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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 Dec 31 2020
Journal Name
Political Sciences Journal
Malaysia and the countries of the Middle East are a vision towards understanding the factors affecting the pattern of the relationship
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Malaysia is linked to the countries of the Middle East by a historical relationship identified by a number of factors and determinants that affected the developments of that relationship, especially its relentless endeavor to preserve its Islamic identity with the leadership of the rest of the other ethnicities, in addition to those factors and international determinants that directly affected the typicality of this relationship and perhaps the United States stands At the forefront of who represents this international variable, as it is considered the Middle East region as a core region and within its vital field, and therefore any analog relationship in the field of international relations and one of its parties is the countries of the

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Publication Date
Mon Sep 20 2021
Journal Name
College Of Islamic Sciences
Positive images in the Holy Quran The story of Solomon - peace be upon him - in Surat An-Naml is a model An objective study
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God Almighty put in his great book secrets that do not end, and wonders that do not expire, for he is the one from which the scholars are not satisfied, and he does not create due to the multitude of response, and it is the comprehensive and inhibitory book that God conceals to the worlds, and he challenged the two heavyweights to come up with something like it.

At all times, issues arise in the Noble Qur’an that fit the needs of the people of that time and their culture, for it is an eternal book, characterized by the ability to give, extend and respond to addressing the problems of the age and its variables, when the Arabs had little luck at the time of the message’s descent from the scientific culture, and their proficienc

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Publication Date
Tue Dec 01 2020
Journal Name
Baghdad Science Journal
Conductivity Study of DTAB in Water and Ethanol-Water Mixture in the Presence and Absence of ZnSO4
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The physicochemical behaviour of dodecyltrimethylammonium bromide (DTAB) in water and ethanol-water mixture in the presence and absence of ZnSO4 were studied by measuring the conductivity at 298.15 K. The pre-micellar (S1) and post-micellar slopes (S2) were obtained and calculated the degree of dissociation (α) and the critical micelle concentration (cmc). With an increase in ethanol content, the cmc and α of DTAB increased whereas, in the presence of ZnSO4, the cmc and α decreased. By using cmc and α, thermodynamic properties as the standard free energy of micellization ( ) were evaluated. With an increase in ethanol content, the negative values of  are decreased indicating less spont

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Publication Date
Mon Jan 01 2018
Journal Name
International Journal Of Science And Research (ijsr)
Optimal Economic Design of Diversion Structures during Construction of a Dam by Particle Swarm Optimization
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Diverting river flow during construction of a main dam involves the construction of cofferdams, and tunnels, channels or other temporary passages. Diversion channels are commonly used in wide valleys where the high flow makes tunnels or culverts uneconomic. The diversion works must form part of the overall project design since it will have a major impact on its cost, as well as on the design, construction program and overall cost of the permanent works. Construction costs contain of excavation, lining of the channel, and construction of upstream and downstream cofferdams. The optimization model was applied to obtain optimalchannel cross section, height of upstream cofferdam, and height of downstream cofferdamwith minimum construction cost

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Engineering
Optimal Economic Design of Diversion Structures during Construction of a Dam by Particle Swarm Optimization
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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of merger in creating differences in the profitability of companies Analytical research between a sample of subsidiaries to the Iraqi Ministry of Industry and Minerals
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The research aims to identify the impact of the merger of the companies affiliated to the Ministry of Industry and Minerals on their financial profitability since the companies before the merger suffered a rise in losses and the deficit reached very high levels that affected its overall performance and even on the morale of workers as losses are increasing and solutions Efficiency is absent. The problem stems from knowing the impact of the merger on the profitability ratios of the companies. The research field was represented by the companies affiliated to the Ministry of Industry and Minerals (21) companies, while the research sample reached (6) companies after the merger (14) companies before the merger, was based on data The f

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Publication Date
Wed Feb 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Strategic Command and its role in activating the Organisational performance analytical study of the views of the heads of academic departments at General Authority of groundwater.
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Abstract

The research aims to identify the strategic leadership and its role in activating the Organisational Performance, which is an analytical study of the views of the heads of scientific departments at General Authority of groundwater researcher's quest focused towards building a theoretical framework suitable for strategic leadership and performance Organisational and itُs dimensions.To achieve the aims of the research is designed to identify the researcher included (35) items to collect the raw data from the research sample consisting of 33 of the heads of departments. Data was collected by questionnaire, field visits, interviews and some official documents to complete the search data. It has also been used a numb

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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi Journal Of Physics
A study of the effect of silica particles addition on some physical properties of PVC as a packaging material
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In this work, varying compositions of SiO2 micro filler were added
with the Polyvinyl Chloride (PVC) and samples have been prepared
using film casting technique. The results have been analyzed and
compared for PVC samples with (1 wt%, 3 wt%, 5 wt% and 10 wt%)
SiO2 micro filler. Mechanical characteristics such as tensile strength,
elongation at break and Young`s modulus were measured for all the
samples, where the tensile strength was increased from 8.39 Mpa for
purified PVC to 16 Mpa for 3% SiO2/PVC composite. Also, thermal
conductivity measurement values illustrated that composite materials
have a good thermal insulation at 10 wt. %, thermal conductivity was
decreased from 0.1684 W/m.

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Publication Date
Sun Jun 30 2013
Journal Name
College Of Islamic Sciences
The Leader: His Qualifications and Attributes in the Quranic Perspective in Light of Surat Al-Naml - An Objective Study
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Praise be to God, prayer and peace be upon the Messenger of Allah and after :
For the Holy Qur’an is the constitution of this nation, and it has included everything that the nation needs, and it has appropriate solutions for all the problems it faces, and for a long time the nation has its vision for the future, waiting for a leader who carries the concerns of this nation and proceeds towards progress and progress, so that it rises to the glory and glory. He brings it out from what it is today, from its deterioration in all levels.
The world has witnessed in recent decades the development of programs and curricula, and books have been prepared showing how to prepare leaders and their industry, and what programs they should adopt

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Publication Date
Wed Oct 01 2014
Journal Name
Al–bahith Al–a'alami
The electronic news bulletin of the ministry of higher education and scientific research: A study in the newspapers of: (AL-Taakhi, AL-Zaman, ALAdala,AL-Sabah and Baghdad) for period from 2nd October 2011 to 1st November 2011
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The research aims to know the reverberation of the the electronica news bulletin of the ministry of higher education and scientific research  in the newspapers of: (AL-Taakhi, AL-Zaman, ALAdala,AL-Sabah and Baghdad) for period from 2nd October 2011 to 1st November 2011 to explain its activity and advantage for the other newspapers and to show the importance which the newspapers showed for the study of the news subject in the bulletin, as well as,to show the proportional differences in which the newspapers interested in the subjects of the published news, and to reach to the results which lead us to good conclusions for the service of decision owner and open new horizons for the researchers to expanding in the s

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