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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
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
THE role of Organizational flexibility and its impact in responding to achieve higher performance requirements; Field research in the General Directorate of Municipalities.
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Municipalities.

Abstract

The purpose of this research is to measure the impact of regulatory flexibility dimensions (formal and authoritarian procedures) to achieve response to the requirements of high performance dimensions (the effective recruitment, intensive training, motivate employees, participation of workers) in the general municipal Directorate as one of the directorates of the Ministry of Municipalities and Public Works. For the purpose of this measure it has been selected sample composed of 88 individuals from the research community represents the levels of assistant general manager of department heads and managers of people and some of the staff to answer the questionnaire prepared for the purpose Hama

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Publication Date
Sun Jun 26 2016
Journal Name
E-marefa
Evolution level of Iraqi journalists residing in Jordan of covering the political and economic reforms in Iraq by the Iraqi satellite TV stations
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هدفت الدراسة إلى التعرف على مستوى تقييم الإعلاميين العراقيين المقيمين في الأردن لتغطية الإصلاحات السياسية و الاقتصادية في العراق من قبل الفضائيات العراقية. و هدفت كذلك إلى التعرف على الف

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Some Inflammatory Markers (IL-6 and CRP) in the Pathogenesis of Acute Coronary Syndrome in Iraqi CCU for Heart Diseases
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In this work an enzyme linked immunosorbent assay (ELISA) technique has been used for detection of some inflammatory markers in serum of acute coronary syndrome (ACS)-Patients Admitted to the cardiac care unit (CCU) of Iraqi Centre For Heart Diseases and Ibn AlNafees Teaching Hospital. The present method includes quantitative measurement of interleukine-6 (IL-6) and C-reactive protein (CRP), as their increase during symptoms may be responsible for identifying the mechanism of myocardial damag, in addition to their best performance than other quantitative tests perhaps due to their association with atherosclerotic process that belongs to the endothelial dysfunction. Aim of this study is to estimate the prevalence and correlation of IL-6 w

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of the statistical methods used to Forecast the size of the Iraqi GDP for the two sectors (public and private) for the period (2025-2016)
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Gross domestic product (GDP) is an important measure of the size of the economy's production. Economists use this term to determine the extent of decline and growth in the economies of countries. It is also used to determine the order of countries and compare them to each other. The research aims at describing and analyzing the GDP during the period from 1980 to 2015 and for the public and private sectors and then forecasting GDP in subsequent years until 2025. To achieve this goal, two methods were used: linear and nonlinear regression. The second method in the time series analysis of the Box-Jenkins models and the using of statistical package (Minitab17), (GRETLW32)) to extract the results, and then comparing the two methods, T

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Publication Date
Tue Feb 20 2024
Journal Name
Aip Conference Proceeding
Evaluation and production of predictive maps on the impact of climate factors on the the land cover for the Baghdad city for the period (1999-2021)
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The general objective of the research is to better understand changes in land cover and their impact on climatic factors by measuring changes in land cover for the Baghdad city for the period 1999-2021 and evaluating changes in land cover and measuring changes in climatic factors (relative humidity and evaporation). This study from 1999 to 2021 and in two different seasons: the April of the growing season and August the dry season. When using the supervised classification method to determine the differences, the results showed remarkable changes, the study showed the spatial variations in LC from 1999 to 2021 as follows: increase in the vegetation and water bodies during April and decrease this in August while the soil and built up decreas

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Publication Date
Sun Jan 07 2024
Journal Name
Migration Letters
The Effect Of Preventive Physical Exercises Supported By Collagen Supplements And Vitamin D In Improving Some Of The Physical And Skill Abilities Of Handball Players
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The purpose of this paper is to preparing preventive exercises supported by collagen supplements and vitamin D for handball players, and identify the effect of preventive physical exercises supported by collagen supplements and vitamin D on some physical and skill abilities of handball players. The researchers used the experimental method and designed two groups, one experimental and the other control, with both pre- and post-tests, to suit the nature of the research. The research community was selected from handball players (specialized school players), numbering (14), and they were divided into two groups, each group numbering (7) players. One of the most important results reached by the researcher is that: The exercises prepared by the r

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Adoption of multi – model Assignment Fuzzy to find Optimizing for the use of internet line in the Ministry of Science and Technlogy
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We have provided in this research model multi assignment  with  fuzzy function goal has been to build programming model is correct Integer Programming fogging  after removing the case from the objective function data and convert it to real data .Pascal triangular graded mean using Pascal way to the center of the triangular.

The data processing to get rid of the case fogging which is surrounded by using an Excel 2007 either model multi assignment  has been used program LNDO to reach the optimal solution, which represents less than what can be from time to accomplish a number of tasks by the number of employees on the specific amount of the Internet, also included a search on some of the

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of The College Of Languages (jcl)
Investigating the Mastering of the Pronunciation of Weak and Strong Forms of English Function Words
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    The weak and strong forms are so called because it is not their lexical content that primary matter, but the role they have in the sentence. The problematic confusion, our students encounter, in recognizing and producing the correct pronunciation of weak and strong forms of the English function words is the main incentive behind conducting  this study. In order to gather the data, this paper used two types of tests: a recognition test and a production test. The general results reached  through the analysis of the students' answers seem to conform to the researcher's assumption: students face a critical problem in recognizing and producing correct pronunciation of the weak and strong forms of the English funct

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Publication Date
Sun Mar 12 2017
Journal Name
Al-academy
The reality of interior design of Sharjah mosques and the possibility of development - selected models
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Observed mosques with the advent of Islam under the auspices of care being the houses of God Almighty, and I like parts of the ground to him, the center of radiation spiritual, intellectual and ideological in the lives of Muslims, was the most important cultural and architectural evidence built by Muslims voicing their deep faith and serenity Aqidthm.valmsadjad better reflecting the reality of communication between the person and his Lord, because he is the most important building of permanence and survival, making it imperative designed the best visual forms both externally and internally.Mosques have been characterized in the United Arab Emirates distinct characteristics in terms of building elements of construction in general, and the

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Publication Date
Sun Jun 04 2017
Journal Name
Baghdad Science Journal
The Effect of Variety and Gibberellic acid and Brassinolide and their Interaction on Some of The Chemical Characteristics and Total chlorophyll of the plant Dill Anethum graveolens L.
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The experiment was carried out to study the effect of variety and gibberellic acid in concentration (0 and 50)mg.lat-1 and BL in five concentration (0, 0.50 ,1 ,2 and 3)mg.ltr-1 and their interaction in some chemical Characteristics and total chlorophyll for Dill plant . the experiment designed according Randomized Complete Block Design (RCBD) and three replicates per treatment, compared to the average using less significant difference at the level of probability (0.05) , the results showed the following:- The effect of brassinolide with it,s concentrations led to obtain a significant increase in all the studied characteristics, so the superiority of the concentration of 2 mg.L-1 of brassinolide in each of Ca, Mg,Fe, and total chlorophyll T

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