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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 Feb 13 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of the Cooperative Inquiry Strategy in the Achievement and Development of Mathematical Communication Skills of Elementary School Students
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Abstract

This study aims at investigating the effectiveness of the cooperative inquiry strategy in developing the achievement and development of mathematical communication skills of elementary school students. To achieve this aim, the experimental method was utilized. The study sample consisted of an experimental group (n = 34) and a control group (n = 31), which were randomly selected from primary schools. A Teacher's Guide for teaching a unit entitled "Statistics and Graphic Representations" for the sixth elementary graders in the first semester were devised. A (30) multiple-choice item achievement test distributed at the levels of (recall, comprehension, and application), as well as an (18) item mathematical c

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Publication Date
Mon Feb 13 2023
Journal Name
Journal Of Educational And Psychological Researches
The Future of Educational Management Reform in Ibn Ashour Vision of Purposes and the Objectives Of The Kingdom's Vision 2030
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The study aims at explaining the extent to which the principles of educational management reform contribute to Ibn Ashour in achieving educational management reform and the extent to which the pillars of the Kingdom's Vision 2030 in the field of Education in achieving the educational management reform. The study also aims to provide a future vision of what the educational administrative reform and its results should be in the Kingdom during the next ten years. To achieve the goals of the study, the researcher followed two approaches: on the theoretical side, he relied on applying the content analysis method. As for the applied side, the researcher adopted the Delphi method by two questionnaires to ask (36) participants from the experts a

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Publication Date
Wed Jan 01 2020
Journal Name
International Journal Of Innovation, Creativity And Change
The techno-strategy of the management information system and its role in enhancing risk management in the general directorate of school and sport activity
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The importance of this research lies in shedding light on the concept of techno-strategy for information management from vital and important topics that showed response for change in all areas of life. As this necessitates the updating and changing of it in order to achieve its strategic goals and enhance its technological advantage. The research problem looked at the role of the information technology system (ITS) in enhancing risk management in general directorates for sports and school activity from the viewpoint of its department heads. The research aimed at the relationship of information techno-strategy in risk management and the ratios of the contribution of information techno-strategy in risk management from the viewpoint of heads o

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Publication Date
Sun Jun 16 2019
Journal Name
Al–bahith Al–a'alami
News frames for the phenomenon of terrorism in international satellite channels directed in Arabic An analytical study of the main news bulletins in the Russian channel today 1/2/31/5/2018
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International satellite channels in Arabic are targeted to the region with their news bulletins and their innovative programs, attracting the interest of the Arab viewers in their news articles and programs with new ideas and methods as well as high technology in the production and synthesis of videos. Therefore, they work on framing the above, And the media policy that governs, so focused the problem of the study to try to answer the question of the President is how to frame the international satellite channels in Arabic to the phenomenon of terrorism? What are the aspects that are working to highlight and aspects that try to hide? The study adopted the survey methodology for the main news bulletins in the Russian channel today for the

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Publication Date
Thu Jan 01 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An Evaluation of Some Mechanical Properties of Autopolymerizing Acrylic Resin with the Modified One after Changing the Curing Environment: (In vitro Study)
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Background: Studying and investigating the transverse strength(Ts), impact strength(Is), hardness (Hr) and surface roughness(Ra) of conventional and modified autopolymerizing acrylic resin with different weight percentages of biopolymer kraftlignin, after curing in different water temperatures; 40°C and 80°C. Material and Methods: Standard acrylic specimens were fabricated according to ADA specification No.12 for transverse strength, ISO 179 was used for impact testing, Shore D for hardness and profilometerfor surface roughness. The material lignin first dispersed in the monomer, then the powder PMMA is immediately added. Ligninadded in different weight percentages. Then cured using pressure pot (Ivomet) in two temperatures;40°C a

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Publication Date
Tue Aug 18 2020
Journal Name
Journal Of Mechanics Of Continua And Mathematical Sciences
THE COMPARISON OF THE METHODS ESTIMATING THE FRACTIONAL DIFFERENCES OF PARAMETER AND ITS DEPENDENCE ON ESTIMATION THE BEST LINEAR MODEL OF TIME SERIES IN THE ENVIRONMENTAL FIELD
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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
The use of the Principal components and Partial least squares methods to estimate the parameters of the logistic regression model in the case of linear multiplication problem
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Abstract

  The logistic regression model is one of the nonlinear models that aims at obtaining highly efficient capabilities, It also the researcher an idea of the effect of the explanatory variable on the binary response variable.                                                                                  &nb

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Publication Date
Mon Nov 15 2021
Journal Name
Studies Of Applied Economics
The Role of Market-Share Management Strategies in Explaining the Stocks Performance Variance of a Number of Industrial Companies- An Analytical Research
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The study aims to know the nature of the expected relationship between market share management strategies and the variation in the performance of the shares of a number of Iraqi industrial companies listed in the Iraqi Stock Exchange. For the period (2005-2018) in the light of both the monthly closing prices and sales volume during the research period, the (Panel Data) method was relied on through a stylistic test (fixed effects model and random effects model), and the results determined the need to adopt the fixed effects model method for sample data and test Assumptions, the results showed the positive impact of market share according to its strategies on the performance of stocks according to its studied indicators (Treynor index

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of technical indicators on the movement of bank stock prices : Applied research in a sample of Iraqi private commercial banks
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This study aimed at indicators of technical analysis and their impact on a group of trading stock indices related to it, by standing on the methods used in technical analysis and its various models, diagnosing the obstacles and difficulties that the participants face in predicting stock prices, and proposing solutions and recommendations to overcome and overcome them. From a scientific and practical perspective.

Where the research community consisted of (25) Iraqi private commercial banks, while the research sample consisted of (3) banks with a percentage of (12%) of the research community. The study used the analytical approach to the financial statements during the period between (1/2/ 2022-30/4/2022),

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Publication Date
Mon Feb 25 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Planning and implementation of the audit process by using the styles of time management and its impact on the quality of the audit process: Applied Research in the Federal Board of Supreme Audit
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Witnessing the global arena many changes in the political, economic, social, scientific and technological have left their mark on the world as a whole, these changes require necessarily Advancement of the profession of auditing, and improve their performance, especially after the mixer skepticism the health of approach and the method followed by a check in the major audit firms global view as for the external audit of an active role in providing services to members of the community in various sectors, were to be provide these services to the highest level of quality.To ensure the quality of the audit process to be a proper planning is based on a scientific basis to be the substrate a strong underlying different audit works, and if planni

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