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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
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
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
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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Publication Date
Wed Aug 17 2022
Journal Name
Al–bahith Al–a'alami
Lawyers’ Use of the Website of the Supreme Judicial Council and the Gratifications Obtained from It Drawn Research Submitted for the Study of the Higher Professional Diploma
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The field study of this paper focused on the motives for lawyers to use the website
of the Supreme Judicial Council, and the gratifications achieved as a result of its use.
This study sought to achieve a number of goals, including:
1. Monitoring the patterns of lawyers’ use of the website of the Supreme Judicial Council.
2. Determining the forms that lawyers use to interact on the website of the Supreme
Judicial Council.
This study is a descriptive in kind as the researcher relied on the ‘survey method’ in
its study of the external audience (lawyers) using the questionnaire and scale toolThe questionnaire was distributed among a deliberately chosen sample, consisting of
(160) lawyers who used the website of

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The economic implications of the housing problem In Iraq and ways to address it - a theoretical research
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The problem of housing in Iraq is a long-rooted and rooted problem, and it needs a great effort to find out its causes and thus give essential points that contribute to alleviating and addressing it, and it is worth noting that research into the housing problem and the housing sector in Iraq is not done in isolation from other sectors and studies. As well as the economic policies pursued and the social and political conditions. It is known that the Iraqi economy is a unilateral (rentier) economy, that is, it depends almost entirely on exporting oil and obtaining revenues, and that the economic decision and economic policies followed in Iraq are greatly affected by several factors, including the economic, social and political fact

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Publication Date
Mon Aug 12 2024
Journal Name
دراسات دولية
Towards formulating a new social contract: The political system in Iraq: the dialectic of continuity and permanence
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The social contract represents a set of laws and determinants agreed upon by a group of individuals in order to organize society for the better.This agreement guarantees them to live in peace according to the pre-agreed laws, and on the basis of that, it represents the key to resolving the crisis relations between the state and society, and this is what prompted Iraqi society to move towards the formulation of a new social contract through popular protest movements in 2019.To overcome the old social contract that shook the trust between the state and society as a result of its negative outputs at various political, economic and social levels, and many problems emerged that hindered the process of building the social contra

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Publication Date
Mon Nov 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Building a model to reduce the cost of hajj in the Iraqi Authority for Hajj and Umrah
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The research is summarized in the construction of a mathematical model using the most common methods in the science of Operations Research, which are the models of transportation and linear programming to find the best solution to the problem of the high cost of hajj in Iraq, and this is done by reaching the optimum number of pilgrims traveling through both land ports and the number Ideal for passengers traveling through airports by Iraqi Airways, instead of relying on the personal experience of the decision-maker in Hajj and Umrah Authority by identifying the best port for pilgrim's travel, which can tolerate right or wrong, has been based on scientific methods of Operations Research, the researcher built two mathematical models

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Publication Date
Mon Jan 02 2017
Journal Name
Al-academy
The semiology of culture and the sign variable in a theatre performance: Iraqi theatre as an example
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The culture of theatre performance has a vital role in the process of reading the linguistic and visual signs of the performance. And the process of transforming a theatre performance from its original context into a new hosting cultural context starts from the actual reading of the text. Directors derives their new signs out of his personal culture, depending on the society where they lives and the culture that forms the social conventions, traditions and beliefs. The text is usually written within its own historical and temporal culture. The process of its production usually takes it away from its original culture, when it interprets the codes of the original writer and their visual and linguistic signs and instils new alternative sign

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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
Fri Mar 06 2026
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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