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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
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
Study About The Robustness Of The Bayesian Criterion
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In this research work an attempt has been made to investigate about the Robustness of the Bayesian Information criterion to estimate the order of the autoregressive process when the error of this model,  Submits to a specific distributions and different cases of the time series on various size of samples by using the simulation,  This criterion has been studied by depending on ten distributions, they are (Normal, log-Normal, continues uniform, Gamma , Exponential, Gamble, Cauchy, Poisson, Binomial, Discrete uniform) distributions, and then it has been reached to many collection and recommendations related to this object , when the series residual variable is subject to each  ( Poisson , Binomial , Exponential , Dis

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Publication Date
Thu Jun 30 2011
Journal Name
Al-khwarizmi Engineering Journal
Study of Adding Ethanol to Gasoline Effects on Produced Noise Intensity of Single Cylinder Spark Ignition Engine
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Since 1990 internal combustion engines and variable systems has been considered as emission. Noise can be defined as undesirable sound, and in high levels it can be considered ahealth hazard. Large internal combustion engines produce high levels of noise. In many countries there are laws restricting the noise levels in large engine rooms and fixed applications. Locomotives engines have the minimum emission influence because of noise control techniques capability.

In this paper study on a single cylinder internal combustion engine was conducted. The engine works by adding ethanol to gasoline, at variable speeds, without adding ethanol, and with adding 10 and 20% ethanol in volumetric ratio. Using one sound insulator or two or with

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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
The impact of the "Senge" Model of Organizational Learning in the adoption of Total Quality Management principles) Exploratory study in an organization)
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      This study is concerned with organizational learning and its impact on total quality management in the education sector. Organizational learning is a process that provides the educational sector with the ability to adapt and respond rapidly to developments and changes in a better way according to its main dimensions (Mental Models, Personal Mastery, Team Learning, Shared Vision, System Thinking) by adopting the philosophy of Total Quality Management (TQM) in accordance with its basic dimensions (leadership, customer satisfaction, participation of workers, continuous improvement, training and education). The main purpose of this study is to know (the impact of the Senge model of organizational learni

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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
The impact of the "Senge" Model of Organizational Learning in the adoption of Total Quality Management principles) Exploratory study in an organization)
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      This study is concerned with organizational learning and its impact on total quality management in the education sector. Organizational learning is a process that provides the educational sector with the ability to adapt and respond rapidly to developments and changes in a better way according to its main dimensions (Mental Models, Personal Mastery, Team Learning, Shared Vision, System Thinking) by adopting the philosophy of Total Quality Management (TQM) in accordance with its basic dimensions (leadership, customer satisfaction, participation of workers, continuous improvement, training and education). The main purpose of this study is to know (the impact of the Senge model of organizational learni

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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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Publication Date
Tue Mar 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Organizational Creativity in Enhancing Knowledge Management Processes: survey study for a sample of academic staff members at the Technical College of management / Baghdad)
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In many organizations, employees who have high mental skills are the main source of organizational creativity. When a firm does not put creativity as a goal, cannot stand solid against the competition. Nowadays, knowledge is the path to discover the innovation and creativity aspects, This can assist the firm to stand face to face with competition in the market. The importance of this research comes from detecting and knowing the relation between creativity and knowledge to know and detect the influence of organizational creativity on backing the management of knowledge and determine the final results. The problem of research is to trace the role of organizational creativity on knowledge management processes in order to enable the

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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
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
Wed Nov 20 2024
Journal Name
Naunyn-schmiedeberg's Archives Of Pharmacology
The potential role of targeting the leptin receptor as a treatment for breast cancer in the context of hyperleptinemia: a literature review
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Since cancer is becoming a leading cause of death worldwide, efforts should be concentrated on understanding its underlying biological alterations that would be utilized in disease management, especially prevention strategies. Within this context, multiple bodies of evidence have highlighted leptin’s practical and promising role, a peptide hormone extracted from adipose and fatty tissues with other adipokines, in promoting the proliferation, migration, and metastatic invasion of breast carcinoma cells. Excessive blood leptin levels and hyperleptinemia increase body fat content and stimulate appetite. Also, high leptin level is believed to be associated with several conditions, including overeating, emotional stress, inflammation, obesity,

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Publication Date
Sun Jun 15 2025
Journal Name
Journal Of Physical Education
The impact of a training field in Lake Al-Razzaza to develop the strength of the legs and arms for young boxers
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