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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
Tue Dec 22 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the Office of Financial Supervision in the federal control over health and sustainable development: Applied research in the Baghdad Soft Drinks Company
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The study aims to indicate the role of strategic financial accounting  in the service investors  to take appropriate decisions in the future, Through what is provided by the strategic accounting, the future of information and data that enable the investor to make future investment decisions appropriate، If no longer traditional financial accounting putting meet all existing and prospective investors Requirements، That reliance on historical data and information already signed and neglected aspect of future, From this point it was to highlight the role of strategic financial accounting to contribute in this area.

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Publication Date
Wed Jun 29 2022
Journal Name
Journal Of The College Of Education For Women
The Predictive Ability of the University Grade Point Average in the Specialized Test Score for thAbility of the University Grade Point Average in the Specialized Test Score for the Teacher Position in the Ministry of Education in the Sultanate of Oman
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the most important purposes and uses of the test results in the educational sector. This is because the quality of tests is related to their ability to predict the learner's behavior in the future, and the accuracy of the educational and administrative decisions that are taken in light of their results. The study aimed accordingly to reveal the predictive ability of the university Grade Point Average (GPA) in the Score of the specialized test for the position of teacher in the Ministry of Education in the Sultanate of Oman. It further aimed to investigate the differences in the predictive ability according to the specialization and academic year using the descriptive approach. The sample of the study consisted of (349) s/he students enro

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Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of the efficiency and effectiveness of the accounting system of the Department of Missions and Cultural Relations (*) at the Office of the Ministry of Higher Education and Scientific Research
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The evaluation and efficiency and effectiveness of account system for the department of delegation and cultural Relationships in the center of ministry of higher Education and Scientific research Considered as a very important and active subjects in the modification of accounting system in this department and to develop it and make it able to make available important and accurate information for the planning requirements and monetary and evaluation performance and to make decisions, besides to develop the performance of Iraqi Cultural departments working abroad and to render its role effective to serve the students of higher education in the progressive Countries to facility its growing in scientific and professional and technica

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Publication Date
Mon Nov 11 2019
Journal Name
Day 3 Wed, November 13, 2019
Drill Bit Selection Optimization Based on Rate of Penetration: Application of Artificial Neural Networks and Genetic Algorithms
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Abstract<p>The drill bit is the most essential tool in drilling operation and optimum bit selection is one of the main challenges in planning and designing new wells. Conventional bit selections are mostly based on the historical performance of similar bits from offset wells. In addition, it is done by different techniques based on offset well logs. However, these methods are time consuming and they are not dependent on actual drilling parameters. The main objective of this study is to optimize bit selection in order to achieve maximum rate of penetration (ROP). In this work, a model that predicts the ROP was developed using artificial neural networks (ANNs) based on 19 input parameters. For the</p> ... Show More
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Publication Date
Sun Nov 23 2025
Journal Name
Kufa Journal Of Arts
Compound thought :Or face crises from oneself to politics A Philosophical Study on the Editions of Edgar Moran
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Publication Date
Mon Jan 01 2024
Journal Name
Infocommunications Journal
On the Performance of Metamaterial based Printed Circuit Antenna for Blood Glucose Level Sensing Applications: A Case Study
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Due to the urgent need to develop technologies for continuous glucose monitoring in diabetes individuals, poten tial research has been applied by invoking the microwave tech niques. Therefore, this work presents a novel technique based on a single port microwave circuit, antenna structure, based on Metamaterial (MTM) transmission line defected patch for sensing the blood glucose level in noninvasive process. For that, the proposed antenna is invoked to measure the blood glu cose through the field leakages penetrated to the human blood through the skin. The proposed sensor is constructed from a closed loop connected to an interdigital capacitor to magnify the electric field fringing at the patch center. The proposed an tenna sensor i

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Publication Date
Sun Feb 02 2025
Journal Name
Engineering, Technology &amp; Applied Science Research
A Numerical Study of Concrete Composite Circular Columns encased with GFRP I-Section using the Finite Element Method
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This paper presents ABAQUS simulations of fully encased composite columns, aiming to examine the behavior of a composite column system under different load conditions, namely concentric, eccentric with 25 mm eccentricity, and flexural loading. The numerical results are validated with the experimental results obtained for columns subjected to static loads. A new loading condition with a 50 mm eccentricity is simulated to obtain additional data points for constructing the interaction diagram of load-moment curves, in an attempt to investigate the load-moment behavior for a reference column with a steel I-section and a column with a GFRP I-section. The result comparison shows that the experimental data align closely with the simulation

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Publication Date
Sun Mar 01 2015
Journal Name
Baghdad Science Journal
Study the effect of Aqueous cold water and Alcoholic extracts of Ziziphus spina christi against bacteria isolated from Conjunctivitis In vitro and In vivo
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This study aimed to study the effect of Ziziphus spina christi Aqueous cold and Alcoholic leaves and fruits extracts on the growth and activities of the following types of bacteria :( Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus pyogenes ). The results appeared outweigh the alcoholic extract of leaves and fruits of Sidr that prepared by saxholate extractor by addition of ethanol 95% significant superiority as compared with aqueous extract that prepared by using distilled water as was its influence inhibitor to the growth and effectiveness of bacteria , about the treatment of in-vivo to cause injury to these types of bacteria diagnosed laboratory mice and treated with alcoholic extract of the leaves o

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Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
Dimensions of binding and non-binding social responsibility and its relationship to organizational performance / Field Study in telecommunications companies in the Republic of yemen
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The study aims at measuring the dimensions of binding and non-binding social responsibility and its relation to the organizational performance in telecommunication companies in the Republic of Yemen using analytical descriptive approach and questionnaire as a main tool for data collection and comprehensive inventory method.

It has been found  that there is a positive effect and significant moral relation between social responsibility with its binding and non-binding dimensions  and the organizational performance of telecommunication companies in the Republic of Yemen at a level of significance below (0.05). It has also been found that the correlation between the non-binding social responsibilit

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Publication Date
Tue Jan 01 2019
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees19gr
Calculation and study of internal radiation doses resulting from the ingestion of some radioactive sources
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