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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 15 2021
Journal Name
Al-academy
Variables related to the performance styles of batik art to achieve linear tactile effects in the printmaking: نجلاء المرضوف السعدي
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The art of batik is one of the ancient arts that has a long history in East Asian countries, especially in Indonesia, where it was considered a traditional craft with which many Indonesian tribes lived. This art began to move to other continents and develops and progresses due to the artist’s connection to the surrounding technological and intellectual development, as art became more outgoing and liberated, it helped the artist to create and innovate in his designs. In this research, he focuses on modern performance methods through which print paintings can be produced through design elements, especially calligraphy, to create aesthetic and creative effects in the productive work. The current research aims to identify the various perfo

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Evaluating the quality of municipal services according to the financial budgets for years 2006-2016 Analytical research in Diwaniyah Governorate
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The research aims at determining the main reason for the deterioration of the services and determining the correct method of distributing the funds to the administrative and administrative units. The discrepancy between the size of the financial allocations and the municipal services was the main research problem. Therefore, the researcher identified the gaps in municipal services by the concerned departments and compared them with The percentage of funds obtained through the work of a checklist for each of the directorates concerned. The researcher studied the specific criteria for these services, which were approved by the Ministry of Construction, Housing, Municipalities, and Public Works, and compared them wi

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The effect of the reciprocal reading strategy in developing innovative reading skills for fifth-year secondary school students / scientific branch
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       This research aims to identify the impact of the reciprocal reading strategy on developing the innovative reading skills of fifth-grade secondary school students/ scientific branch. To achieve the goal of the research, an achievement test to measure the academic achievement of fifth-grade secondary school students in  Arabic language grammar was prepared,  a sample of (60) female students from the secondary school of Al- Bawaba Al-Sharkey for Girls in Baghdad were chosen for the academic year (2019-2020). For the purpose of applying the experiment, the test was applied on a pilot sample consisting of (30) students from the same research community. The researcher herself had taught the three

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Publication Date
Sun Apr 04 2010
Journal Name
Journal Of Educational And Psychological Researches
The Factorial Structure of The Emotional Intelligence Scale to Bar-On Applied on Students from Preparatory School in Baghdad City.
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The aim of the study was to know the factors analysis of scale Bar-On & Parker, post analysis is found fourteen factors for the first degree of the scale. Also we extracted five factors from the second degree.

  The scale consists of (60) items , applied on sample of (200) students (Male &Female ) age (15-18) years randomly chosen from preparatory schools . The scale unveiled satis factors  validity and reliability. An others aims is to low the  emotional  Intelligence level and  know the difference of statistical in sex , age variable and the specialization variable .The result was no difference of statistical in sex and specialization variable , but the difference appear

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Publication Date
Sat Jan 01 2022
Journal Name
Geotechnical Engineering And Sustainable Construction
Determine the Most Common Geotechnical Risks and Their Impacts on the Cost and Time Schedule for Implementing Water Treatment Plants in Iraq
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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Coordination between real estate and income tax and its impact on the tax outcome: Applied research in the General Authority for Taxes
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The research aimed to demonstrate the possibility of benefiting from the coordination between real estate and income tax as the independent variable on the tax outcome as the dependent variable as the dependent variable. Which were practiced within rented buildings, as information was obtained from real estate owners, and the annual controls for the year 2021 were relied upon in the process of calculating the tax amounts expected to be obtained. used in the tax inventory process lacks seriousness and continuous updating

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Publication Date
Fri May 03 2024
Journal Name
International Journal Of Economics And Finance Studies
THE CREDIT BUREAU SYSTEM'S ROLE IN ACHIEVING THE BANKING SOUNDNESS PRINCIPLE
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The regulatory authorities have implemented various standards to address the risks associated with credit facilities. One important aspect is the use of the Credit Bureau System (CBS), which plays a central role in ensuring banking soundness. Thus, the study seeks to explore the role of CBS in attaining banking soundness as a fundamental principle. The research sample consisted of three Iraqi banks spanning from 2010 to 2022. The research findings indicated that the implementation of CBS had a significant positive impact on achieving Banking Soundness (BS) rates in my bank. Furthermore, the asset quality index's value increased significantly, surpassing the standard value of 5%. It became evident that the banks needed to formulate a well-de

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Publication Date
Fri Jun 29 2018
Journal Name
Journal Of The College Of Education For Women
Scientific values in the chemistry curriculum For the sixth grade scientific
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The goal of current research to know the according of scientific values in the curriculum of chemistry sixth - grade science To achieve this goal wasa to build aalistaofa scientifica values toa be included in the curriculum of chemistry sixth - grade science after seeing a group of literature and previous studies, the list presented to a group of arbitrators and specialists in educational and psychological sciences and methods of teaching science, and curricula and teaching methods , Arbitrators and specialists have expressed their views and comments on the tool, and that the list was formed in final form (9) values Head of scientific includes ( 35) sub - value, then the researcher analyzed the chemistry curriculum for sixth grade Scient

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Publication Date
Sat Oct 29 2022
Journal Name
Current Trends In Geotechnical Engineering And Construction
Identify the Critical Risk Factors at the Tendering Phase in Iraq
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Risk factors can be considered unique in construction projects, especially in tendering phase. This research is directed to recognize and evaluate the importance of critical risk factors in the tendering phase related to Iraq’s construction project. As a rule, construction projects are impacted by risk factors throughout the project life cycle; without identifying and allocating these risk factors, the project cannot succeed. In this paper, the open and closed questionnaires are used to categorize the critical risk factors in tendering phase. Research aims to recognize the factors that influence the success of tendering phase, to determine the correct response to the risk’s factors in this research article, (IBM, SPSS, V23) package has

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Publication Date
Sat Oct 29 2022
Journal Name
Current Trends In Geotechnical Engineering And Construction
Identify the Critical Risk Factors at the Tendering Phase in Iraq
...Show More Authors

Risk factors can be considered unique in construction projects, especially in tendering phase. This research is directed to recognize and evaluate the importance of critical risk factors in the tendering phase related to Iraq’s construction project. As a rule, construction projects are impacted by risk factors throughout the project life cycle; without identifying and allocating these risk factors, the project cannot succeed. In this paper, the open and closed questionnaires are used to categorize the critical risk factors in tendering phase. Research aims to recognize the factors that influence the success of tendering phase, to determine the correct response to the risk’s factors in this research article, (IBM, SPSS, V23) package has

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