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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 Mar 01 2024
Journal Name
Results In Engineering
Experimental and analytical study of the energy and exergy performance for different evaporative pads in hot and dry climate
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In this work, effects of using different evaporative cooling pads (ECPs) on the energetic and exergetic efficiency of a direct evaporative air cooler (DEAC) have been theoretically and experimentally investigated. Three types of ECPs were used, i.e., honeycomb cellulose cooler pad (HCCP), shading-cloth cooler pad (SCCP), and aspen wood wool cooler pad (AWWCP). For SCCP and AWWCP, a 3-cm pad thickness was used, while for the HCCP, three different values of pad thickness were used, i.e., 3, 5, and 7 cm. Tests were carried out using air velocities of 8, 14, and 19 m/s, measured at the DEAC outlet. Engineering equation solver (EES) used for performing the required calculations of the various parameters affecting the thermal performance of the D

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The vocational Adjustment of workers according to the analysis of job and design ((Local Research in the technology al information and communication office in the parliament))
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Abstract

The purpose of the present paper is to light on the relationship between jobs design, analysis and its reflections on reinforcing workers' vocational adjustment. The present paper aims to accomplish cognitive and applied goals, top of which, test of functional analysis ability to have effect upon workers' vocational adjustment via job design directly and indirectly owning to the virtual factor practiced by these practices on the sought organization. The problem of the present paper comes with many, the most important is the of how to bolster and back up worker's technical adjustment through good and accurate design for the job.

Based on this problem and goals as to expla

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Publication Date
Tue Jan 01 2002
Journal Name
Msc Thesis
Anatomical , Histological and Ultrastructural Study of the Hypophysis and Epiphysis Cerebri in Common Quail . Coturnix coturnix coturnix L
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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
A proposal to impose a tax on the profits of securities trading to increase tax revenues: Applied research in the General Commission of Taxes
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Abstract:

                The research aims to identify the concept of trading securities in Iraq and to propose a new mechanism for the taxation of trading profits and the extent of its impact on tax revenues, as it was observed that there are professional investors in the trading market and some of them achieve huge annual profits. and this profit should be like other taxable profits. The General Commission of Taxes and in cooperation with the Iraq Stock Exchange should identifying those profits, subjecting them to income tax, and adding them to the tax base. The researcher relied on the use of the descriptive and analytical approach bas

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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The relationship of empowering workers with organizational performanceField research of the views of the scientific leaders of a number of colleges at the University of Baghdad
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The Strategy of employees' empowerment, organizational performance and total quality management represent three informative which were and still the hub of many studies and researches including the current study. The higher education is considered one of the most important services sectors and the main development as well as the civil progress in the society. It is the main source that provides the organizations with the human resources having scientific or practical professions. So Higher Education has been chosen especially Baghdad University as a sample of the study. The study problem is concentrated to find answers of the following   questions: What the level of the powers mandate in the organization concerning the

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Publication Date
Thu Jun 29 2017
Journal Name
College Of Islamic Sciences
The prohibition of cheating in the Sunnah of the Prophet
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In The Name of Allah Most Gracious Most Merciful

Cheating is one of the forbidden actions and reprehensible morals that are forbidden by Islamic law, because it involves an assault on rights, whether they are the rights of God Almighty or the rights of God.

people, or self-rights, and because it involves harming others.

Since the Sunnah of the Prophet is the second source of Islamic law, many of the noble hadiths of the Prophet forbid and prohibit cheating.

This study sheds light on it.

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of Materials And Environmental Science
Study the effect of some chemicals used locally in agricultural processes in Iraq on the DNAof some non-targeted organisms
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Publication Date
Sun Sep 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of target cost technology in reducing product costs: Applied Study in the General Company for Soft Drinks Industry
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The Research dealt with the role of the target costs in reducing the cost of products in the General Company for soft drinks. One the modern approaches reduce costs and thus increase the ability and continuity to compete in the market. Where the problem of research in identifying the shortcomings in the traditional method used in the company sample research. Which led to a weak control of the cost and the researcher relied on data and costs of the company. The research recommended that the target cost of the company should be applied to the research sample. Training the employees. In addition, preparing training courses for them. He stressed the need to address obstacles that prevent the existence of an effective cost system. Including t

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The impact of brand identity in achieving marketing objectives Applied Study in the International Company for smart card "Key Card"
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Each organization has values ​​and objectives, tangible and intangible properties of its products. The reflection of properties on the brand constitutes the identity of the brand that contributes to building the customer's convictions about the products or services provided by any organization and its brand in a positive or negative way. This is reflected in purchasing behavior, which may push forward the progress towards marketing goals or deviation from them. Therefore, the current research came to identify the brand identity, its types and the factors affecting them and how they affect to achieve each of the marketing goals. At a time when

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Publication Date
Wed Nov 03 2021
Journal Name
International Journal Of Energy Research
Simulation and experimentation study on the performance of metal hydride storage vessels
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This paper details the process of designing, analysing, manufacturing, and testing an integrated solid-state hydrogen storage system. Analysis is performed to optimise flow distribution and pressure drop through the channels, and experimental investigations compare the effects of profile shape on the overall power output from the fuel cell. The storing of hydrogen is given much attention in the selection of a storage medium, and the effect of a cooling system to reduce the recharging time of the hydrogen storage vessel. The PTFE seal performed excellently, holding pressure over 60 bar, despite requiring changing each time the cell is opened. The assembly of the vessel was simple and straightforward, and there was no indication of pressure

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