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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 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
THE IMPACT OF LISTEN TO THE VOICE OF THE CUSTOMER IN ACHIEVING COMPETITIVE SUPERIORITY
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The subject of the listen to the voice of the customer of topics relatively new in management thought, as it won the attention of many organizations of different types, because it is important to achieve success and to continue and superiority to them, so there is a need to study this term in the Iraqi organizations and try to diagnose the implementation of the study sample to listen voice of the Customer and its

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Publication Date
Sun Jan 01 2023
Journal Name
Oncology And Radiotherapy
The role of Modulation Complexity Score (MCS) of the VMAT and IMRT techniques in the treatment planning of left non-small lung cancer
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Background: Lung cancer is a common disease for patients over the age of 50 years, especially males due to smoking habits. This study aimed to compare the modulation complexity score (MCS) for the advanced treatment planning techniques which the intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). Materials and Methods: Thirty patients who had non-small lung cancerous tumors on their left side participated in this study. The range ages were 68 to 98 years, the heights were between 151 and 182cm and they having weights from 46 to 79 kg. For Each patient will create two plans dial using two different techniques, which will be Intensity Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy

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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of organizational symmetry in improving the quality of work life an applied research at the University of Information and Communications Technology
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"The aim of the research is to identify the availability of the dimensions of the research variables represented by organizational symmetry and the quality of work-life at the University of Information and Communications Technology, which is one of the formations of the Ministry of Higher Education and Scientific Research in Baghdad, in addition to knowing the relationship and influence between them. The research relied on the descriptive analytical approach based on peer description. The research was analyzed and the research sample consisted of (148) individuals, the sample was chosen using the comprehensive inventory method, data was obtained by relying on the questionnaire which was prepared from ready-made m

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The use of two indicators of market value-added and return on capital invested in measuring the performance of the Iraqi banking sector
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For a long time, the intensification of profit represented a major goal for the company management ,but this goal confirmed a series of restrictions such the constriction on short period, the time rather than on long and medium strategic goal, the relationships with customers ,the supplies, employees , This goal is replaced by another one (intensification of the company's value) ,and the fortune of the share holders itself ,for the purpose  of creating value, the company must generate  great outcomes to cover the operating expense and to insure the a suitable compensation to the invested capital (the market value added) is  the indication used to estimate the company ability to create value –added the development

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Settling Accounts of tax According to the unified Tax A Suggested Mechanism for: Application in the general Commission for Taxes
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Consistent "with the thought of tax talk is unified tax natural evolution for him, as the application leads to the inclusion of tax all branches of income and its sources and through truncated part of this entry through the application of price ascending it, it means the procedures of tax reform. Taxes on total income characterized by giving a clear picture of the total income of the taxpayer and its financial situation and its burden family which allows granting exemptions, downloads, and application of prices that fit this case. This requires reconsideration of the structure of the tax system in force and the transition from a system specific taxes to the tax system on the total income of the integration of income from the rental of re

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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The reality of quality in the SAI reports: Applied research in the Federal Board of Supreme Audit
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The research aims to shed light on the role of SAIs and the nature of their work, with the definition of the concept of quality reports and to clarify the reality of quality in the FBSA reports, the researchers reached to conclusions, including: The quality of the SAI reports is a requirement seeks to achieve any regulatory system in order to develop audit work output of the form in which its impact is reflected positively on the performance of the entities controlled, and researchers gave a set of recommendations, including: the need to increase community awareness of the importance of the FBSA Supervisory reports through conferences, seminars and workshops and that FBSA to follow-up reports, and check the quality continuously to the fa

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Publication Date
Wed Jan 23 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of accountability measures in enhancing the results of the federal budget in government spending units
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The role and procedures for accountability in the spending units significant impact in enhancing the results of the budget it is found by studying and comparing the results of the implementation of the budget for the research sample for a period of two years to repeat the same deviations and irregularities of Guanyin, regulations and instructions that have occurred in implementation results and two consecutive Kaltjaoz customizations and low rates of implementation and the lack of exchange of allocations Finance despite the presence budget note that such remarks are always indicate in regulatory reports, but these observations repeated Bostmr in the results of the implementation of the budget. Which clearly reflects the absence of the ro

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Publication Date
Sun Sep 15 2019
Journal Name
Journal Of Global Pharma Technology
Effect of Citric Acid Application on Anatomical and Physiological Properties of the Vegetative Parts of a Species of Tamarindus Indica Cultivated in Iraq
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Publication Date
Fri Jan 23 2026
Journal Name
Journal Of Oral And Dental Research
Prevalence of Orofacial Clefts: A Retrospective Crosssectional Analysis of Gynecology and Obstetrics Hospital Records in the City of Sulaimani, Kurdistan Region of Iraq
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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
Transformations of the form of postmodern arts in the projects of students of the Department of Art Education
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The art of postmodernism has undergone a number of changes in the course of art and art schools, as art has left the traditional means and paved the way for this artistic transformation to change the materials, techniques, methods and visions as a result of the changes that occurred in the thought and this change played an important role in the artist's vision, To demolish and destroy all of the above and to reconsider the formal systems and intellectual contexts and expressive modes, so it is necessary for the whole art to keep up with the variables of the era and its elements. The current research aims to: "Detect the transformations of form in postmodern art in the projects of students of the Department of Art Education".

Sinc

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