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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
Mon Nov 11 2019
Journal Name
Journal Of Global Pharma Technology
Using the Water Quality Index as a Powerful Tool to Assess the Water Quality for Drinking Purposes in Al-Salam, Western Region of Baghdad City, Iraq
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Background: Tap waters play an important role in fulfilling the people needs for drinking and domestic purposes. Contaminate the tap water with different pollutants has become an issue of great concern for 90% of people who are depended on the tap water as the main source of drinking. Pollutants can make their way easily into the delivering pipes which suffer from the leaking resulting in decreasing the quality of water. Objective: Therefore, assess the water quality for drinking purpose by calculating the water quality index is an important tool to ascertain whether the water is suitable for human consumption or not. Methods: In the present work, the water quality of the Al-Salam, western region of Baghdad city, Iraq was investigated for 7

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The relationship between the external environment analysis and banking facilities: An Applied Research in the Rafidain and Rasheed Bank
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Is the subject of environmental analysis of the important issues that should occupy the attention of the departments of banks in general and banks in particular, the research sample, regardless of their size and the nature of its activity, So if the current era and witnessing rapid developments and changes, making the banking environment is more complex and interconnected than ever, And it became not possible for banks to be aware and understand the external environment variables without an analysis of the various constituent elements and influential heavily in its financial and administrative,Therefore research aims to find out the relationship between the external environment and banking facilities analysis application on the Rafidain

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Publication Date
Wed Jan 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Study the synergistic Effect between Nanoparticles and Spiramycin on Immunological Response Against Toxoplasmosis
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Abstract<p>This investigation was carried out to estimate the antiparasitic potential of silver and Chitosan nanoparticles loaded with spiramycin against toxoplasmosis infected. After mice injected intraperitoneal in a dose 10<sup>3</sup>viable tachyzoites for acute infection; then treated with spiramycin, chitosan nanoparticles and silver nanoparticles as a single or combined therapy given for seven days. Peritoneal fluid examination revealed a significant decrease in the number of<italic>T. gondii</italic>tachyzoites in all treated infected mice compared with infected non-treated. The combined therapy presented better results than the single one. The best effect was observed in a group of </p> ... Show More
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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Blockchain Technology and its Potential Effect on the Banking Industry (China Case Study)
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The aim of the research is to investigate potential effects of the finance industry and block-chain to general business of financing in particular, as well as its shortcomings and difficulties. To answer the research questions, the researcher used the objective narrative-analytical descriptive approach and included a qualitative analysis of Blockchain technology. The process of Blockchain technology based on their industries, the authors were selected based on their reputation in the Blockchain field. The research found that Blockchain can improve the efficiency of the banking industry's various sections. It has the ability to upgrade and transfer wages across borders, financial reporting and compliance, as well as trade finance

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
" Measuring the competitive performance of the National Insurance Company and some of its branches using the Revealed comparative advantage index RCAI "
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The research dealt with the subject of measuring the competitive performance of the National Insurance Company and some of its branches (Basra, Ninwa, Kirkuk and Babil), Depending on the Revenue Growth Index at the activity level, and the Revealed Comparative Advantage Index RCAIAt the branch level,To measure the competitiveness of the company And some branches, As the problem of research in the lack of adoption by some companies in the insurance service sector on scientific indicators to measure their competitive performance, The aims of the research is to measure the competitiveness of the National Insurance Company, as well as the competitiveness of its branches according to the scientific method, One of the main Conclusions of the re

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Publication Date
Sat May 01 2021
Journal Name
Materials Today: Proceedings
WITHDRAWN: Analyzing and measuring the impact of trade openness on the gross domestic product growth of the Iraqi economy after 2003
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Publication Date
Sun Feb 15 2026
Journal Name
Modern Sport
The reasons for the failure of simple assault and its relationship to the level of levelp performance skill players weapon sword
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The method of analysis is one of the tools the coach to identify strengths andweaknesses of each player, and how to avoid mistakes that in the course ofperformance on the other hand, Voslob analysis is important for the player, as throughthe analysis will determine the capacity enjoyed by both the coach and player, as wellas being the possibility of progress in a scientific manner thoughtful, and also helps inthe evaluation of physical and skill level and tactical, psychological and trainingcapacity of the coach in order to avoid obstacles and make the coach is movingtowards the right track to improve the good level, and then an investigation tocomplete higher education.Hence the importance of research in the analysis of simple attack and n

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Publication Date
Mon Oct 01 2018
Journal Name
Xlinguae
The three-level phono-grammar order and its derivational connecting link: the elements of language system (on the material of Arabic)
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Publication Date
Wed May 12 2021
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
The Effect of the Programmed Education Strategy to Learning the Under Hand Service and Receiving Service Skills of Volleyball for Juniors
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In order to advance the education process and raise the educational level of the players, it became necessary to introduce new educational aids, programmed education in the education process, through which the basic skills to be learned are explained and clarified, and immediate feedback is provided that would enhance the information of the learner, and Reaching the goal to be achieved, taking into account the individual differences between the players, and thus it is possible to move away from the educational methods used in learning skills, which requires great effort and time, in addition to that the open playground may not perform the skill accurately and the player looks from one side, while when using the computer you look from severa

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Proposed Strategy According to the Realistic Mathematics Theory on the Achievement and Mathematical Interrelation of third Intermediate Students
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Abstract

The current research aims to identify the effect of the proposed strategy in accordance with realistic mathematics on the achievement and mathematical Interrelation of third Intermediate students. Two samples were tested from the middle third grade in a school affiliated with the General Directorate of Baghdad- Rusafa, the first for the academic year (2022-2021). The experimental group is (30) students taught according to the proposed strategy, and the control group is (30) students based on the traditional method. To achieve the research objective, the researchers developed a test for achievement consisting of (30) items and a test of sports interconnection composed of (20) items. The results of the stu

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