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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 Jan 01 2021
Journal Name
E3s Web Of Conferences 318, 03006 (2021)
Effect of External Post-Tensioning Strengthening Technique on Flexural Capacity of Simple Supported Composite Castellated Beam
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This research is carried out to study the effect of the external post-tensioning technique on the flexural capacity of simply supported composite castellated beam experimentally. In this research, seven composite castellated beams having the same dimensions and material properties were cast and tested up to failure by applied two concentrated loads at 700 mm from each end. Two external strands of 12.7 mm diameter were fixed at each side of the web of strengthening beams and located at depth 180 mm from top fiber of the section (dps) at each end of the beam. The strands have been tensioned by using a hydraulic jack with a constant stress of 100 MPa. This research aims to study the effect of the strengthening by different shapes of st

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Publication Date
Sat Dec 30 2023
Journal Name
Al-kindy College Medical Journal
Radiological Significance of Shear-Wave Elastography Technique for Evaluation of Solid Breast Masses with Histopathological Correlation
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Background: Although various imaging modalities are available for evaluating suspicious breast lesions, ultrasound-based Shear-Wave Elastography (SWE) is an advanced, non-invasive technique complementary to grayscale sonography. This technique evaluates the elasticity of a specific tissue by applying sonic pressure to that tissue.

Objective: The aim is to assess the role of SWE in evaluating solid breast masses in correlation to histopathological study results.

Subjects and Methods: This prospective study was done in a tertiary care teaching hospital from September 2019 to August 2020. A study population of 50 women aged 18 years or above with an

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Publication Date
Fri Sep 30 2016
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Applied Spatial Data Analysis Technique on Petrophysical Properties of MA Unit of Mishrif Formation / Noor Field
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Noor oil field is one of smallest fields in Missan province. Twelve well penetrates the Mishrif Formation in Noor field and eight of them were selected for this study. Mishrif formation is one of the most important reservoirs in Noor field and it consists of one anticline dome and bounded by the Khasib formation at the top and the Rumaila formation at the bottom. The reservoir was divided into eight units separated by isolated units according to partition taken by a rounding fields.

In this paper histograms frequency distribution of the porosity, permeability, and water saturation were plotted for MA unit of Mishrif formation in Noor field, and then transformed to the normal distribution by applying the Box-Cox transformation alg

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The use of IT infrastructure and its impact on the performance of human resources in public universities: A field study at the University of Diyala
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This study aims to identify the impact of using the infrastructure of the Information Technology (IT) on the performance of human resources in the public universities. This process is done by doing research in the size, quality, and efficiency of the performance, also speed of achievement and simplification of procedures. Diyala University was chosen for the diagnosis through the opinions and attitudes of its employees.  Consequently, suggestions that contribute to improve the performance of the employees and thus its overall performance are obtained. Another objective of this study is identifying the human resources which are currently used in academic institutions and educational services systems because the significant role of th

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Publication Date
Tue Apr 29 2025
Journal Name
Modern Sport
A Comparative Study on the Results of the Administrative Performance Skills Scale Among Heads of Sports Talent Departments in the Ministry of Youth and Sports
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Sports management is a fundamental pillar that supports sports institutions and plays a pivotal role in achieving advanced levels of success in talent development. The Talent Development Project is one of the key strategic initiatives of the Ministry of Youth and Sports. This study compares department heads with effective managerial competence to those with ineffective competence to highlight differences in performance quality. Through this comparison, the urgent need to assess the administrative performance skills of the heads of sports talent departments becomes evident, particularly their ability to lead and manage the Sports Talent Development Project. The objective is to identify strengths and weaknesses, establish a clear framework fo

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Publication Date
Fri Dec 30 2022
Journal Name
Al-mustansiriyah Journal Of Science
Study of Photons Emission Rate of Quark-Antiquark at Higher Energy
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In this paper, the dynamic of quark and anti-quark interaction has been used to study the production of photons in the annihilation process based on the theory of chromodynamic. The rate of the photon is to be calculated for charm and anti-strange interaction c→γg system with critical temperature 113 and 130 MeV and photon energy GeV/c. Here the critical temperature, strength coupling and photons energy are assumed to be affected dramatically on the rate of photons emission of state interaction c, which can form gluon possible structures and photon emission state. The decreased photons emission yields with increased strength couple of quarks reaction due to increase critical temperature from 113 MeV to 130 MeV were predicted. We

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Publication Date
Sun Sep 28 2025
Journal Name
Journal Of Physical Education
A survey Study to Measure the level of Motivation a Squash lesson for junior students in the College of Physical Education and Sports Sciences
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            Human behavior is one of the topics that has captured the attention of researchers throughout the ages, and motivation is one of the manifestations of this behavior, which indicates the extent of interest in a particular topic and their unwillingness to rush towards a particular topic. The topic of motivation is one of the important topics of interest to the teacher and coach in the field of sports. The aim of this research was identifying the level of motivation for junior students, and the differences in the dimensions of motivation for junior students in squash lessons. We used the descriptive survey method, and the research sample was chosen randomly. Only male of the junior students in the College of Phys

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Publication Date
Thu Feb 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Job Enrichment in Building Differentiation Strategy Service: Analytical Exploratory Study of the Views of a Sample of the General Managers and Heads of Departments and Officials of the People in the General Establishment of Civil Aviation
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According to the importance of the subject of research, and the importance of the surveyed organization as a dynamic sector of the country in general , The research attempts to suggest to service organizations in general reconsidering the currently adopted mechanisms in the redesign of its functions , and in the services provided industry . The data was collected from (98) Director Mangers , head of department and head of division . The research tool is the questionnaire , which included (50) items . The results show Significant Effect & Correlation relationship between the two variables due to their dimensions . These lead to he application of job enrichment technology will increase the organization's ability to possess efficient hu

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Publication Date
Mon Oct 20 2025
Journal Name
Научный форум
Strategies of cultural adaptation and linguistic russification in the muravyov-kistyakovsky translation of 'the fellowship of the ring' (1982): a comprehensive study of fantasy text domestication
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This study examines strategies of cultural domestication in Muravyov and Kistyakovsky’s Russian translation of (The Fellowship of the Ring). It documents transformations of character names, toponyms, dialogues, and cultural references, highlighting systematic Russification and the infusion of Soviet political commentary that reshape the text into cultural rewriting.

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
Attitudes of the Private Sector towards the Application of Operational Contracting in Private Education Schools in the Sultanate of Oman: A Qualitative Study
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Abstract

The research aims to investigate the private sector attitudes toward operational contracting in special education schools. The research adopted the qualitative approach by using personal interviews with a sample of (45) private school owners and managers in Oman. The results of the research revealed that there is an agreement among the majority of respondents on the ability of the private sector to manage special education schools, the advantages of the partnership, as well as the need for guarantees to support this partnership. The government should fully assume it. The role of the private sector remains to raise the operational efficiency of schools. Opinions vary about the level of powers granted to t

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