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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 Jun 25 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of the cash flow statement indicators in market value change of the industrial firms listed on the Palestine Stock Exchange
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This research aims to examine the ability of impact of the cash flow statement indicators in the change in the market value of the industrial firms listed on the Palestine Stock Exchange. The research population consisted of (13) firms during the period (2015-2020). Data were collected from the annual financial statements of the firms. The research relies on the Pooled effects model to analyze the cross-section data (Panel Data), and the multiple regression method to test the hypotheses. The research finds a positive significant impact of (the ratios of cash flows from operating activities to sales, the return on assets from operating cash flows, and cash flows from operating activities to total current liabilities) in the change

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Publication Date
Tue Feb 03 2026
Journal Name
Modern Sport
Impact style of the changeable resistance in the development some of physical &amp; functional changes for the National team for the badminton
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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of the dimensions of the strategic lens on achieving tax pioneer performance: Practical research in the General Authority for Taxes
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The aim of the research is to shed light on the dimensions of the strategic lens and its impact on achieving the pioneer tax performance and represented by the dimensions (strategic direction, growth, pilot indicator, renewal and modernization, efficiency and effectiveness) in the General Tax Authority. The questionnaire was adopted as a tool to collect data and information from the adult sample They are (91) who are on the site (Assistant Director General, Head of Division, First Division Deputy, Second Division Deputy, Division Officer, Division Officer Associate) The statistical program (SPSS) has been used to calculate (the mean, the standard deviation, the correlation coefficient, the difference coefficient, the F test, the

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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
the role of marketing intelligence in promoting new product policies.a sample survey of workers in a number of mineral water plants in dohuk governorate
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Marketing Intelligence is one of the important methods of collecting information about competitors ' products and changes in customers ' tastes and needs that contribute to determining the policies to be followed in product development.

The problem of research, which seeks to be answered by the extent to which the companies in question have the appropriate and effective mechanisms to develop their products, and the nature of the relationship between the components of marketing intelligence and new product development policies. The importance of research is determined by the importance of obtaining important and necessary information to make the appropriate decision on the development of the new product an

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Synthesis and some of the electrical properties of the polymer Mosul poly Berrol
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Thin films were prepared from poly Berrol way Ketrrukemaaih pole of platinum concentrations both Albaarol and salt in the electrolytic Alastontrel using positive effort of 7 volts on the pole and the electrical wiring of the membrane record

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Reflection of the application of the IFRSs on financial ratios and performance indicators
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The research aims to delve into the nature of international financial reporting standards and the unified accounting system adopted in the Iraqi environment and financial ratios in the theoretical side. In the practical aspect, the results of some financial ratios of Basrah Gas Company were compared with the adoption of the financial statements prepared on the basis of the consolidated accounting system with the prepared financial statements Based on the International Financial Reporting Standards (IFRS). The research has reached a number of conclusions, including a difference in the accounting rules and practices between IFRS and the consolidated accounting system in force in Iraq. The adoption of IFRS has led to a decrease in profitabi

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Publication Date
Sun Dec 10 2017
Journal Name
Al-academy
cognitive references of the directorial imagination and modeling of the theatrical actor performance
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This research is determined by the study of  the " cognitive references of the directorial imagination and modeling of  the theatrical actor performance ." it has described an Iraqi theatrical model, The research began with the great importance of the director's imagination as the basic premise for crystallizing the  director's vision according to its cognitive references in creating a solid performance model based on the aesthetic, intellectual and technical bases, It is also contributes to the formation of the theatrical show as a technical framework that presents the show in one unified fabric.

The research sought to reach through the problem of research, which is in the question of: What is the modeling of the

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Publication Date
Wed Feb 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Local policy and its impact on the performance of the province of Baghdad.
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Abstract

The current research aims to clarify the role of local policies on the performance of the province of Baghdad, after studies proved practical experience what those policies of the major role and effect on the lives of citizens, as well as alleviate the burden on central government, which make a lot of states give local governments broad powers and her specialty funds for the exercise of its vital role and actor in various joints of local development, research has indentified a problem in a number of questions such as: do you have the policy of the provincial council of local qualified and able to influence the performance of the province? What are the main forces of powerful and implementation of policies at all

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Publication Date
Sat Oct 01 2022
Journal Name
Journal Of Engineering
Evaluation of the Physical and Chemical Treatment of Wastewater for the Dairy Industry
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Dairy wastewater generally contains fats, lactose, whey proteins, and nutrients. Casein precipitation causes the effluent to decompose into a dark, strong-smelling sludge. Fluid waste contains soluble organic matter, suspended solids, and gaseous organic matter, which cause undesirable taste and smell, grant tone and turbidity, and advance eutrophication, which plays an essential role in increasing biological oxygen demand (BOD) in water. It also contains detergents and disinfecting agents from the rinses and washing processes, which increase the need for chemical oxygen (COD). One of the characteristics of dairy effluents is their relatively high temperature, high organic contents, and wide pH range, so the discharge of wastewater into

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Crossref (6)
Crossref
Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Semantic (Badi'iyah)Readings in The Prophetic Praise Poetry (Mada'h Nabawiya) (Abdel Rahim Bin Ahmad Bin Ali Al Borai as a case study)
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The importance of this topic may not be overlooked by many of the specialists, because it is one the sciences of the Arabic language, but it is an important method in the field of influencing the recipient and his aesthetic ability to create influential images as well.
The talking about Semantic (Badi'iyah)is as old as the Arabic age, so it may be talking about it not the new thing because the people who specialized have preceded us and exhausted all the talk .

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