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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
Tue Feb 08 2022
Journal Name
South Asian Journal Of Social Sciences And Humanities
The Impact of University Leadership and the University Organizational Environment on the Performance of staff: A Case Study at Al Maaqal University (Private Sector)
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This study aims to explore the impact of the interaction of the university leadership and the university organizational environment on the performance level of the staff at Al-Maaqal university. This university was chosen as a field of study because it is a new university and needs studies that develops and contributes to improve its overall performance. The problem defined by the following question: to what extent does the interaction of the university leadership and the university organizational environment affect the performance level of the teaching staff at AlMaaqal University?). The method of this study adopted a major hypothesis in which there is a statistically significant effect of university leadership and university environment o

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Organizational Change in the Development of the Insurance Service: (applied study in The National Insurance Company)
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تشهد بیئة الأعمال المعاصرة جملة من التغیرات والتطورات التكنولوجیة وتزایداً في حدةالمنافسة، وأتساع الفجوة بین العاملین والإدارة ، وقدرة الإدارة على التمییز بین الموظفین، والمشاركة فيإتخاذ القرارات، الامر الذي یلقي على عاتق شركة التأمین إجراء التغییر التنظیمي لتحقیق تطور فيالخدمات التأمینیة التي تقدمها للجمهور من تنوع التغطیات التأمینیة )الوثائق( والسرعة في تسویةالتعویضات وغیرها من الانشطة التي تمارسه

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Publication Date
Fri Dec 15 2023
Journal Name
Iraqi Journal Of Laser
Study the Impact of Silica Nanoparticles on the Properties of Several Dyes for the Fabrication of a Random Laser Gain Medium
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Random laser gain media is synthesized with different types of dye at the same concentration (1×10-3 M) as an active material and silicon dioxide NPs (silica SiO2) as scatter centers through the Sol-Gel technique. The prepared samples are tested with UV–Vis spectroscopy, Fluorescence Spectroscopy, Field Emission Scanning Electron Microscopy (FESEM), and Energy Dispersive X-ray Diffraction (EDX). The end result demonstrates that doped dyes with silica nanoparticles at a concentration of 0.0016 mol/ml have lower absorbance and higher fluorescence spectra than pure dyes. FESEM scans revealed that the morphology of nanocrystalline silica is clusters of nano-sized spherical particles in the range (25-67) nm. It is con

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Publication Date
Fri Jul 01 2022
Journal Name
Aip Conf. Proc. 2450, 020031 (2022)
The study of the identification and association of adiponectin and Interleukin-6 and some variables. Biochemical parameters in the Iraqi cord blood of newborns
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t. The current study was conducted on the umbilical cord blood of newborns in the Banks Hospital in Baghdad, Diyala, and Khalis in Diyala, where the study included 90 samples of blood, and samples were collected for the period from the 1st of October;2020 to The first of February;2021 AD, where the study included measuring levels of interleukin-6;Adiponectin,glucose and bilirubin in the blood, comparison study between the study variables with the child's weight (greater than 3 kg),(less or equal 3 kg),the mother's age (greater than 25 years, less or equal to 25 years),the sex of the child (male, female).The results of our study showed that there were no significant differences between the variables of the current study between the two sex

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Publication Date
Tue Jan 01 2019
Journal Name
Ieee Access
Sensing Performance of Modified Single Mode Optical Fiber Coated With Nanomaterials-Based Ammonia Sensors Operated in the C-Band
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Publication Date
Sat Jul 01 2017
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
EFFECT OF HONEY ON SPERM CHARACTERISTICS AND PREGNANCY RATE IN MICE
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    The aim of the current study is to demonstrate the effect of honey on the sperms characteristics (sperm concentration, sperm motility, grade of activity and sperm normal morphology) as well as pregnancy rate in mice. Sperms were obtained from caudal epididymis of male mice and prepared by adding10% of honey to the IVF medium using direct sperms activation technique for 30 minute incubation period before artificial insemination.

 

    The study revealed a significant (P > 0.05) increase in active sperm motility (grade A and grade B) 49% and pregnancy rate 53.3% in female mice artificially inseminated with sperms. On the other hand, there were no significant differences in sperm con

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Publication Date
Thu Nov 30 2023
Journal Name
Iraqi Geological Journal
Multiple and Coherent Noise Removal from X-Profile 2D Seismic Data of Southern Iraq Using Normal Move Out-Frequency Wavenumber Technique
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Multiple eliminations (de-multiple) are one of seismic processing steps to remove their effects and delineate the correct primary refractors. Using normal move out to flatten primaries is the way to eliminate multiples through transforming these data to frequency-wavenumber domain. The flatten primaries are aligned with zero axis of the frequency-wavenumber domain and any other reflection types (multiples and random noise) are distributed elsewhere. Dip-filter is applied to pass the aligned data and reject others will separate primaries from multiple after transforming the data back from frequency-wavenumber domain to time-distance domain. For that, a suggested name for this technique as normal move out- frequency-wavenumber domain

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Publication Date
Thu Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
360 degree reverse feedback / comparative analytical study for a sample of managers and heads of departments in the Central Electricity DepartmentAnd the General Directorate of Water and Sewage
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يسعى البحث إلى الاهتمام بإحدى الوظائف المهمة في إدارة الموارد البشرية وهي تقويم الأداء التي تواجه مجموعة من الانتقادات والآراء السلبية، اذ ظهر في الأّونة الأخيرة أنموذج جديد يمكن إن يتجاوز تلك السلبيات وهو أنموذج التغذية العكسية المتعدد المصادر درجة .وقد حاول الباحثان توظيف هذا المفهوم في اثنتين من المنظمات العامة العراقية هما (دائرة كهرباء الوسط) التابعة لوزارة الكهرباء
و (دائرة الماء والمجاري) ال

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Publication Date
Sat Sep 30 2023
Journal Name
Al–bahith Al–a'alami
Political Use of the Photograph: A Semiotic Study of the Photograph of Al-Kadhimi's Visit to Fallujah on the Anniversary of the Victory Over ISIS
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The research aims to determine what a photograph intends to convey as a visual text. Photographs are not captured randomly, especially those of politicians. Each photograph carries a message, even if interpretations of that message vary from person to person. The research adopts a methodology based on semiotic analysis, applying Laurent Gervero's model to analyze a photograph of the Iraqi Prime Minister Mustafa Al-Kadhimi's visit to Fallujah on the anniversary of the victory over ISIS. The photographs in question constitute a visual language built upon a sequence of iconic symbols and signs. These elements coalesce to give rise to an image centered around a particular theme, one designed to convey a precise messag

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Publication Date
Thu Jun 28 2018
Journal Name
Journal Of The College Of Education For Women
Self-confidence among the children of Riyadh (Before-during-after) Play and its relation to parental treatment methods
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The basis of the personality of each individual lies in the early years of his or her life. If the personality of the child has been well organized and if the motives have been fully expressed and effectively directed, the child will have a strong will, happy self-confidence and a strong personality. If there is a failure In the early years, the individual will be unable to meet his responsibilities in life and may be the victim of many psychological disorders. The family is a learning process through which children acquire the customs, traditions, attitudes and values ​​prevailing in their social environment. (Pre-and-after) play and its relationship to parenting methods of (democratic-bullying-overprotection- and neglect), which wi

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