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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 Jun 30 2023
Journal Name
Pakistan Heart Journal
Workplace Violence and Nursing Job Performance at Pediatric Emergency Departments: A Comparative Study
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Publication Date
Tue Dec 29 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Personal tax exemptions "a comparative study with some Arab and European system legislations
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This research aims primarily to highlight personal tax exemptions A comparative study with some Arab and European regulations. And by conducting both theoretical comparative analyses. Most important findings of the study is the need to grant personal and family exemptions that differ according to the civil status of the taxpayer (single or married). In other words, the exemption increases as the number of family members depend on its social sense. Also taking into account some incomes that require a certain effort and looking at the tax rates, it is unreasonable for wages to be subject to the same rates applied to commercial profits.      

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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Engineering
THE EFFECTS OF BLOOD REHEOLOGICAL ON THE FLOW THROUGH AN AXISYMMETRIC ARTERIAL STENOSIS
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The prediction of the blood flow through an axisymmetric arterial stenosis is one of the most important aspects to be considered during the Atherosclrosis. Since the blood is specified as a non-Newtonian flow, therefore the effect of fluid types and effect of rheological properties of non-Newtonian fluid on the degree of stenosis have been studied. The motion equations are written in vorticity-stream function formulation and solved numerically. A comparison is made between a Newtonian and non-Newtonian fluid for blood flow at different velocities, viscosity and Reynolds number were solved also. It is found that the properties of blood must be at a certain range to preventing atheroscirasis

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Publication Date
Wed Oct 11 2023
Journal Name
Journal Of Educational And Psychological Researches
Linguistic Competencies Required for Teachers of the Arabic Language for the Preparatory Stage
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The current research aims to determine the necessary linguistic competencies for Arabic language teachers of the preparatory stage (fourth grade preparatory), which were five main competencies: Arabic grammar competencies, literary competencies, cultural competencies, rhetorical competencies, and expression competencies. To achieve the objective of the research, the researcher developed a questionnaire as the main tool for collecting data based on literature, it consists of (28) items including the five main competencies. The questionnaire was administered to (60) male and female teachers at Al-Karkh's first Education Directorate in the city of Baghdad. The findings of the research indicated that Arabic language proficiency got the highe

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Publication Date
Fri Nov 01 2019
Journal Name
Journal Of Engineering
Assessment the Engineering Characteristics of the Smear Zone around PVDs Using Laboratory Tests
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Smear zone is usually formed around the prefabricated vertical drains (PVD’s) due to mandrel driving. The geotechnical properties of the soil in this zone exhibit significant changes that affect the performance of the PVD’s. The most relevant property in this respect is the coefficient of permeability. So far, no serious attention is paid to investigate the effects of shearing under large shear strains on the geotechnical properties of the soft soil in Fao region. In this study, an extensive laboratory testing program was conducted to assess the characteristics of the smear zone with an emphasis on the permeability coefficient of Fao soft soil. The results show that the permeability of the smear zone is about 70% of

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Achieve the requirements of the Administrative Control according to human resource management practices
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Human Resources Management Practices (HRMP) and managerial control represent two academic fields that have been and still are the focus of many studies. However, merging both fields and studying the relationship that connects them and also the role that HRMP play in achieving the requirements of managerial control represents a new and novel study according to the available literature in these fields.

To achieve these goals, this study has been conducted, using the surveying questionnaire method, on a sample of ten general inspector offices in Iraq that work in the field of control for ministries and independent committees. A questionnaire has been used to collect the data which was analyzed with several s

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Publication Date
Wed Apr 17 2024
Journal Name
International Journal Of Mathematics And Computer Science
The Effect of Vaccination on the Monkeypox Disease by Using Holling Type II
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Scopus
Publication Date
Sun Mar 15 2020
Journal Name
Al-academy
The Image of Woman by the Artist Jaber Alwan: احلام عبد الستار شنين
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The woman represents an existential dualism with the man along history. This existence has been manifested through the history of Art starting from the arts of the old civilizations until modernism. It must be said that the history of Art refers to her presence as an extension for this history in the oriental arts, and the Arab countries including Iraq.  The woman has varying outputs in terms of the content of her presence and the style of presentation. In her characterizations: maternity, fertility, femininity and others. The Iraqi artists adopted these fields among them the artist Jaber Alwan who formulated his style of presentation and its units depending on the feminine presence and his experience in her formal and stylistic fie

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Publication Date
Wed Sep 01 2010
Journal Name
Al-khwarizmi Engineering Journal
The Stress Distribution on the Zygapophyseal Joint of Lumbar Vertebra by ANSYS Program
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Zygapophyseal joints (or facet joints), are a plane synovial joint which located between the articular facet processes of the vertebral arch which is freely guided movable joints. Ten dried vertebrae were used for the lumbar region and taking (L4) as a sample to reveal stress pathways across the joints by using ANSYS program under different loading conditions which used Finite Elements Analysis model. Results obtained from the ANSYS program are important in understanding the boundary conditions for load analysis and the points of stress concentration which explained from the anatomical point of view and linked to muscle and ligament attachments. This model used as a computational tool to joint biomechanics and to prosthetic im

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Publication Date
Mon Mar 04 2013
Journal Name
Iraqi Journal Of Science
Influence of the Beam Size Radiation on the Depth Dose by Using 60Co
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Radiotherapy is medical use of ionizing radiation, and commonly applied to the cancerous tumor because of its ability to control cell growth. The amount of radiation used in photon radiation therapy called dose (measured in grey unit), which depend on the type and stage of cancer being treated. In our work, we studied the dose distribution given to the tumor at different depths (zero-20 cm) treated with different field size (4×4- 23×23 cm). Results show that the deeper treated area has less dose rate at the same beam quality and quantity. Also it has been noted increasing in the field increasing in the depth dose at the same depth even if the radiation energy is constant. Increasing in radiation dose attributed to the scattere

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