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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 09 2019
Journal Name
Journal Of The College Of Education For Women
A comparative Study to calculate the Runs Property in the encryption systems
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Cryptographic applications demand much more of a pseudo-random-sequence
generator than do most other applications. Cryptographic randomness does not mean just
statistical randomness, although that is part of it. For a sequence to be cryptographically
secure pseudo-random, it must be unpredictable.
The random sequences should satisfy the basic randomness postulates; one of them is
the run postulate (sequences of the same bit). These sequences should have about the same
number of ones and zeros, about half the runs should be of length one, one quarter of length
two, one eighth of length three, and so on.The distribution of run lengths for zeros and ones
should be the same. These properties can be measured determinis

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Effect of Swelling Soil on Load Carrying Capacity of a Single Pile
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Expansive soils are recognized by their swelling potential upon wetting due to the existence of some clay minerals such as  montmorillonite. An effective solution was found to avoid the danger of such soils by using piles. A single pile embedded in an elasto-plastic expansive soil has been analyzed by using one of the available software which is ABAQUS to investigate the effect of applied loads on pile’s top and investigate the effect of swelling soils on load carrying capacity of the pile. The result shows that as the pile is axially loaded at its top, the axial force along the pile gradually changes from (tension) to (compression) and the pile tends to move downward. The applied load needed to initiate pile’s settlement depend

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Internal Debt Options during the Two Double Shocks and Its Impact on Foreign Reserve in Iraq
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The research aims at a statement Internal Debt options during shocks and the impact of this borrowing in the volume of the foreign reserve, using induction and deduction with available data analysis. During the period (2004-2013) did not require the use of borrowing across (financial institutions, discounted transfers, bonds); it was only sufficient by transfer with commercial banks that can finance of temporary budget deficits: rose and decline of volume of foreign reserve according to the changes of oil prices and the volume of purchases and sales of the Central Bank of Iraq. Central Bank of Iraq (CBI) has significantly contributed to Internal Debt through bond and discounted transfers in the secondary market; thus, funding the

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Publication Date
Fri May 05 2023
Journal Name
International Journal Of Professional Business Review
The Effect of Emotional Intelligence on Manager Performance: a Field Study in the General Authority for Irrigation and Reclamation Projects in Baghdad
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Purpose: the purpose of this study is to investigate how managers working for the General Authority for Irrigation and Reclamation Projects react to the impact of Emotional Intelligence (EI) on their performance.   Theoretical framework: The current study includes an intellectual framework on two variables, namely EI and Manager Performance (MP), because it is essential to investigate the relationship between these two variables and the impact of EI on MP.   Design/methodology/approach: The research problem is that a manager's capacity to make wise decisions about their work or interactions with subordinates is diminished when they have inadequate EI. The questionnaire is used as a tool for gathering data for the study, and the st

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Publication Date
Thu May 22 2025
Journal Name
Journal Of Physical Education
A study of some variables biomechanics in clean and jerk for the world champions men and women
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Publication Date
Wed Sep 30 2015
Journal Name
European Journal Of Chemistry
Reaction pathways and transition states of the C-C and C-H bond cleavage in the aromatic pyrenemolecule - A Density Functional study
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The activation and reaction energies of the C-C and C-H bonds cleavage in pyrene molecule are calculated applying the Density Functional Theory and 6-311G Gaussian basis. Different values for the energies result for the different bonds, depending on the location of the bond and the structure of the corresponding transition states. The C-C bond cleavage reactions include H atom migration, in many cases, leading to the formation of CH2 groups and H-C≡C- acetylenic fragments. The activation energy values of the C-C reactions are greater than 190.00 kcal/mol for all bonds, those for the C-H bonds are greater than 160.00 kcal/mol. The reaction energy values for the C-C bonds range between 56.497 to 191.503 kcal/mol. As for the C-H cleavage rea

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Publication Date
Tue Jan 01 2019
Journal Name
International Journal Of Research In Social Sciences And Humanities
A DISCOURSE ANALYSIS STUDY OF THE TRUTH AND REALITY IN NEWS WEBSITES ABOUT THE WARIN SYRIABETWEEN AL-JAZEERA ENGLISH AND BBC WORLD
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BN Rashid, International Journal of Research in Social Sciences and Humanities, 2019 - Cited by 1

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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Relationship Between The Internal Marketing and Quality Services : a Filed Study on Samples of Customers and Employees In Iraqi Commercial Banks
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Abstract

The Paper highlights on one of the main activities in marketing management. That is the internal marketing in the commercial banks and its relationship with the quality services offered to satisfy customers needs and wishes in order to reach he ultimate objectives of those banks. Two state and five private banks in Basrah city (Iraq) were taken in a field study. The survey covered the opinions of (184) state bank employees and (158) clients . The analysis of the survey shows that there is a strong relationship between the internal marketing ( in the banks covered by the survey) and the quality of banking objective services and the private banks show greater interest and concern to the internal ma

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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
The role innovative leadership in administrative empowerment (Study analysis of the views of a sample of decision makers in the General Company for Food Industries(
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 Abstract

The objective of the research is to identify the role of innovative leadership in achieving the dimensions of administrative empowerment in the company for the public of food industries. The various variables have shown the importance of innovative leadership to achieve the dimensions of administrative empowerment in both international and local companies. Administrative Empowerment "In order to answer this question, a virtual model was developed to reflect the relationship and impact between innovative leadership and administrative empowerment. The research was based on the analytical descriptive approach.  the research community, The company represented the general company for food industries, retrie

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Publication Date
Sat Sep 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of the volume of Capital heldin stock prices: An analytical study in a sample of Iraqi banks listed in the Iraqi Stock Exchange
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 The capital in the bank is the important element in establishing it, because it maintains the banking sector in the event of exposure to losses or risks In addition to contributing to the provision of liquidity And protection of depositors' money from potential and unexpected losses. There is also a relationship between the prices of shares and the indicators of the durability of the capital owned, considering that the shares are the components of the bank capital The study limited the indicators of capital to assets and capital to deposits, capital to loans and financial investments Where the most important conclusions are the damage to the detriment of shareholders in contrast to the depositors in the case of increasing the propo

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