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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
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The role of industry specialization of audit companies in detecting fraud in the financial statement
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Abstract:

The aim of the research is to demonstrate the impact of the professional specialization of the audit companies in the detection of fraud in the financial statements of the economic units listed in the Iraqi market for securities for the period 2014-2015 through the application of the model (Carcello) to test the hypothesis of research on the impact of professional specialization of audit companies in the detection of fraud in lists The effect of the variables was revealed through the use of statistical models of logistic regression model and correlation coefficient. After testing the hypotheses of the research, a number of conclusions were reached. The most important was the existence of a signi

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Publication Date
Wed Jun 01 2022
Journal Name
Res Militaris
The Effect of Internal Control in Supporting the Implementation of Cost Techniques in Iraqi Companies
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In the last few years, there have been a lot of changes in the economy, society, and the environment. This has led to much competition between companies, directly and indirectly affecting production and marketing processes. Most companies are trying to cut production and manufacturing costs by using modern cost techniques such as product life cycle costing and Continuous Improvement (Kaizen) technology, in the method of measuring production costs or service costs, and the need for internal control to keep an eye on how these technologies are being used and how well they work. And to find out the effect of internal control on the implementation of costing techniques in Iraqi companies, 64 questionnaires were given to people who work in the i

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The frequency of IgM-anti HAV in the sera of patients with hepatitis in Iraq
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Three hundred and fifty five patients with hepatitis were investigated in this study all cases gave negative result with HBs Ag , IgM-anti HCV , IgM-anti HEV, IgM-anti HDV and anti-HIV tests . The frequency of IgM-anti HAV was 113 and the percentage was 32 % in all ages but when these patients divided into five groups dependent on ages. The highest percentage of IgM-anti HAV was (45%) in age <10 and the percentage declined with age increase till to 9% in age >41 year.

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Publication Date
Wed Jun 11 2025
Journal Name
Discover Oncology
The role of non-coding RNAs in the regulation of cell death pathways in melanoma
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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Baska Style in Achievement and Creative Thinking among Students in the Fifth Grade Literary Material and Application Rhetoric
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The current research aims to identify the effect of Baska style on students’ achievement and the creative thinking in material rhetoric and the application of students for fifth grade literary. To achieve the study objectives, the researcher has designed an achievement test to measure group of students in the fifth grade literary in material application. The researcher chose a sample of 40 female students from Khansa School for Girls in Baghdad for the academic year (2014 - 2015), he applied the test on an exploratory sample consisted of 30 female students from the research community. The study resulted in being no statistically significant difference at the level of significance (0.05) between the mean scores of the experimental group

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Theoretical Estimation of Electronic Flow Rate at Al-TiO<sub>2</sub> Interfaces System
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Abstract<p>The mechanism of the electronic flow rate at Al-TiO<sub>2</sub> interfaces system has been studied using the postulate of electronic quantum theory. The different structural of two materials lead to suggestion the continuum energy level for Al metal and TiO<sub>2</sub> semiconductor. The electronic flow rate at the Al-TiO2 complex has affected by transition energy, coupling strength and contact at the interface of two materials. The flow charge rate at Al-TiO2 is increased by increasing coupling strength and decreasing transition energy.</p>
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Publication Date
Wed Jul 01 2020
Journal Name
Journal Of Engineering
Design of Multi-Rate Multi-Zone Wireless Fuzzy Temperature Control System for Greenhouse Application
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sensor sampling rate (SSR) may be an effective and crucial field in networked control systems.  Changing sensor sampling period after designing the networked control system is a critical matter for the stability of the system. In this article, a wireless networked control system with multi-rate sensor sampling is proposed to control the temperature of a multi-zone greenhouse. Here, a behavior based Mamdany fuzzy system is used in three approaches, first is to design the fuzzy temperature controller, second is to design a fuzzy gain selector and third is to design a fuzzy error handler. The main approach of the control system design is to control the input gain of the fuzzy temperature controller depending on the cur

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Publication Date
Thu Dec 01 2022
Journal Name
Journal Of Engineering
The Effectiveness of a Simulation Model of Thermal Insulation in Building Materials Using Cellulose Extracted from Agricultural Waste in Baghdad
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This study found that one of the constructive, necessary, beneficial, most effective, and cost-effective ways to meet the great challenge of rising energy prices is to develop and improve energy quality and efficiency. The process of improving the quality of energy and its means has been carried out in many buildings and around the world. It was found that the thermal insulation process in buildings and educational facilities has become the primary tool for improving energy efficiency, enabling us to improve and develop the internal thermal environment quality processes recommended for users (student - teacher). An excellent and essential empirical study has been conducted to calculate the fundamental values ​​of the

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The role of Job Engagement for Employees in ensuring customer loyalty :Applied research in a Sample of private Iraq banks
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ABSTRACT

      The current research aims at highlighting the role of engagement of a sample of employees who works in some of the Iraqi private banks in terms of their interaction , commitment and enthusiasm and the positive impact they own regarding their job and devote their efforts to achieve the core purpose  which is customer loyalty. The problem was expressed through a number of intellectual and practical questions.

In order to achieve the aim of the research the quantitative analytical method was used depending on a questionnaire as a basic tool to collect research data and the qualitative survey method depending on semi-structured interviews which were distrib

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Publication Date
Tue Jun 21 2022
Journal Name
Journal Of Planner And Development
Evaluation of some indicators of urbanization in the city of al-Qaim in the Iraqi province of Anbar
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Urban Balance is one of the important indicators that leads to an assessment of the urbanization process in a particular country  , province or even a city that is multi-centered. By examining  the data related to Anba  province, it was found that the value of this indicator is equal to 0.96, which is less than the absolute one, and therefore the urbanization in the province is distributed collectively  

The development of a mathematical or statistical model for estimating urban growth is a complex process due to the overlap between indicators or variables that can be adopted to calculate estimate growth rates Al-Qaim city has been considered as an example to develop a statistical method by which changes

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