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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
Thu Jul 08 2021
Journal Name
Turkish Online Journal Of Qualitative Inquiry (tojqi)
Legislative Insufficiency in the Legal Regulation of the Trademark Study of the Iraqi Law
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Publication Date
Thu Oct 01 2009
Journal Name
Iraqi Journal Of Physics
Effect of Glass Inclination of Windows Facing East and West on Solar Radiation Transmittance into Buildings
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To reduce solar radiation transmittance into buildings through windows facing east or west during summer, a window inclination from vertical position is suggested. The inclination of the window glazing and the rate of unwanted solar radiation during summer can be calculated knowing the dialy inclination of the sun rays. The inclination of window glazing depends on the latitude of the position required. For instance in Baghdad which is at about 33o north latitude a slope of 15o for window glazing is sufficient to prevent about 419 MJ/m2 of total solar radiation energy from penetration during summer for clear glazing of window facing east. This value drops to about 96 MJ/m2 during winter. Therefore the ratio between the energy saved for co

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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
The Degree of Implementation of the Coronavirus Prevention Standards (Covid-19) In the Kingdom Of Saudi Arabia (A COMPARATIVE STUDY BETWEEN FAMILIES OF PEOPLE WITH INTELLECTUAL DISABILITIES AND FAMILIES OF ORDINARY PEOPLE)
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The study aims to identify the degree of implementation of the coronavirus prevention standards (covid-19) in the kingdom of Saudi Arabia and compare it with the families of intellectual disabilities. The study population consisted of all families residing in the Kingdom of Saudi Arabia. To achieve the objectives of the research, the analytical descriptive approach was employed. The study sample consisted of (372) families, among them (84) families with intellectual disabilities, and (288) families without intellectual disabilities. They were chosen from the Saudi community according to what is available for collection in a simple random way, using the standard criteria for the prevention of coronavirus (Covid- 19) Prepared by the resear

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The impact of managing employees' performance in building intellectual capital Analytical study of the views of a sample of heads of scientific departments At the University of Kirkuk
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The research aims to identify the impact of managing performance's employees in building intellectual capital, Because employing the practice of managing the performance of employees may acquire familiar skills to improve their performance and reflect on the construction of intellectual capital in the surveyed area, Especially that the independent dimension represented by the management of the performance of employees is one of the important topics that has received attention in the world of management in general and human resource management in particular.  While the adopted dimension was represented by Intellectual capital in the important practice of human resource management in the increasing of  their knowledge, to

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Publication Date
Wed Jan 01 2020
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees20
Theoretical estimation of the trapping reaction rate for deuteron-deuteron fusion in nickel metal using Bose-Einstein condensates phenomena
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A mathematical model has been introduced to investigate the effect of nuclear reaction constant ( A ), probability of the BEC ground state occupation Ω i, nD is the number density of deuteron (d) and the overall number of nuclei ND on the total nuclear d-d fusion rate (R). Under steady-state of the condensates of Bose-Einstein, the postulate of quantum theory and Bose-Einstein theory were applied to evaluate the total nuclear (d-d) fusion rate trapping in Nickel-metal The total nuclear fusion rate trapping predicts a strong relationship between astrophysical S-factor and masses of Nickel. The reaction rate trapping model was tested on three reaction d(d,p)T, d(d, n)3He and d(d, 4He)Q = 23.8MeV respectively. The reaction rate has described

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Impact of the Application of Corporate Governance On the Financial Performance Evaluation in Banks: Applied Study- Sample of the Conventional and Islamic Banks in the Kingdom of Bahrain
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 The aim of this research is to identify the extent to which the Conventional and Islamic banks are committed to implement the requirements of the corporate governance in its financial reports. In addition to its commitment to transparency and clarity in dealing with the shareholders and stockholders to protect their interests and to determine the impact of the commitment of the corporate governance on assessing the financial performance of the conventional and Islamic banks that participate in Bahrain Stock Exchange.

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Publication Date
Mon Feb 18 2019
Journal Name
Iraqi Journal Of Physics
Derivative of an image that corrupted by additive noise
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In this paper the behavior of the quality of the gradient that implemented on an image as a function of noise error is presented. The cross correlation coefficient (ccc) between the derivative of the original image before and after introducing noise error shows dramatic decline compared with the corresponding images before taking derivatives. Mathematical equations have been constructed to control the relation between (ccc) and the noise parameter.

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Publication Date
Tue Feb 08 2022
Journal Name
South Asian Journal Of Social Sciences And Humanities
The Impact of University Leadership and the University Organizational Environment on the Performance of staff: A Case Study at Al Maaqal University (Private Sector)
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This study aims to explore the impact of the interaction of the university leadership and the university organizational environment on the performance level of the staff at Al-Maaqal university. This university was chosen as a field of study because it is a new university and needs studies that develops and contributes to improve its overall performance. The problem defined by the following question: to what extent does the interaction of the university leadership and the university organizational environment affect the performance level of the teaching staff at AlMaaqal University?). The method of this study adopted a major hypothesis in which there is a statistically significant effect of university leadership and university environment o

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Publication Date
Sat Apr 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Estimation & Analysis Relationship between Growth rate GDP and Unemployment Rate In Iraqi Economic in Period (1990-2014)
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Crossref
Publication Date
Mon Aug 01 2011
Journal Name
Journal Of Engineering
EXPERIMENTAL STUDY OF AIR FLOW RATE EFFECTS ON HUMIDIFICATION PARAMETERS WITH PREHEATING AND DEHUMIDIFICATION PROCESS CHANGING
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This research study experimentally the effect of air flow rate on humidification process
parameters. Experimental data are obtained from air conditioning study unit T110D. Results obtained
from experimental test, calculations and psychometrics software are discussed. The effect of air flow rate
on steam humidification process parameters as a part of air-conditioning processes can be explained
according to obtained results. Results of the steam humidification processes (1,2) with and without
preheating with 5A and 7.5A shows decreasing in dry bulb temperature, humidity ratio, and heat add to
moist air with increasing air flow rate, but humidification load, and total energy of moist air increase with
increasing air flo

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