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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
Sat Dec 31 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Workplace Respect on Employee Performance: A Survey Study in Abu Ghraib Dairy Factory
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This paper aims to explain the effect of workplace respect on employee performance at Abu Ghraib Dairy Factory (AGDF). For achieving the research aim, the analytical and descriptive approach was chosen using a questionnaire tool for collecting data.  It covers 22 items; ten of them for the workplace respect variable and twelve items for the employee performance variable. The research population involved human resources who work at AGDF in Baghdad within two administrative levels (top and middle). We conducted a purposive stratified sample approach. It was distributed 70 questionnaire forms, and 65 forms were received. However, six of them had missing data and did not include in the final data analysis. The main results are t

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Publication Date
Sat Aug 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
Building and legalizing a test for evaluating the tactical learning of the footwork for the foil fencer in the fencing game
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AA wahid, journal mustansiriyah of sports science, 2023

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Publication Date
Tue Jan 01 2008
Journal Name
University Of Baghdad
The use of remote sensing to study the reflection of the ground cover and its relationship to some soil characteristics in the Abi Gharib area
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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
The study of physical and chemical properties of wells water in district of Samarra
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The Study was achieved adjectives physical and chemical water wells in the district of
Samarra , where a study has 42 sample groundwater in different regions of the judiciary
randomly distributed all over the judiciary and examined in vitro.
The study showed that the quality of groundwater in the general area of study
Kipritateh punctuated Klordih water quality and other quality Bicarboonatih.
Varied the key components of groundwater in the study area in concentrations
between periods of rain and drought, especially because of the cation ion exchange processes
as well as mitigation as a result of filtering rain water and dominated the calcium ion,
followed by sodium.
As for the negative ions has dominated ion s

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Publication Date
Tue Oct 11 2022
Journal Name
College Of Islamic Sciences
(639هـ) The speech act in the grammatical discourse, a study in the book "Guiding Al-Luma'" by Ibn Al-Khabbaz (639 AH)
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The study of the " Speech act " in grammatical codes reveals great efforts in the study of the elements of linguistic communication contained in their efforts, and is part of the study of the linguistics of heritage, and the research has been designed to identify the verbal act in the blog of Ibn al-Khabaz (guiding the shine) by studying its sections comprehensively; To the spirit of grammatical discourse as well as the combination of the concept of the semantic act already verbal according to Searle, and its response in the form of indirect verbal acts more than direct acts, as well as the pure formulas of the opinions of the violators in the speech of Ibn al-Khabaz other than the proven verbal formulas Approval and approval, the class

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Green Innovation and its Impact in Reinforcing Sustainable Competitive Advantage: An Exploratory Study of Opinions of a Sample of Employees in the Karungi group in Kirkuk
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The development of the world, and in light of the intensity of competition highlighted the need to research and create a sustainable competitive advantage is sustained from an internal source in the company earned by the scarcity and difficulty of imitation by competitors, and this source is green innovation. In order to achieve the objective of the research, which is the diagnosis and analysis of the relationship between green innovation (in products, processes) and sustainable competitive advantage in the group of companies Kronji, was developed a default model of the research reflects the nature of the relationship and influence among its variables, the research adopted the questionnaire as a key tool for collecting data and i

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Publication Date
Tue Mar 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The role of strategic leadership in knowledge management processes "Diagnostic Study in the Office of the Ministry of Oil - Project Department"
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The research deals with the important and modern two subjects, strategic leadership which have six demotions and knowledge management
(four demotions') . the gools & the research is to know the relation & the effect them in the oil ministry (project department) , the sample was (50) persons who works in the department the questionnaire was the tool of data gathering .

The research divided to four parties, the first  to the theotical review of the research variables, the second to the research methrology, the third to analysis and discoed the empirical results the last to the conclusions and recommendations .

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Publication Date
Wed Apr 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of the effectiveness of self-managed teams in improving the quality of services / an applied study in Ramadi municipality
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This research aims to identify the effective role of self-managed teams in the quality of service performance in the directorate of Ramadi municipality. The problematic nature of our research involves this main question of the effective role of self-managed teams in the Municipality of Ramadi in improving the services of performance quality to the beneficiaries from the Directorate service. The importance of this study lies in the role played by the work teams in the organizations that excel in their field, the attendant of the changes in the leadership, administrative roles of the institutions, and teams leaders, will be achieved by the self-managed teams in improving the quality of the service provided by the institution to whi

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Publication Date
Tue Dec 30 2014
Journal Name
College Of Islamic Sciences
The problem and its manifestations with the modernists through the Iberissian systems in modern terminology (applied study): (Applied study)
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Islamic law has relied on a number of sources in order to denote the rulings issued by them, including what is original and what is sub, and it is known to all scholars, that the Prophet's Sunnah is the second major source after the Koran, which separated the overall and devoted its year and restricted absolute. God Almighty obeyed the owner and his followers, and that his obedience of obedience to God Almighty said: (Who obeys the messenger has obeyed God) (women: 80), and then between the peasant who believes in him and his victory and follow him, he said: (and he said: And the one who was revealed with them were the successful ones (al-A'raf: 157).
     It is known that the Sunnah commanded to follow is the

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
The Homomorphism of a cubic set of a semigroup in a KU-algebra
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Abstract<p>The study of homomorphisms in cubic sets is considered one of the important concepts that transfer algebraic properties between different structures, so we study a homomorphism of a cubic set of a semigroup in a KU-algebra and defined the product of two cubic sets in this structure. Firstly, we define the image and the inverse image of a cubic set in a KU-semigroup and achieve some results in this notion. Secondly, the Cartesian product of cubic subsets in a KU-semigroup is discussed and some important characteristics are proved.</p>
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