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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 Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Improve operational performance by simulating the Holonic manufacturing system A case study at the rubber product plant in Al-Najaf Al-Ashraf
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The research aims to improve operational performance through the application of the Holonic Manufacturing System (HMS) in the rubber products factory in Najaf. The problem was diagnosed with the weakness of the manufacturing system in the factory to meet customers' demands on time within the available resources of machines and workers, which led to time delays of Processing and delivery, increased costs, and reduced flexibility in the factory, A case study methodology used to identify the reality of the manufacturing system and the actual operational performance in the factory. The simulation was used to represent the proposed (HMS) by using (Excel 2010) based on the actual data and calculate the operational performance measures

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Publication Date
Fri Jan 01 2021
Journal Name
University Of Southern Queensland
An Investigation of Leadership Style and the Strategic Planning Process of Public and Private Colleges in Iraq: An Empirical Study
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Globalisation and rapid environmental change have created many challenges for public and private organisations across Iraq as a developing country, particularly in the higher education sector. This includes, for example, decreases in government funding; increased demand for higher education; a need for economic transformation, and related competitiveness of organizations. Such challenges require exceptional leaders and strategic planning in order to take action to improve. In Iraq, the higher education sector is still one of the main foundations in progressing the knowledge economy. Studies into leadership style, strategic planning processes, and the importance of leadership and organisational culture to an organisation’s success have bee

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Publication Date
Fri Dec 27 2024
Journal Name
Epitheorese Klinikes Farmakologias Kai Farmakokinetikes – Greek Edition
Response surface optimization and in vitro study of nasal solusomes nanovesicles for the bioavailability improvement and brain targetting of sumatriptan
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Background: One effective second-generation triptan for migraine attacks is sumatriptan. Following oral use, it has a 40% restricted bioavailability because of the first-pass metabolism. Aim: To develop the best intranasal Solusomes formula as a substitute that delivers into the brain directly, improving its bioavailability, and removing the first-pass outcome was the aim of this effort. Methodology: We developed solute formulations based on the Box-Behnken design and subsequently produced them via thin-film hydration. The quality by design technique was used to establish a correlation between the formulation parameters (Soluplus® and phosphatidylcholine (PC) concentrations) and signif¬icant quality powers (entrapment efficiency (

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Publication Date
Tue May 01 2018
Journal Name
Journal Of Physics: Conference Series
The study of Bacteriocin of Pseudomonas fluorescens and Citrus limon effects against Propionibacterium acnes and Staphylococcus epidermidis in acne patients
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Research was carried out antibacterial of (Citrus limon) juice on Acnevulgaris. Samples were obtained from individuals having (Pimples) by swabbing their faces. Substances natural from plants are promising to treat disease cause Acnevulgaris, the study in vitro biological activity of the juice, as well as bacterocin cultivated and fruits was investigated on two strain bacteria (Propionibacterium acnes, Staphylococcus epidermidis). The new antimicrobial (bacteriocin and Citrus juice) is ongoing search. This study used s juice at different concentrations at (20%, 30%, 40%, 60%, 80% and 100%). The Bacteriocin produced from local P. fluorescens isolates from wound infection and majority of isolates were found to produce crude Bacteriocin were (

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Publication Date
Mon May 01 2023
Journal Name
Materials Today: Proceedings
An experimental study of the effects of matrix acidising on the petrophysical characteristics of carbonate formation
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Publication Date
Wed Mar 01 2023
Journal Name
Al-khwarizmi Engineering Journal
Study of the Effect of Magnetic Abrasive Finishing on the Material Removal of AA1100 Aluminum Alloy
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This study evaluates the performance of magnetic abrasive finishing (MAF) of aluminum alloy in terms of achieving materials removal (MR). A vertical milling machine is used to perform the finishing process using a developed MAF unit that consists of an inductor made out of a 150 mm long and 20 mm diameter iron core wound with 1500 turns and 0.5 mm copper wire. The commutator and magnetic pole are attached at the top and bottom of the inductor, respectively. The required current is supplied using a DC power supply. The South Pole workpiece is a 100×50×3 mm3 plate of AA 1100 aluminum alloy, whereas the magnetic pole represented the North Pole. Pole rotational speed, applied current, and abrasive finishing time was selected as

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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The Probability of Implementation Some Rules of Process Organization –Study of the Production Air-cooler engines
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This research is Interested in how the performance and implementation of factory production engine coolants of the General Company for Electrical Industries of its work, and to facilitate the flow of the decisions of senior management and access to all configurations, to ensure differentiation desired and reduce lost sales, resulting from poor scheduling of operations through the application of certain rules of scheduling operations in the production plant Engines Air-cooler, the objectives of research in identifying the best base and working to reduce the time and cost of Same Rules of Process which are considered the most influential of any organization and thr

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of local tax revenues in financing local development: Case Study of Tebessa State for the Period[2010-2014[
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Local communities are in need of self-resources so that they can perform their multiple functions which serve the objectives of the local development, and tax revenues are considered as important sources of their funding. However, despite the efforts of the state to reform the fiscal system and to improve the management in the local administration, tax collection can increase when the state adopts a more effective policy to combat tax evasion and tax fraud. Accordingly, this research aims to shed light on the role of local tax revenues in the local development. A set of conclusions are drawn; the most important one is that Algeria, in order to achieve local development, has taken a set of reforms, which are still valid until now. The mos

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The effect of knowledge assimilation on strategic clarity - an exploratory study in the Iraqi Ministry of Transport - Iraqi Airways Company*
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The research aims to build an integrated frame of knowledge for the basic research topics, represented by (assimilation of knowledge, strategic clarity) and their basic variables, by examining the most important scientific propositions on these topics in administrative thought, and framing the knowledge contained in them, in a serious attempt to provide appropriate answers to questions The research dilemma, and the research was applied in the Iraqi Airways Company, whose number is (1200) employees, and the descriptive and analytical approach was adopted in conducting the research. A valid form for statistical analysis, i.e., with a retrieval rate of (92%). The two researchers used the (SPSS & AMOS) program for

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Publication Date
Sat Dec 27 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The effects of various beverages on the shear bond strength of light-cured orthodontic composite (An in vitro comparative study)
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Background: This study was conducted to assess the effects of various beverages on the shear bond strength of light-cured orthodontic composite used to bond stainless steel orthodontic brackets on human teeth and to determine the site of bonding failure of this material. Materials and Methods: Fifty extracted human premolars were selected and randomly divided into five equal groups each with 10 teeth according to the beverage type (Control, One Tiger, Milk, Green tea and Coffee). After bonding, the teeth were immersed in specific beverages for 5 minutes twice daily with equal intervening intervals then washed and stored in distilled water at 37º C for the reminder of the day. The process was carried out for 30 days. The samples were then

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