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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 Nov 01 2017
Journal Name
Journal Of Engineering
Calculating Production Rate of each Branch of a Multilateral Well Using Multi-Segment Well Model: Field Example
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Multilateral wells require a sophisticated type of well model to be applied in reservoir simulators to represent them. The model must be able to determine the flow rate of each fluid and the pressure throughout the well. The production rate calculations are very important because they give an indication about some main issues associated with multi-lateral wells such as one branch may produce water or gas before others, no production rate from one branch, and selecting the best location of a new branch for development process easily.                                &nbsp

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The role of the requirements of Total Quality Environmental Management in promoting environmental sustainability-An Empirical Study in the Iraqi Drilling Company
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Abstract

quality issue is the only issue the interesting in recent years of the last century, but also came out of sync with the other issue is the issue of environment, Where they have become represent two sides of one currency, challenges faced by the world and raised by the environmental problems have made industrial organizations pay great attention to the environment by improving their environmental performance, and that's where the oil industry is one of the most dangerous industries, influential and damaging to the environment due to the organizations move away from oil for adoption The application of EMS then a tool to improve environmental performance has been chosen sam

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Publication Date
Mon Jan 01 2024
Journal Name
2nd International Conference For Engineering Sciences And Information Technology (esit 2022): Esit2022 Conference Proceedings
Synthesis of Sn1-xMnxO2Nanoparticles and study of the structural and optical properties
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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Information Technology Competency in Activating of Human Resources Management Practices/ Applied Study in the Informatics and Communications Public Company in Iraq
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This research aims to clarify the role of Information Technology Competency (ITC) with dimensions' (IT Usage, IT Knowledge, and IT Operations) as an independent variable in the activation of Human Resources Management Practices (HRM Practices) as a dependent variable with dimensions' (Training and Development, Recruitment, Job Design, and Performance appraisal). Based on this, the correlation and effect relationships between the independent and dependent variables are determined by formulating two main hypotheses. There are a significant relationship and effect of IT competency with HRM practices within the dimensions. Furthermore, the scope and population of this research are the Informatics and Communications P

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Publication Date
Thu Mar 05 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of curvature angle and rotational speed on the cyclic fatigue of three types of rotary instrument (In vitro): comparative study
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Background: The fracture of instruments within root canal during endodontic treatment is a common incidence, fracture because of fatigue through flexure occurs due to metal fatigue, this study aimed to assess the effect of curvature angle and rotational speed on the cyclic fatigue of different type of Endodontic NiTi Rotary Instruments and compare among them. Materials and method: Three types of rotary instruments with tip size 0.25: ProTaPer F2 (Densply, Malifier) Revo-S SU( 0.06 taper, MicroMega) and RaCe system (0.06 taper, FKG, Dentaire), Forty file of each instrument were used within two canals with angle of curvature (40 &60 )at two speed (250&400)RPM, twelve group were formed for all instruments(total number=120),ten file fo

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The contribution of e-banking to the competitive advantage of banking institutions in Algeria: Case Study of Agricultural and Rural Development Bank
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The importance of the study stems from the fact that it deals with a very important subject, namely, the pivotal role played by E-banking in achieving the competitive advantage of the banking institutions operating in Algeria. By adopting the banking institution and adopting the elements of the electronic marketing mix and developing it as required by the environment The banking system of developments will inevitably be able to achieve excellence from its competitors as each of these elements have an important role in achieving competitive advantage, we relied in this study on studies and research that directly affect the problem of the study and we have put Estep In order to activate the contribution of e-banking in achieving competitiv

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Publication Date
Thu Mar 05 2026
Journal Name
Baghdad Science Journal
Study the effect of position on the time of astronomical twilight
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Twilight is that light appear on the horizon before sunrise and after sunset, Astronomically it is known that sunrise and sunset are effected by high above sea level, but the effect of high above sea level on the time of astronomical twilight still not decided and controversy among astronomers, in This research we studies the effect of high above sea level on the time of astronomical twilight, through adding the equation correct high above sea level to equation computation of twilight and then calculate of changing in the time of twilight for different highest (0-10000) meters above sea level , and the ratio of increase for time with high between (15.45-20.5) minutes. It was found that there was an increase in the time of the twilight along

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Publication Date
Sat Mar 30 2002
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study of the Factors Affecting the Efficiency of Reverse Osmosis Process
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Publication Date
Tue Dec 28 2021
Journal Name
College Of Islamic Sciences
The concept of the phenomenon of nuns: an analytical ideological study
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ملخص البحث باللغة الإنجليزية

The concept of the phenomenon of nuns: an analytical ideological study

Dr. Samia bint Yassin Al-Badri

Department of Islamic Doctrine & Contemporary Ideologies

College of Shariʿah & Islamic Studies

Qassim University

 

The study of concepts is one of the main pillars of doctrinal studies, in order to understand the formation of the concept, and to understand its contexts in religious sources, in order to be systematically criticized; So, this research came with the title:

The concept of the phenomenon of nuns, an analytical doctrinal study

The study concluded with resu

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Publication Date
Fri Jan 03 2020
Journal Name
مجلة القادسية في الآداب والعلوم التربوية
The Effectiveness of a Teaching Style Based on the Brunner Model in the Achievement and Retention of Grammar Material for Students of the Arabic Language Department at the Faculty of Education for Girls
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This research aims to find out the impact on the receptive style according to the specimen in the collection of material Brawner and retention as students at the Arabic Department at the Faculty of Education for Girls. For confirmation from the goal of the research, the researcher placed two hypotheses, one to two for collections and one for pods. - chosen as the College of Education for Girls / Department of Arabic language for the application of choice Intentionally search experience for reasons of researcher he is teaching them and thus ensures cooperation of teachers and students in them. - selected Division (b) of the fourth grade students of the Arabic language section at random to represent the experimental group, while the Division

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