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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
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
Measuring and analysis of the impact of public budget deficit on external debt in lraq with in the framework of joint integration of the period (1990 – 2016 )
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The concept of deficit in public budget becomes a chronic economic phenomenon in most of the world, whether the advanced countries or developing countries. Despite  the difference in the visions of the economic schools to accept or reject the deficit in public budget but the opinion that prevailed is the necessity of the state to reduce the public spending which led to a continuous deficits in the public budget which consequently increased the government borrowing ,increase income taxes and wealth, consequently this weakened the in motivation in private investment which contributed to the increase of in factionary stagnation , so that governments have to cover the lack of local funding sources which become difficult to be eq

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Publication Date
Wed Jan 21 2026
Journal Name
College Of Basic Education Researches Journal
Identify the effect of exercise of the arm is the practice in the development of accurate performance skill transmission (short and long) arm of practice for students badminton
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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluating the extent of the response of the tax administration leaders towards the concept of the strategic lens and its relationship to tax pioneer performance: Applied Research in the General Authority for taxes
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The aim of the research is to evaluate the response of the researched leaders towards practicing the concept of the lens, which is its dimensions with (stakeholders, resource mobilization, knowledge development, culture management) and the nature of its relationship to tax pioneer performance represented in its dimensions (strategic direction, leadership indicators, growth, renewal and modernization, efficiency, Effectiveness) The questionnaire was approved as a main tool in collecting data and information from the sample members in the General Authority of Taxes, which number (91) Who are on (M. General Manager, Division Director, Deputy Director, Senior Division Director, Deputy Director, Second Division, Division Officer, M. D

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Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
Performance Appraisal of Human Resource Management and Its Effect on Achieving the Organizational Success -A Field Search at the Ministry of Oil-
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The present study addressed "Performance Appraisal of Human Resource Management and Its Effect on Achieving the Organizational Success", for the topics of performance appraisal of human resource management and the organizational success gained an increasing interest being relatively important and modern topics which had a great effect on the future of organizations.

The study aimed at revealing the pattern of appraising the performance of human resource management for the study sample, and whether it was qualified to lead the ministry towards the organizational success, for this purpose two main hypotheses were formulated: 1) there is a positive significant correlation between both variables: performanc

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Publication Date
Mon Feb 01 2021
Journal Name
Iop Conference Series: Materials Science And Engineering
A Critical Review on Expansive Soils Including the Influence of Hydrocarbon Pollution and the Use of Electrical Resistivity to Evaluate their Properties
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Abstract<p>This paper reviews the studies on expansive soil with a main focus on failure mechanism, financial losses, mineralogy, determination of swelling parameters and others. Effect of hydrocarbon pollution on geotechnical properties of expansive soil was presented. The paper discussed the assessment of electrical response of contaminated swelling soils. Wide extend of expansive grounds around the world and the serious impact created on infrastructures requires to identify its influential aspects and the appropriate treatments. Also, it was found that petroleum product affect significantly on the basic properties of swelling soils such as gradation, consistency, compaction, swelling and othe</p> ... Show More
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Crossref
Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Auditing the technical reserves of the aircraft body insurance branch and its reflection on the fairness of the financial statements : applied research in the National Insurance Company
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The research gained its importance from the importance of technical reserves in the insurance activity and its impact on the result of the activity of insurance companies and their financial position and thus reflected on the insurance prices as the technical reserves are one of the most important and most valuable budget items usually, as well as that the insurance activity has a role in maintaining economic development where some countries develop laws and instructions for the formation of those reserves binding application to insurance companies and the fact that the financial statements in general are of interest to shareholders, banks, the General Tax Authority and other beneficiaries In the insurance activity as policyholders and t

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Publication Date
Tue May 20 2008
Journal Name
Journal Of Planner And Development
The use of mathematical formulas to control river pollution Study area Diyala River within the city of Baquba
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Pollution of the aquatic environment and the depletion of the natural resource cause imbalance in the natural balance of the river environment and contributes to the deterioration of life and the killing of living organisms. Most of the old and modern cities and urban centers were set up close to the rivers because water enters the main lifeblood and all its facilities. The proximity of cities to rivers caused environmental problems resulting from the dumping of residues of these cities to a large and continuous, these wastes include all uses of the city (industrial, agricultural, residential and commercial) and others. The accumulation of these wastes inside the rivers water kills life and makes them unsuitable for various uses to bury

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Publication Date
Thu Oct 01 2020
Journal Name
Biochemical & Cellular Archives
STUDY THE EFFECT OF LINUM USITATISSIMUM (FLAX SEEDS) AND EUCALPTUS ROSTRATA (ECALYPTUS) LEAVES EXTRACTS ON PSEUDOMONAS AERUGINOSA GROWTH IN VIVO AND IN VITRO
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This study included the isolation and diagnosis of Pseudomonas aeruginosa from cases of burns samples. 100 samples were collected from resident patients at Al-Kindi Teaching Hospital, who suffer from different types of burns. Pseudomonas aeruginosa was isolated and diagnosed with 39% of the total samples. The cold and hot aqueous and alcoholic extract of flaxseeds oil was prepared and its inhibitory efficacy has been studied on the growth of isolated Pseudomonas aeruginosa. It is revealed that both extracts of flaxseeds oil had a high inhibitory effect on Pseudomonas aeruginosa growth. The Minimum Inhibitory Concentration (MIC) of flaxseed oil on the studied bacteria was also estimated, which was 25 mg/ml. In conclusion, the efficacy of fla

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Scopus (2)
Scopus
Publication Date
Sun Dec 12 2010
Journal Name
Journal Of Planner And Development
Utilizing the resources of the local environment in the establishment of the constituent units of the urban fabric within the framework of preservation of the urban heritage (Hassan Fathi's model experiment)
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No country in the world has an ancient heritage of its own. It represents the product of the civilizations left behind by previous eras. It represents the development of urban life and its capital of the interest of its people in the field of construction and reconstruction. The urban heritage and its associated arts may seem to be a material heritage at first glance, but it is not free from the spiritual side. Therefore, the nations in different parts of the earth cherish it and care for it with all due diligence, because it mixes with its history, memories and emotions.
This research discusses the use of local environment materials in the production of urban fabric constituents. I

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Publication Date
Sun Dec 12 2010
Journal Name
Journal Of Planner And Development
A documentary study of natural resources and ways of protecting them
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The problem of research is that there are ways to protect and sustain environmentally important sites in Iraq. There are no documentary sources for these sites, such as the natural landscape of natural and important natural resources, which suffer from severe environmental neglect

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