case study at the Ministry of Construction, Housing and General Municipalities/Audit Directorate
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The current research seeks to achieve several objectives, including knowing the extent of the audit directorate of the Ministry of Construction, Housing and General Municipalities of the International Standard (ISO19011:2018) regarding determining the efficiency and evaluation of auditors and diagnosing the gap between requirements and application and knowing the reasons for not applying some of the items in the standard, starting from the problem, The field raised the following question (Does the audit directorate determine the efficiency and evaluation of auditors according to the standard ISO19011:2018?), and the importance of research lies in determining the return that can be achieved by the directorate through its application of stand

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Publication Date
Mon Jun 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Maximizing competitive strategies in the general framework of the critical success factors and the risk management process: applied research in a sample of Iraqi private banks
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Discussion dealt with the independent factors critical  such us success factors and the risk management process, and dependent factor of the general competitive strategies, and began searching the dilemma of thought, as crystallized his problem in the light of the need for organizations to philosophy and deeper vision of a more comprehensive understanding of the concept of risk management, assessment and management to maximize the competitive strategies of public, and on this basis, Search queries formulated problem of the gap between the knowledge-based intellectual propositions farcical for the purposes of interpretation of the relationship between the critical success factors and the risk

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