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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 Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The history of political conflicts in Zimbabwe: The history of political conflicts in Zimbabwe
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Abstract
This research shows the history of political conflicts in Zimbabwe, the
merits of the political struggle for power in this country since the British
colonial period, especially after the British administration announced that
Zimbabwe is a local colony of the British Crown in 1923, as the settlement
process against the wide white deprive local people to own and lease land
and low income, as well as the 1961 Constitution, which granted access to
the white powers in accordance with the authority of the top menu for the
existing lower allocated to blacks.
These events and factors led to a national rejection in Zimbabwe,
which crystallized in the form of parties and political organizations through the

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Publication Date
Wed Nov 01 2023
Journal Name
Journal Of Modern Project Management
THE IMPACT OF STRATEGIC INTELLIGENCE ON ORGANIZATIONAL PERFORMANCE: A TEXTILE SECTOR PERSPECTIVE OF A DEVELOPING ECONOMY
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In today’s competitive environment, organizational efficiency and sustained growth are crucial for survival. The performance of an organization is intricately connected to strategic planning, prompting firms to gather and leverage competitive information for a competitive advantage. Senior managers, recognizing this, initiate actions accordingly. This study aims to investigate the relationship between foresight, vision, strategic partnerships, motivation, system thinking, and organizational performance. Data, gathered through a self-administered questionnaire from various textile units, were analysed using structural equation modelling (SEM). The findings indicate that sub-constructs of strategic intelligence positively impact organizatio

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Publication Date
Wed Apr 01 2020
Journal Name
Plant Archives
Effect of alternate water quality irrigation on pore sizes distribution during drainage in clay loam texture soil
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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The impact of monetary policy variables inflation in Algeria: standard study using self regression time gaps
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                In the past years, the Algerian Economy has witnessed various monetary developments characterized by different monetary and banking reforms aimed by monetary authorities to achieve monetary stability and driving overall growth. It should be noted that there is evidence to initiate fundamental changes on the basis of which new monetary, financing and banking policy mechanisms must be formulated in Algeria by enhancing the pursuit of reforming the monetary system, in order to improve monetary and economic indicators.

                The study a

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Publication Date
Fri Dec 30 2022
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Well Performance Following Matrix Acidizing Treatment: Case Study of the Mi4 Unit in Ahdeb Oil Field
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The productivity of oil wells may be improved by determining the value of enhancing well productivity and the likely reasons or sources of formation damage after the well has been recognized as underperforming. Oil well productivity may be improved, but the economics of this gradual improvement may be compromised. It is important to analyze the influence of the skin effect on the recovery of the reserve.    The acid treatment evaluated for the well AD-12, primarily for the zone Mi4;  using a license of Stimpro Stimulation Software to validate the experimental work to the field scale, this software is considered the most comprehensive instrument for planning and monitoring matrix acid treatments and utilizing actual data to provide a far

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Publication Date
Tue Apr 11 2023
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
The role of digital content systems used in managing Arab academic scientific journals: An analytical study
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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
PARAMETRIC STUDY OF LAMINAR FREE CONVECTION IN INCLINED POROUS ANNULUS WITH FINS ON THE INNER CYLINDER
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An experimental and numerical study has been carried out to investigate the heat transfer by natural convection in a three dimensional annulus enclosure filled with porous media (silica sand) between two inclined concentric cylinders with (and without) annular fins attached to the inner cylinder under steady state condition; The experiments were carried out for a range of modified Rayleigh number (0.2 ≤Ra*≤ 11) and extended to Ra* =500 for numerical study, annulus inclination angle of (δ = 0˚, 30˚, 60˚ and 90˚). The numerical study was to write the governing equation under an assumptions used Darcy law and Boussinesq’s approximation and then solved numerically using finite difference approximation. It was found that the averag

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Publication Date
Mon Oct 01 2018
Journal Name
Iraqi Journal Of Physics
Study the effect of Iraqi weather parameter in FSO communication using different wavelength (650, 532) nm
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Light has already becomes a popular means of communication, and the high-bandwidth data into free space without the use of wires. A great idea took us to design a new system for transmitting sound through free space at (650, 532) nm wavelengths using reflective mirrors under different atmospheric conditions. The study showed us the effect of various weather factors (temperature, wind speed and humidity) on these wavelengths for different distances. As well as studying the attenuation caused by long-distance laser and beam divergence, A reflective dish was used to focus the spot of the laser beam on the photocell. Results were discussed under the effect of these factors and the attenuation resulting from the beam divergence. Thus, the sys

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Publication Date
Fri Dec 30 2022
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Well Performance Following Matrix Acidizing Treatment: Case Study of the Mi4 Unit in Ahdeb Oil Field
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The productivity of oil wells may be improved by determining the value of enhancing well productivity and the likely reasons or sources of formation damage after the well has been recognized as underperforming. Oil well productivity may be improved, but the economics of this gradual improvement may be compromised. It is important to analyze the influence of the skin effect on the recovery of the reserve.

   The acid treatment evaluated for the well AD-12, primarily for the zone Mi4;  using a license of Stimpro Stimulation Software to validate the experimental work to the field scale, this software is considered the most comprehensive instrument for planning and monitoring matrix acid treatments and utilizing actual data to prov

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Publication Date
Mon Apr 21 2025
Journal Name
Structural Concrete
On the effectiveness of shear reinforcement type in <scp>GFRP</scp>‐reinforced concrete beams: Experimental study
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Abstract<p>This study investigated the shear performance of concrete beams with GFRP stirrups vs. traditional steel stirrups. Longitudinal glass fiber‐reinforced polymer (GFRP) bars were used to doubly reinforce the tested beams at both the top and bottom of their cross sections. To accomplish this, several stirrup spacings were provided. Eight beam specimens, measuring 300 × 250 × 2400 mm, were used in an experimental program to test under a two‐point concentrated load with an equal span‐to‐depth ratio until failure. Four beams in Group I have standard mild steel stirrups of 8 mm diameter, while four beams in Group II have GFRP stirrups with the same adopted diameter. The difference betwe</p> ... Show More
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