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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
Thu Apr 07 2016
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
DETECTION OF MICROBIAL CONTAMINATION IN SOME TYPES OF FLOUR THAT AVAILABLE IN LOCAL MARKETS USING BACTRAC DEVICE 3400: DETECTION OF MICROBIAL CONTAMINATION IN SOME TYPES OF FLOUR THAT AVAILABLE IN LOCAL MARKETS USING BACTRAC DEVICE 3400
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A microbial study conducted for a number of flour samples (30 samples) Uses in the bakery ovens in various areas of the city of Baghdad, by used the conventional methods used in laboratories in microbial tests and compared with the modern techniqueby usedof BacTrac Device 3400 equipped from SY-LAB Impedance analysersAustrian company.The results of two ways showed (The conventional way and BacTrac Device test)that the total counts of aerobic bacteria, coliform bacteria, StaphylococcusSpp. bacteria, Bacillus cereus bacteria and yeasts and molds,Most of them were within the permissible borders in the Iraqi standard for grain and its products With free samples from SalmonellaSpp. bacteria, and that the screening by BacTrac device are shorten

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Organizational Red Tapes and their Reflections on Entrepreneurial Orientation: an Exploratory Study of a Sample of Employees in Some Organizations in the Province of Ninewah
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Organizations adopt a number of procedures and instructions in their field of activities in order to aid their resources development   and energies to serve their entrepreneurial orientations. This calls for preparing a range of mechanisms to mitigate the strictness and complexity of procedures. The ambiguity and severe  complexity  of procedures means acknowledging the loss in energy and this in turn  impedes the hopes while in the same time weakens the  enthusiasm in these organizations and an impedes the possibility to achieve continues innovation, thereby losing opportunities to the level of surrender to the risks and  assuming them to be unconquered obstacles.

There

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Publication Date
Thu Jun 12 2025
Journal Name
Journal Of Baghdad College Of Dentistry
A study to compare the cleaning efficiency of different irrigation systems for macro debris removal in instrumented canals (An in vitro study)
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Background: Irrigation of the canal system permits removal of residual tissue in the canal anatomy that cannot be reached by instrumentation of the main canals so the aim of this study was to compare and evaluate the efficiency of conventional irrigation system, endoactivator sonic irrigation system,P5 Newtron Satelec passive ultrasonic irrigation and Endovac irrigation system in removing of dentin debris at three levels of root canals and to compare the percentage of dentin debris among the three levels for each irrigation system. Materials and methods: Forty extracted premolars with approximately straight single root canals were randomly distributed into 4 tested groups of 10 teeth each. All canals were prepared with Protaper Universal ha

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Effect of The Tax Core Competencies in The Tax Settlement: An Empirical Study of The General Commission for Taxes
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This Study Sought to Determine The Relationship and Impact Between The Tax Core Capabilities and Tax Settlement The Study Took Place in The Tax Administration, and Based The Problem Was to Two Hypotheses As Solutions Initial Mocked Content to Explain The Relationship Between The Phenomena, and to Test The Validity of Assumptions And Due To The Fact That The General Authority for Taxes is The Body for The Advancement of The Collection Tax In Iraq Random Sample Was Selected to Represent The Population of The Study, Since The Sample Included 22 Individuals Representing 70% of The Total Community to Study, Represented by The Director General, Agents and Directors of Departments and Branch Managers Managers Working in The General Authority fo

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Publication Date
Sat Dec 31 2022
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of the Strategic Performance of the State Board of Antiquities and Heritage/Case Study
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This research aims to the possibility of evaluating the strategic performance of the State Board for Antiquities and Heritage (SBAH) using a balanced scorecard of four criteria (Financial, Customers, Internal Processes, and Learning and Growth). The main challenge was that the State Board use traditional evaluation in measuring employee performance, activities, and projects. Case study and field interviews methodology has been adopted in this research with a sample consisting of the Chairman of the State Board, 6 General Managers, and 7 Department Managers who are involved in evaluating the strategic performance and deciding the suitable answers on the checklists to analyze it ac

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Publication Date
Sat Dec 31 2022
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of the Strategic Performance of the State Board of Antiquities and Heritage/Case Study
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This research aims to the possibility of evaluating the strategic performance of the State Board for Antiquities and Heritage (SBAH) using a balanced scorecard of four criteria (Financial, Customers, Internal Processes, and Learning and Growth). The main challenge was that the State Board use traditional evaluation in measuring employee performance, activities, and projects. Case study and field interviews methodology has been adopted in this research with a sample consisting of the Chairman of the State Board, 6 General Managers, and 7 Department Managers who are involved in evaluating the strategic performance and deciding the suitable answers on the checklists to analyze it according to the 7-points Likert scale. Data analysis re

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Publication Date
Tue Mar 20 2018
Journal Name
Mustansiria Dental Journal
A comparative Study in the Antibacterial effect of Eugenol as Hand Wash Material with two Types of Soap
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Hands have consistently been an important vehicle in the transmission of disease (1). Thus, thorough hand-washing remains the single most important factor in preventing infection specially in hospitals and labs.Twenty-nine non-clinical volunteers (do not work or come in contact with a clinical or hospital setting) that lacked visible skin injuries, eczema or apparent skin disease were used, those subjects were all tested by a material of each of the three used in the study weekly and laboratory tests were done pre- and post washing.All three material were effective , Eugenol extract as effective as the bar and lotion soap. And this was confirmed statistically.Eugenol has a great antibacterial action even in small concentration and t

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Publication Date
Sat Dec 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Quality of Work Life in Reinforcing Core Competencies: A Descriptive and analytical research in the Ministry of Health
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The research aims to diagnose the shortcomings and weaknesses in applying the dimensions of the quality of work life and the extent of their impact on employees’ attitudes and behaviors, and thus their relationship to enhancing their core competencies. The scientific value of the research stems from highlighting the importance of the dimensions of the quality of professional life in improving the productive efficiency of workers in the public sector and raising the level of organizational performance. Because the quality of working life plays an important role in enhancing the core competencies of employees in the public sector, it can also be an incentive or a disincentive for any employee by adapting to the economic and social condit

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Publication Date
Sat Dec 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Quality of Work Life in Reinforcing Core Competencies: A Descriptive and analytical research in the Ministry of Health
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The research aims to diagnose the shortcomings and weaknesses in applying the dimensions of the quality of work life and the extent of their impact on employees’ attitudes and behaviors, and thus their relationship to enhancing their core competencies. The scientific value of the research stems from highlighting the importance of the dimensions of the quality of professional life in improving the productive efficiency of workers in the public sector and raising the level of organizational performance. Because the quality of working life plays an important role in enhancing the core competencies of employees in the public sector, it can also be an incentive or a disincentive for any employee by adapting to the economic and social condition

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Publication Date
Tue Mar 05 2024
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Quality of Work Life in Reinforcing Core Competencies: A Descriptive and analytical research in the Ministry of Health
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يهدف البحث إلى تشخيص أوجه القصور ونقاط الضعف في تطبيق أبعاد جودة الحياة الوظيفية ومدى تأثيرها على اتجاهات وسلوكيات الموظفين، وبالتالي علاقتها بتعزيز مقدراتهم الجوهرية. وتنبع القيمة العلمية للبحث من إبراز أهمية أبعاد جودة حياة العمل في تحسين الكفاءة الإنتاجية للعاملين في القطاع العام ورفع مستوى الأداء التنظيمي. ولأن جودة الحياة العملية تلعب دوراً مهماً في تعزيز المقدرات الأساسية للموظفين في القطاع الع

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