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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 Sep 15 2020
Journal Name
Al-academy
Aesthetic Presence Hypothesis of the Role Character in the Actor's Theatrical Performance: يــاسين إسماعيل خلـف
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The current study monitors the mechanisms of formation of the actor's performance expressive system (voice and motion) and the levels of their construction consistent with the aesthetic premise of the theatrical performance through incorporating what is natural, materialistic (physiological) and artistic and philosophical virtual (aesthetic ), through which the creative actor seeks not to repeat the image and substance of a thing according to its natural life image, in favor of new aesthetic reproduction governed by a group of significant relationships formed according to (artistic and philosophical) characteristics and features that distinguish the artistic accomplishment from its reality(its natural and functional reference). According

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Engineering
The Use of the Artificial Damped Outrigger Systems in Tall R.C Buildings Under Seismic Loading
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This paper studies the combination of fluid viscous dampers in the outrigger system to add supplementary damping into the structure, which purpose to remove the dependability of the structure to lower variable intrinsic damping. This optimizes the accuracy of the dynamic response and by providing higher level of damping, basically minimizes the wanted stiffness of the structure while at the same time optimizing the achievement.

     The modal considered is a 36 storey square high rise reinforced concrete building. By constructing a discrete lumped mass model and using frequency-based response function, two systems of dampers, parallel and series systems are studied. The maximu

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Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
Employing Digital Technology in the Formation of the Theatrical Show Space: ثامر طه عبد علي
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  The current research tries to identify the employment of the digital technology in the formation of the theatrical show space. The researcher started with the significant importance of the digital technology and its workings in the formation of the contemporary theatrical show being a modern, artistic, aesthetic, intellectual and technological means to convey the topic in an integrated manner, as well as its close connection with the creative directive vision and the creative designing vision. It provides a variety of models of numerous implications in terms of transmission and advancement of the relationships represented by clarifying the scenography and dramatic conflict forms according to the numerous motivations of the directo

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Publication Date
Sat Apr 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Measuring the level of unemployment in Iraq by using the user / product schedule for 2010
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Economic performance is one of the most important indicators of economic activity and with the performance of the economy progress varied sources of output and increase economic growth rates and per capita national income, and to recover the business environment and increase investment rates and rising effectiveness of the financial and monetary institutions and credit market. Which leads to increased employment rates and reducing unemployment rates and the elimination of many of the social problems and improve the average per capita income as well as improve the level of national income.

The input / output tables is a technique mathematical indicates economic performance

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
"The Impact of International Public Sector Accounting Standards (IPSASs) on the Public Budget in Iraq"
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     The aim of the research is to determine the impact of the Iraqi public budget on IPSASs by conducting the questionnaire; the research was based on the hypothesis that "there is an impact of the adoption of the International Accounting Standards in the general budget of Iraq”. The research concluded that the government accounting system closely interferes with the general budget at all stages. The shifting towards the accrual basis is the first element of the reform package towards reaching the reform of the state budget. Without reforming government accounting, it is almost impossible to develop the budget. IPSASs are a recognized reference to the assessment and development of governmen

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Publication Date
Fri Mar 15 2019
Journal Name
Spe Middle East Oil And Gas Show And Conference
Evaluation of the Potentials for Adapting the Multistage Hydraulic Fracturing Technology in Tight Carbonate Reservoir
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Abstract<p>Hydraulic fracturing is considered to be a vital cornerstone in decision making of unconventional reservoirs. With an increasing level of development of unconventional reservoirs, many questions have arisen regarding enhancing production performance of tight carbonate reservoirs, especially the evaluation of the potential for adapting multistage hydraulic fracturing technology in tight carbonate reservoirs to attain an economic revenue.</p><p>In this paper we present a feasibility study of multistage fractured horizontal well in typical tight carbonate reservoirs covering different values of permeability. We show that NPV is the suitable objective function for deciding on the optimum number</p> ... Show More
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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
Towards measuring the aggregate index of banking stability in Iraq for the period 2010 -2016
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Abstract:

    The paper aims to measure an aggregated banking stability index reflecting the degree of stability of the banking system to help policy makers to take the necessary actions to avoid financial crises facing banks and to achieve a banking system with high efficiency in terms of banking risk.

    Therefore, the problem of paper is that the Central Bank of Iraq did not seek until 2016 to build a aggregated index for the purpose of identifying the stability of the banking situation in Iraq, but rather on the adoption of scattered indicators, which depend on the mechanism of relative changes in those indicators for the purpose of identifying the situation of b

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Evaluating health services in the private suites for governmental hospitals from the perspective of patients
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ABSTRACT                                                                                            

The study aims to identify the level of health services provided in private suites to government hospitals from the perspective of the recipi

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of Barman model in acquiring the historical concepts among fourth-grade literary students
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The researcher attempts to examine Barman model in acquiring the historical concepts among fourth-grade students at literary classrooms. To this end, the researcher held the null hypothesis, there is no significant difference between the experimental groups who was taught based on Barman model and the control group that taught based on the traditional method in acquiring the historical concepts on the post-test. To testify the effectiveness of Barman model, the researcher administered a questionnaire included (60) items on bunch of female-students who were selected from al-khamaeal preparatory school in al-hurriyah district in Baghdad. The author utilized different statistical tools to analyze the collected data.    &

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Testing the Moderating Role of Financial Resources in the Relationship between Diversification Strategy & Firm Value
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It has aimed by this research at presenting new interpretations to diversification phenomenon and its possible effects on firm value. These interpretations are culminated by the disclosure of the distinct role of resource-based view in the study of relationship between diversification strategy and firm value. The study has conducted on a sample consisted of the largest American companies listed in Fortune 500 along with seven years period
(2005-2011). This first local attempt, which has based on panel dat--a analysis for interpreting an expected variance of firm value due to diversification strategy, may helps with a clear vision to solve the contradiction and confusion surrounded the true linkages between t

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