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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
Fri Sep 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
A Comparative Study for Estimate Fractional Parameter of ARFIMA Model
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      Long memory analysis is one of the most active areas in econometrics and time series where various methods have been introduced to identify and estimate the long memory parameter in partially integrated time series. One of the most common models used to represent time series that have a long memory is the ARFIMA (Auto Regressive Fractional Integration Moving Average Model) which diffs are a fractional number called the fractional parameter. To analyze and determine the ARFIMA model, the fractal parameter must be estimated. There are many methods for fractional parameter estimation. In this research, the estimation methods were divided into indirect methods, where the Hurst parameter is estimated fir

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Publication Date
Sun Mar 04 2018
Journal Name
Journal Of The College Of Education For Women
Novel of (Ya Mariam), for Sinan Antwane : A Pragmatic Study
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Pragmatics looked at literary discourse as an external subject that needed an actor and based on a communicative relationship, that is, it examines literary work by focusing on the author's intent, and attempting to monitor the pilgrim and logical dimension in the text. It focuses on the practical and communicative aspect of the language, which aims to convince the recipient and his or her emotional influence.And the novel (Yamrim) starting from the title (Sos) communication, and building dialogue and pilgrims based on two different logic completely, the logic of optimism and look at things with absolute objectivity, the logic of pessimism and closure and look at things with absolute passion. These two tendencies are embodied by the char

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Cleaner Production
A study of biogas production from date palm fruit wastes
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Publication Date
Fri Dec 01 2023
Journal Name
مجلة العلوم و التكنولوجية للنشاطات البدنية و الرياضية
The effect of the think, pair, and share strategy of using educational movies on learning jumping opened legs and closed legs skills on vault in artistic gymnastics for women
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The research aimed at identifying the effect of the think, pair, and share strategy by using educational movies on learning jumping opened legs and closed legs skills on vault in artistic gymnastics for women. It also aimed at identifying the group that learned better the skills understudy. The researcher used the experimental method on second-grade College of Physical Education and Sport Sciences female students. Twelve female students were selected from each of the two sections to form the subjects of the study. The main program was applied for eight weeks with one learning session per week. The data was collected and treated using SPSS to conclude that the think, pair, and share strategy and the traditional program have positive effects

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Publication Date
Fri Jun 17 2022
Journal Name
Journal Of Baghdad College Of Dentistry
Clinicopathological analysis of 80 cases of oral lobular and non lobular capillary hemangioma (pyogenic granuloma): A Retrospective study
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Background: Oral pyogenic granuloma (PG) is a clinicopathological entity that could develop due to the reaction to a variety of stimuli, such as low-grade local irritation, traumatic damage, and hormonal stimulation. There are two histopathological types of pyogenic granuloma; lobular type -capillary hemangioma (LCH) and non-lobular type; with PG,LCH has highly vascular, diffuse capillary growth while non- lobular variant mimicking granulation tissue with heavily inflammated stroma. The study aims were to review the clinical  and histopathological spectrum of an oral pyogenic granuloma from different intraoral sites in order to avoid diagnostic pitfalls associated with similar morphological lesions and to determine

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Publication Date
Sun Mar 20 2016
Journal Name
Al-academy
The Floors and transparent role in the design studios satellite channels: وسام صالح حمد
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The search (floors and transparent role in the design studios satellite channels) and presented as a study-oriented, and the research aims to identify the role of flooring transparent spaces studios satellite channels and side performative and aesthetic, and formulas design to highlight the role floors transparent spaces studios satellite channels. And highlight the importance of research, particularly in its contribution to the clarification of the concept of the relationship between transparency and performing aesthetic treatments for floors by clarifying its role in the designs of the internal spaces of the studios, as well as his contribution to the founding of the theory of looking at the base of such concepts. To achieve the object

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Publication Date
Tue Sep 06 2022
Journal Name
International Journal Of Professional Business Review
The Relationship Between Audit Services and Non-Audit Actuarial Services in the Auditor’s Report
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Purpose: In view of the trend toward using international financial reporting standards when generating financial statements, we looked at the interaction between audit services and non-audit services for auditors in the context of actuarial services for insurance firms. CPAs are authorized to work in banks and insurance businesses, but those with a practicing license obtained after earning a higher academic degree are not. Design/methodology/approach: A small number of auditing firms control the decisions issued by the Iraqi Accountants Association, monopolizing audit services in banks and insurance businesses. In the case of actuarial services used in reserve estimation, they are credited to an external party's account withou

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The secondary vocational education and labor market requirements in Iraq (the period after 2003(
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Vocational education has great importance to comprehensive national development as it provides intermediate cadres able of operating the factories and laboratories in the farms and fields beside the work in the fields of health, service, administration and commercial. Due to the importance of this type of education in society, it is necessary to do a qualitative reform of vocational education in order to make the educational staffs get the necessary basic expertise to adapt the requirements of the labor market and try to rearrange and organize the workforce through put long-term economic and social policy through certain planning open to the workforce. The workforces structure according to gradual expansion in all the national ec

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Fuzzy Analytic Hierarchy Process FEAHP to Prioritize The Evaluation of The Main and Subsidiary Criteria in B2B Industrial Market Sectors – Applied Research
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The research aims to define the main and subsidiary criteria for evaluating the industrial market sectors and proposing a model for arranging these criteria according to priority and knowing the highest criteria in terms of relative importance in the General Company for Automobile Trade and Machinery, and for the purpose of establishing this model, experiences in the concerned company were approved, and this study proposes a multi-criteria decision model According to the FEAHP, the expanded fuzzy hierarchical analysis method enables the commercial company to develop clear strategic policies on which the company’s management system depends on determining criteria for evaluating and selecting market sectors and making appropriate

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Central Bank control of external transfers and its impact on the tax information system: Applied research in the General Authority for Taxes
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Tax information system is one of the most important means that help the tax administration to reach the real income of the taxpayer, and the problem of research came in the General Authority for Tax ,The next question (Does the control carried out by the Central Bank on foreign remittances to reach the real income of the taxpayer). The research is gaining importance by focusing on the Central Bank's control over foreign remittances, and how to use this control to finance the tax information system. The relationship between the Central Bank's control over foreign remittances and the tax information system.The study has reached a number of recommendations, the most important of which are the following: The work of an integrated information

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