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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
Sun Jul 01 2001
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
HAEMATOZO`A OF THE AVIAN FAMILY PHASIANIDAE IN IRAQ
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A collection of 118 specimens of Iraqi phasianid birds belong to four species was examined
for haematozoa. Results show that 21.2% of them were infected with one or more of four
species of blood parasites; Haemoproteus danilewskyi, H. santosdiasi, Plasmodium sp. and
microfilaria. Haemoproteus danilewskyi is reported here for the first time in Iraq.

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Publication Date
Wed Aug 26 2020
Journal Name
International Journal Of Research In Social Sciences And Humanities
THE ROLE OF A PROTEAN CAREER IN HIGH PERFORMANCE
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Publication Date
Tue Nov 01 2022
Journal Name
Journal Of Engineering
The Use of Lightweight Aggregate in Concrete: A Review
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One of the artificial lightweight aggregates with a wide range of applications is Lightweight Expanded Clay Aggregate. Clay is utilized in the production of light aggregates. Using leftover clay from significant infrastructure development projects to manufacture lightweight aggregates has a favorable environmental impact. This research examines the expanded clay aggregate production process and the impact of processing parameters on its physical and mechanical qualities. It also looks at secondary components that can be used to improve the qualities of concrete with expanded clay aggregates. The effect of the quantity of expanded clay aggregate on the fresh, hardened, and durability qualities of concrete is also studied.

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Publication Date
Thu Oct 31 2024
Journal Name
Sabrao Journal Of Breeding And Genetics
THE ROLE OF NANOTECHNOLOGY IN CROP IMPROVEMENT – A REVIEW
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Publication Date
Sun Oct 01 2017
Journal Name
Al–bahith Al–a'alami
Employ of Public Relations in Building Awareness of Security against Terrorism A Survey of the Employees of the Directorate General of Public Relations and Media at the Ministry of Interior
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This study aims at identifying the role played by Public Relations in the field of security awareness of the dangers of terrorism. The research is directed to the employees at the Directorate General of Public Relations and Media at the Ministry of Interior. And that on the basis that those who play an important role in the security awareness are the security institutions, primarily the Ministry of Interior, since this Directorate is responsible for all subjects related to the public security using public relations science. It aims at identifying the functions, methods and communication tools used by the Directorate to raise awareness about the dangers of terrorism. In order to achieve the research objectives, the researcher uses the sur

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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Engineering
ORGANIZATION OF MEMORY CHIPS IN MEMORY SYSTEMS THAT HAVE WORD SIZE WIDER THAN 8-BIT
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This paper presents a method to organize memory chips when they are used to build memory systems that have word size wider than 8-bit. Most memory chips have 8-bit word size. When the memory system has to be built from several memory chips of various sizes, this method gives all possible organizations of these chips in the memory system. This paper also suggests a precise definition of the term “memory bank” that is usually used in memory systems. Finally, an illustrative design problem was taken to illustrate the presented method practically.

Publication Date
Thu Dec 01 2011
Journal Name
Journal Of Engineering
ORGANIZATION OF MEMORY CHIPS IN MEMORY SYSTEMS THAT HAVE WORD SIZE WIDER THAN 8-BIT
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This paper presents a method to organize memory chips when they are used to build memory systems that have word size wider than 8-bit. Most memory chips have 8-bit word size. When the memory system has to be built from several memory chips of various sizes, this method gives all possible organizations of these chips in the memory system. This paper also suggests a precise definition of the term “memory bank” that is usually used in memory systems. Finally, an illustrative design problem was taken to illustrate the presented method practically

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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The role of efficiency in the banking performance: An applied research in a sample of Iraqi private banks
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Abstract

The research stems from the problem that focuses on a number of questions. They are as follows:   What is the extent of interest in the topic of efficiency by the banks and their role in raising the efficiency of the banking business and its development?  Is the banking efficiency used in Iraqi banks clear and specific for the Iraqi banking sector? How the banking sector efficiency is measured and what are the approaches adopted in determining the banking inputs and outputs? What is the level of efficiency in the research sample of the banks and what are the causes of its decline or rise in private banks individually and in the Iraqi banking sector in general?

 The re

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of knowledge Workers in Organizational Excellence Field research in a number of the Iraqi industrial companies
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The Knowledge Workers is The Largest And Most Powerful Resource Of The Organizational Excellence it is A Precious  Treasure, Therefore Find Organizations at present is looking for them and seek to invest their ideas For achieving excellence, creativity and access to the excellence Organizational , As a result of their importance in terms of engagement and influence in the success or failure of the as an organizational Of The Research is Measuring The Correlation And  Impact Between Knowledge Workers And Organizational Excellence in Sample Of Companies Iraqi Industrial By Standing The Dimensions Of Knowledge Workers ( Characteristics , Skills , Roles , Competencies ) And

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Publication Date
Mon Jun 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Performance Series Performance Metrics (*) A case study in the General Company for Cotton Industries
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The problem of the research is focused on importance limited of Iraq industrial companies in application of scientific measurements of supply chains performance,  The research sought to achieve a group of goals, the most important are , identifying the strengths and weaknesses in the reality of supply chain in General Company for Cotton Industries, The data and information required are gathered from the dependence company, records through the field observations and personal interviews, the research used some quantitative indicators to measure of supply chain performance, The research reached to many conclusions , the most outstanding among them is the existence of a strong inverse correlatio

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