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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.

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
Wed Mar 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Effect of Heterogeneity on Capillary Pressure and Relative Permeability Curves in Carbonate Reservoirs. A Case Study for Mishrif Formation in West Qurna/1 Oilfield, Iraq

The special core analysis tests were accomplished on a set of core plugs for Mishrif Formation (mA, mB1, and mB2cde/mC units) in West Qurna/1 oilfield, southern Iraq. Oil relative permeability (Kro) data and the Corey-type fit of the data as functions of the brine saturation at the core outlet face for individual samples in the water-oil imbibition process to estimate relative permeability measurements by the centrifuge method were utilized. Identical correlations for oil and water relative permeabilities were extracted by steady-state and unsteady-state methods. For the mA samples, the gas-water capillary pressure curves were within a narrow range (almost identical) indicating that mA is a homogeneous unit. Kro curves for three mB2

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Publication Date
Wed Mar 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Effect of Heterogeneity on Capillary Pressure and Relative Permeability Curves in Carbonate Reservoirs. A Case Study for Mishrif Formation in West Qurna/1 Oilfield, Iraq

The special core analysis tests were accomplished on a set of core plugs for Mishrif Formation (mA, mB1, and mB2cde/mC units) in West Qurna/1 oilfield, southern Iraq. Oil relative permeability (Kro) data and the Corey-type fit of the data as functions of the brine saturation at the core outlet face for individual samples in the water-oil imbibition process to estimate relative permeability measurements by the centrifuge method were utilized. Identical correlations for oil and water relative permeabilities were extracted by steady-state and unsteady-state methods. For the mA samples, the gas-water capillary pressure curves were within a narrow range (almost identical) indicating that mA is a homogeneous unit. Kro curves for thr

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Publication Date
Sun Sep 01 2024
Journal Name
Heliyon
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Publication Date
Sun May 02 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of applying lean construction tools to improving the results of the earned value management model: Applied research in Al-Rasheed General Company for Construction Contracting

Contracting companies play a prominent role today in economic activity, due to their contribution to the implementation of major construction projects which together constitute the infrastructure of society. Most construction projects also suffer from exceeding the time and cost specified and planned for the completion of the project, and this comes for several reasons, including the work environment, country conditions, The method of managing project costs and the techniques used in its implementation Accordingly, the concepts of lean construction came, which help in addressing the causes of waste, both in time and cost, in addition to the fact that project management needs techniques that are useful in controlling the control and manag

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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Frequency inborn error of mitochondrial function in Mosul and Kurdistan region: the Frequency inborn error of mitochondrial function in Mosul and Kurdistan region

This work aimed to estimate the frequency of mitochondrial inborn errors of metabolism (MIEMs) in patients presenting with family history and IEM-picture who referred for advance IEM assay in Mosul province and Kurdistan region. This study was observational study conducted on 364 cases referred from different general /or private pediatric clinics with unexplained sign and symptoms and suspension of mitochondrial dysfunction. The study included 364 children with an age ranging from 1 month to 1 year. Started from January 2018 to January 2020. All patients referred with their full history review, notes about their clinical examination, and laboratory investigations including blood ammonia, serum lactate/ pyruvate, arterial blood gases. In

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Publication Date
Sun Dec 16 2018
Journal Name
Al-academy
Deconstruction the Theatrical Time in the Expressionist Doctrine

Time affects all elements of the intellectual scene or the theatrical scene. It came along with the theatrical doctrines according to the conditions of those doctrines and their conceptual ideas or the method of their mechanisms in the application. While it is classically or realistically integrated, we see it in the expressionist doctrine inconsistent and its inconsistency makes it responsive for the deconstruction strategy. Hence the researcher entitled his study (deconstruction the theatrical time in the expressionist doctrine) so that deconstruction would be a field for his study.   The study starts with an introduction presenting the research problem, importance and objective. The theoretical framework consisted of three s

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Publication Date
Tue May 02 2023
Journal Name
Social Science Journal
Publication Date
Mon Nov 05 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
EFFECT OF PLANT DENSITIES ON THE GROWTH AND YIELD OF SUNFLOWER Helianthus annuus L.: EFFECT OF PLANT DENSITIES ON THE GROWTH AND YIELD OF SUNFLOWER Helianthus annuus L.

A field experiment was conducted at the experimental field of botanical garden, faculty of science, university of Baghdad, in order to study the effect of plant density on growth and yield of two local cultivars of sunflower (Sin Althieb and Shumose). The densities used were 4.4 and 8.8 plant/m2. The results showed difference between cultivars in their agronomic traits and their yields. There was a significant increase in plant height and leaf area index by increasing the plant density, while head diameter, number of seeds and leaf area decreased. But the most significant effect was the increasing in yield and biological yield by increasing the plant density. There was an increase by 72% and 58% in the yield and 79% an

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Publication Date
Fri Jan 26 2024
Journal Name
Iraqi Journal Of Science
The Effect of Mhd on Unsteady Flow of A Second Grade Fluid Film Over an Unsteady Stret Ching Sheet

The aim of this paper is the study of the influence of magnetic field on unsteady
flow of the second-grade fluid with constant viscosity. The equations which
controlled this type of fluid flow are complicated, so finding an analytical solution is
not easy, because it is a system of partial differential equations.We obtained an
expression for the velocity by using homotopy analysis method HAM.
It is found that the equations motion are controlled by many dimensionless
parameter, namely magnetic field parameter M and material constant α,
dimensionless film thickness β and unsteadiness parameter S.We have been studied
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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Research In Social Sciences And Humanities
The Effect of Default Risk on Cash Flow Profitability Indicators: Analytical Research for a Sample of Iraqi Private Banks

Focusing on the negative role of default risk on banks, as it is one of the most important risks facing banks, which are difficult to determine accurately, and its reflection on the indicators of profitability of cash flows. The increasing competition between banks led to an increase in the credit facilities granted by banks, and was accompanied by an increase in exposure to the risks of default, which led to an impact on the level of performance of banks in terms of achieving the required return according to the levels of high competition. Therefore, the problem of this study focused on the extent to which the risk indicators of default affect the profitability indicators of the cash flows of the banks research sample in the profit

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