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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
Mon Mar 01 2010
Journal Name
Journal Of Economics And Administrative Sciences
Pais estimator for the reliability function of the Pareto model of Type I failure
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In this paper an estimator of reliability function for the pareto dist. Of the first kind has been derived and then a simulation approach by Monte-Calro method was made to compare the Bayers estimator of reliability function and the maximum likelihood estimator for this function. It has been found that the Bayes. estimator was better than maximum likelihood estimator for all sample sizes using Integral mean square error(IMSE).

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Publication Date
Sat May 11 2013
Journal Name
Journal Of Arts Of Thiqar
Mistranslation of Sex-related Euphemistic Expressions with reference to the Translations of the Qur'an
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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of the proposed strategy of Maysan Oil Company for the years 2020-2024
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ناقش البحث في طياته عدداً من القضايا الرئيسة المتعلقة بالتقييم الاستراتيجي والإطار العام للخطة الاستراتيجية المقترحة لشركة نفط ميسان للسنوات الخمس المقبلة (2020_2024)، وهدف هذا البحث يتمحور في تقييم عملية صياغة استراتيجية شركة نفط ميسان لتحديد نقاط القوة وتعضيدها ومواطن الضعف ومحاولة معالجتها لتجنب الوقوع بها عند وضع استراتيجية للسنوات القادمة، وعلى هذا الاساس فان مشكلة البحث تكمن في مدى نجاح الاستراتي

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Publication Date
Sun Dec 05 2010
Journal Name
Baghdad Science Journal
Detection of the Typical Condition of chitinase Production from the Yeast Saccharomyces cerevisiae S4
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Five Saccharomyces cerevisiae isolated from the ability of chitinase production from the isolates were studied. Quantitative screening appeared that Saccharomyces cerevisiae S4 was the highest chitinase producer specific activity 1.9 unit/mg protein. The yeast was culture in liquid and solid state fermentation media (SSF). Different plant obstanases were used for (SSF) with the chitine, while liquid media contained chitine with the diffrented nitrogen source. The favorable condition for chitinase producers were incubated at 30 ºC at pH 6 and 1% colloidal chitine.

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Publication Date
Sat Jul 01 2023
Journal Name
American Journal Of Economics And Business Innovation
The Effect of Workplace Stress on Employee Engagement, the Mediation Role of Leadership Style
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The aim of the current study was to investigate the impact of workplace stress on employee engagement within Iraqi universities through the mediator role of leadership style. Work-related stress and non-work-related stress were identified as representing workplace stress. Employee engagement has been measured through three types: social engagement, affective engagement, and intellectual engagement. Two types of leadership styles have been tested: directive and participative leadership. the structural equation Modeling was used to test the study model. A sample of 245 employees in Iraqi universities, including university professors, was targeted. Only 214 respondents participated in the survey. The results showed that non-work-relate

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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Investigations about the characteristic behavior of the linear mode of quantum acoustic waves ion
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The dispersion relation of linear quantum ion acoustic waves is derivate according to a fluid approach that depends on the kinetic description of the systems of charged particles model. We discussed the dispersion relation by changing its parameters and graphically represented. We found through graphs that there is full agreement with previous studies on the subject of interest. That motivates us to discuss the dispersion relation of waves depending on the original basic parameters that implicitly involved in the relationship which change the relationship by one way or another, such as electron Fermi temperature and the density at equilibrium state.

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Publication Date
Mon Dec 03 2018
Journal Name
Journal Of Engineering
The Influence of Clay Bricks Dust Incorporation on the Self-Curing of Cement Mortar
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Self- curing is the potential of lightweight aggregate to absorption great amount of water thru mixing which prominently can moves to the paste during hydration process. Self- curing empowers a water to be distributes more evenly act out the cross section. Whereas, the external curing water is only able to penetrate several millimetres into concrete with low water cement ratio. Brick dust accumulates in the demolish site creates serious environmental contamination. This study investigates the effect of brick dust recovered from construction site on the Properties of mortar cured in three curing conditions. Mortar in this study produced using BD as cement additive with (2, 4, 6, and 8) % by weight of cement. BD was used a

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Publication Date
Fri Mar 30 2001
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Effect of Asphaltenes Removal on the Kinetics of Iraqi Reduced Crude Oil Hydrotreating
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Publication Date
Wed Jul 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Increasing the Setting Time of Local Gypsum (Joss) by the Use of TGP additive
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Abstract<p>This research presents a study of using an additive for the objective of increasing the setting time of a material used in several aspects in the constructional field, this material is “Local-Gypsum” which is locally called “Joss”, and the additive used in this study is “Trees Glue Powder” denoted by “TGP”. Nine mixtures of Local-gypsum (joss) had been experimented in the current study to find their setting time, these mixes were divided into three groups according to their water-joss ratios (W/J) (0.3, 0.4 and 0.5), and each group was sub-divided into three sub-groups according to their TGP contents (0.0%, 0.3% and 0.6%). It was found that, when TGP is added with the </p> ... Show More
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Publication Date
Wed May 31 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Solutins of Systems for the Linear Fredholm-Volterra Integral Equations of the Second Kind
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In this paper, we present some numerical methods for solving systems of linear FredholmVolterra integral equations of the second kind. These methods namely are the Repeated Trapezoidal Method (RTM) and the Repeated Simpson's 1/3 Method (RSM). Also some numerical examples are presented to show the efficiency and the accuracy of the presented work.  
 

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