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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
Fri Sep 30 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Dimensions of organizational immunity and its relationship Enhancing the strategic capabilities of the company: applied research in the Iraqi General Insurance Company
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The aim of the research is to diagnose the nature of the relationship between the dimensions of organizational immunity with its dimensions represented by (organizational memory, organizational DNA, organizational learning) in enhancing the strategic capabilities of the company with its dimensions represented by (marketing capabilities, administrative capabilities, technological capabilities, creative capabilities), and the degree of arrangement of those dimensions According to priority, as well as revealing the differences in the respondents’ response to the two variables according to the personal and functional variables, and the importance of the expected results, the researchers adopted the questionnaire as a tool for collecting da

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Teaching Practices of Science and Mathematics Teachers Based on the National Framework for Future Skills in the Omani School
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Abstract

The research aims to identify the level of effectiveness of the teaching practices of science and mathematics teachers in light of the national framework for future skills in Omani schools. To achieve the objectives of the study, the researchers used the descriptive approach, as he designed a note card consisting of (30) phrases distributed on three axes: basic skills, practical skills, and technical skills. After verifying the validity and reliability of the tools, they were applied to a sample of (116) teachers. The results of the research revealed that the level of effectiveness of the teaching practices of mathematics teachers has recorded a medium degree with a mean (3.05). The results a

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Publication Date
Wed Dec 13 2023
Journal Name
Drug And Chemical Toxicology
Single and repeat-dose toxicity and local tolerance assessment of newly developed oil emulsion adjuvant formulations for veterinary purposes
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Publication Date
Thu Oct 10 2019
Journal Name
Journal Of The College Of Education For Women
Constitutional Review of 1992 and 1996 and the role of the Party of Progress and Socialism
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Constitutional Review of 1992 and 1996 and the role of the Party of Progress and Socialism

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Publication Date
Thu Aug 01 2013
Journal Name
Desalination And Water Treatment
Competitive biosorption of Pb(II), Cr(III), and Cd (II) from synthetic wastewater onto heterogeneous anaerobic biomass in single, binary, and ternary batch systems
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Biosorption of lead, chromium, and cadmium ions from aqueous solution by dead anaerobic biomass (DAB) was studied in single, binary, and ternary systems with initial concentration of 50 mg/l. The metal-DAB affinity was the same for all systems. The main biosorption mechanisms were complexation and physical adsorption of metallic cations onto natural active functional groups on the cell wall matrix of the DAB. It was found that biosorption of the metallic cations onto DAB cell wall component was a surface process. The main functional groups involved in the metallic cation biosorption were apparently carboxyl, amino, hydroxyle, sulfhydryl, and sulfonate. These groups were part of the DAB cell wall structural polymers. Hydroxyle groups (–O

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
The Role of Education in Enhancing the Value of Citizenship in Children through the Interactive Life Process in Educational Institutions
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The aim of the research is to diagnose the methods of enhancing the value of citizenship in children through the interactive life process in educational institutions; the descriptive approach was used to achieve the objective by identifying social theories that corresponded to the national value or the theoretical principles of citizenship education. The study focused on educational activities and their role in establishing values, national educational philosophy in interactive activities, as well as the presentation of previous studies on the subject of citizenship, and maps of each of the strategies of active learning, skills in the process of interactive life in the field of education, Institutions that have the responsibility to prom

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Publication Date
Sun Sep 15 2019
Journal Name
Al-academy
Intellectual and Aesthetic Relationship between the Public and the Modern Theater (the play Oh Lord!) as a model: فيصل عبد عودة
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The issue of the public in the directions and theories of the theater director in the world theater, especially after the emergence of realism and the crystallization of the term direction and the definition of the role of the director in 1850 AD by the Duke Max Mengen took different paths to the Greek, Roman and even Elizabethan audience because it was here subjected to the theatrical equation from  its production and presentation due to the fact that the  theatrical performance is a technical artistic production, and the audience participation, watching and consumption, and here the participation of the audience was subjected to three directions:  the enlightenment in the sense of arousing sense, the incitement in the se

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Publication Date
Tue Dec 01 2009
Journal Name
Iraqi Journal Of Physics
The Calculation of the Charge Density Distributions and the Longitudinal Form Factors of 10 B Nucleus by Using the Occupation Numbers of the States
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The charge density distributions of 10 B nucleus are calculated using the
harmonic oscillator wave functions. Elastic and inelastic electron scattering
longitudinal form factors have been calculated for the similar parity states of 10B
nucleus where a core of 4He is assumed and the remaining particles are
distributed over 3/ 2 1p and 1/ 2 1p orbits which form the model space.
Core-polarization effects are taken into account. Core-polarization effects are
calculated by using Tassie model and gives good agreement with the measured
data.

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Analysis the Expected Profit By the Relation Between the Sustainable growth and Actual growth: Apply Study for Iraq Stock Exchange
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The research aims to analysis the future profits of companies listed on the Iraq Stock Exchange through analyzing the relationship between Actual Growth and Sustainable Growth, The study was applied to the sample of companies included in the Iraq Stock Exchange for the period (2010- 2014), The Internal Growth Rate has been used as a measure for the Actual Return Rate but the Sustainable Growth Rate has been measured under the Rose model, The research showed group of conclusions, the most important are:1. From the analysis of sustainable growth for the banks sample and the variables involved in its measure shows that investment in the investors amounts have achieved a significant return, which demonstrates the company's efficiency at gene

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Publication Date
Wed Jan 03 2024
Journal Name
Eximia
The reality of the organizational brilliance of physical Educators in the college of Physical Education and Sports Sciences / University of Baghdad from female students point of view
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Achieving goals effectively reflects the success of the institution. However, unless this indicator is coupled with efficiency when achieving goals, the institution will be equal in its achievements, and distinction will remain unachieved. Perhaps the role of the teaching staff in pushing the institution or college towards brilliance focuses on their ability to motivate people on the one hand and their interest in achieving brilliance for the institution. On the other hand, the importance of the research lies in the institution’s reaching a prominent position through the brilliance and creativity of teaching and achieving competition between institutions that make it more brilliance. The study seeks to achieve the goal of the real

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