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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
Sat Feb 12 2022
Journal Name
Engineering, Technology &amp; Applied Science Research
The Possibility of Minimizing Rutting Distress in Asphalt Concrete Wearing Course
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The excessive permanent deformation (rutting) in asphalt-concrete pavements resulting from frequent repetitions of heavy axle loads is studied in this paper. Rutting gradually develops with additional load applications and appears as longitudinal depressions in the wheel path. There are many causes of the rutting of asphalt roads, such as poor asphalt mixing and poor continuous aggregate gradation. All factors affecting the mixture resistance to permanent deformation must be discussed, and all must be properly considered to reduce the rutting propensity of asphalt-aggregate mixtures. In this study, several mixtures were produced with the most common techniques in rutting resistance (using the most effective additives for each mixture), and

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Publication Date
Sun Apr 02 2023
Journal Name
Journal Of Oral Microbiology
Current concepts in the pathogenesis of periodontitis: from symbiosis to dysbiosis
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Publication Date
Sun Jan 21 2018
Journal Name
The Iraqi Geological Journal
GEOCHEMICAL PARTITIONING OF HEAVY METALS IN THE URBAN SOIL, KIRKUK, IRAQ
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This work focused on anthropogenic influences of the trace metals distribution in the soils of Kirkuk city. Sequential extraction technique was used to determine the distribution of the chemical fractions of Ag, Cd, Co, Cu, Ni, Pb, Zn, As, Cr and V in soil of Kirkuk city. This area is affected mainly by burning oil trash. Results show that these heavy metals were primarily restricted to surface horizons and mostly associated with the residual fraction (28.8 – 50%). The remnant fractions (13.8 – 33.1%) linked to the organic matter, 7.9 – 27.2% was bound to Fe-Mn oxide, 0.7 – 27.9 was bound to carbonate. Only a small amount of the total metals in the soil is exchangeable (0.5 – 4.2%) and water soluble (0 – 4.1%) fractions.

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Role OF Human Resource managment Strategies In Enhancing Cognitive Skills.
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Abstract:

 In its theoretical farm, the research adobet  the subject of human resource management strategies  and the cognitive skills. It comes as result of the rapid development which considers it human resource. as main axis in organization , the research in includes ,connective analysis  , between  human resource management strategies  and cognitive skills which is considers one of the new concept that should  be  studied widly so that the organization can be able recognize it as concept and type and its importance for people in the organization.The study method was descriptive and  analytics , it identified collation of hypothesis which were by statist too

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Publication Date
Tue Oct 14 2025
Journal Name
Cab Reviews: Perspectives In Agriculture, Veterinary Science, Nutrition And Natural Resources
The role of modern agricultural practices in enhancing soil erosion resistance
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This review focuses on conservation agriculture (CA) and its effects on increasing the soil’s resistance to erosion. CA involves minimum soil disturbance (minimum tillage/ no-till), diversified crop rotation, and maintenance of the soil cover to increase soil fertility and reduce erosion. CA reduces soil loss by up to 90% and water erosion by approximately 50 to 70% from runoff as it increases the health of the soil, yield of crops, and water-retention capacity of the soil by incorporating soil organic matter and promoting biodiversity. Crop rotation prevents the replenishment and depletion of soil nutrients by atmospheric fixation of nitrogen/biological nitrogen fixation. Controlled traffic farming (CTF) is a new strategy in which travel

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The strategic role of human resource development in developing competitive advantage
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This research aims at highlighting the strategic role of human resource development in developing competitive advantage in light of the great challenges and rapid changes witnessed in recent years in the business world. The human element is the main engine of the organization's resources, especially when it possesses the skill quality and cognitive abilities commensurate with the nature of work. Therefore, this research focuses on the importance of human resources development strategy in contemporary organizations and reviews the summary of literature and theoretical foundations related to human resources development, as well as various philosophical concepts related to the competitive advantage and to indicate the important role

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Publication Date
Sat Sep 30 2017
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Enhancing the Lifting Capacity of Drilling Fluids in Vertical Oil Wells
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Of the many functions that are performed by the drilling fluid, the most important is to transport cuttings from the bit up the annulus to the surface. Various drilling fluid have been widely used in the oil industry to improve lifting capacity. In this study, three mud type have been used which they are, oil base mud, X-anthan polymer and a mixture of CMC and bentonite ,by using Carrying Capacity Index  calculation (CCI) , the Xanthan  gave good values of CCI than other studied drilling fluid. By using Sifferman chart and field data from well in south of Iraq and API equation to find cutting concentration in the annulus, The results showed that the used of thick mud increase the lifting capacity and decrease volumetric drill c

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Goserelin versus Norethisterone in the Management of Menorrhagia with Uterine Fibroid
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Menorrhagia is common in patients with uterine fibroids, if operation needs to be delayed for a particular reason, goserelin can be used safely to reduce bleeding and the size of the tumor.The objective is to compare between goserelin acetate and norethisterone on patients with menorrhagia and uterine fibroid. A randomized controlled study conducted in Elwiya maternity teaching hospital, Baghdad from the first of November 2007 to the end of April 2009. 90 patients from the consultant outpatient clinic with menorrhagia and fibroid, and their operations were delayed for medical reason were allocated in two groups, the first group, was given 3.2 mg goserelin acetate subcutaneously monthly for 3 months and the second group was given 5 mg nor

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Research In Social Sciences &amp; Humanities
The Role of Human Resources Management Professionals' Skills in Information Technology
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The current research aims to measure the impact of the skills of human resources management professionals in information technology in Iraqi private banks, as the skills of human resources management professionals constitute the modern trend of banks' interest in employees with outstanding performance, and the presence of information technology in banks is a prerequisite for dealing with the huge amount of data. And converting it into information to support the decision-maker in light of a complex environment, and the field research problem was the presence of a clear lack of interest in the skills of human resource management professionals and the weak adoption of information technology, which was reflected negatively on the compet

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Publication Date
Fri Jun 03 2022
Journal Name
International Journal Of Health Sciences
Corrosion risk assessment of the oil flow line in Southern Iraq
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The risk assessment for three pipelines belonging to the Basra Oil Company (X1, X2, X3), to develop an appropriate risk mitigation plan for each pipeline to address all high risks. Corrosion risks were assessed using a 5 * 5 matrix. Now, the risk assessment for X1 showed that the POF for internal corrosion is 5, which means that its risk is high due to salinity and the presence of CO, H2S and POF for external corrosion is 1 less than the corrosion, while for Flowline X2 the probability of internal corrosion is 4 and external is 4 because there is no Cathodic protection applied due to CO2, H2S and Flowline X3 have 8 leaks due to internal corrosion so the hazard rating was very high 5 and could be due to salinity, CO2, fluid flow rate

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