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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
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
The Inner Wasteland in Selected Later Plays of Samuel Beckett
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The inner wasteland can be observed in Samuel Beckett’s early and later plays. His characters suffer from loss of identity, emotions, and sense of time. They lead a life of failure, repetition, inaction, loneliness, doubt, suffering, and nothingness. The inner wasteland includes many aspects, such as the multi and split identity, the habitual repetitive element of life, the dark sorrowful life the characters lead, lack of communication and relations among them, their unfree, inactive condition, their foggy terrible recollections, loneliness, dryness of love, and uncertainty. The analysis and the illustration of each aspect will show how the inner wasteland is intensified in the selected later plays of Beckett.

 

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Publication Date
Sun Sep 01 2013
Journal Name
Baghdad Science Journal
Spectrophotometric method for the determination of Captopril in pharmaceutical formulations
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A simple, rapid and sensitive spectrophotometric method has been developed for the determination of captopril in aqueous solution. The method is based on reaction of captopril with 2,3-dichloro 1,4- naphthoquinon(Dichlone) in neutral medium to form a stable yellow colored product which shows maximum absorption at 347 nm with molar absorptivity of 5.6 ×103 L.mole-1. cm-1. The proposed method is applied successfully for determination of captopril in commercial pharmaceutical tablets.

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Publication Date
Thu Jan 24 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Impact of Tax knowledge in compliance costs: Applied Research
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This research Sought to Determine the Relationship and  impact  between the tax knowledge in dimensions  of the tax compliance costs (monetary costs, time costs, psychic costs) Since the sample included 81 individuals represented by the Executive directors and Financial  and Accountant working in the Joint-stock company,  A questionnaire was used as a tool for data collection and its analysis.  For the purpose of analyzing the research data the statistical package for social science, SPSS. The most important tools used in the statistical analysis are:(standard deviation, and simple linear regression, percentages,  arithmetic mean, Cronbach's alpha, F-test, T- Test). The research found a weakness attenti

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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The impact of public debt on financial stability in Iraq
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Countries have faced the challenges of high levels of public debt and seek to define the optimum limits to reduce risks to which the financial system can be exposed and its impact on the economy as a whole. Hence the importance of research in studying the impact of internal and external public debt components on indicators of stability of the financial system for the period 2005-2017 for the purpose of knowing the extent of the financial stability indicators response to the high level of the public debt from its optimum ratio, as the aim of the research is to estimate and analyze the dynamic relationship of short and long term between the components of public debt and indicators of financial stability using the (ARDL) model that

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Publication Date
Sun Jun 30 2024
Journal Name
Management And Social Perspectives
The Role of Green Target Costing in Improving Supplier Relations
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This study aims to explain the role of green target costing technique in improving the relationship with suppliers in a sample of industrial companies listed on the Iraq Stock Exchange. The descriptive analytical approach was used, where a questionnaire was designed that included a set of questions that were directed to a sample of 84 individuals including production managers, finance managers, quality managers, and purchasing managers in these companies. The study uses some statistical analyzes such as correlation analysis and regression analysis to analyze the questionnaires. The study finds a positive impact of the green target costing technique on improving the relationship with suppliers. The results indicate that the relation

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Management Accountant In Implementing Corporate Governance Mechanisms
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Abstract

    This research  aims to highlight the Cooperate Governance concept and determine its accounting dimensions, especially what has connected with development the management accountant role concerning the nature, scope and its location in the organizational structure in the companies as to be complied with implementing the cooperate governance principles and mechanisms in the modern businesses environment. This research has focus on clear shortage in the management accountant role in the companies,  regarding to implement the governance mechanisms, especially his role to provide the information and consultations to the internal & external parties (stakeholders) . This

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Publication Date
Fri May 15 2009
Journal Name
Journal Of Planner And Development
Rapid Urbanization of the Cities Studying in some Iraqi Cities
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The cities are not yet a temporal status in the process of the human and civilization development. The cities consider as a life pattern, this mean that people cannot live without cities, which surround us. Several phenomena like globalization, revolution of information, technical development, increased of consumption, do not confirmed without the living in cities. The urbanization – in its simple meaning – means transferring from rural community to city community. In other word, it means that socioeconomic changes happened subject to the patterns and conditions of the urban life. Each government depend a certain policy, this policy contains set of plans and programs, that targeting to affect the population factors and the st

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Publication Date
Sun Nov 01 2020
Journal Name
Travel Medicine And Infectious Disease
Incidence of the COVID-19 in Iraq – Implications for travellers
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Publication Date
Tue Aug 30 2022
Journal Name
Acta Scientiarum Polonorum Administratio Locorum
Cities' urban resilience in the face of urban sprawl challenges
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Motives: The research deals with the issue of urban sprawl on agricultural lands. It is an urban problem caused by rapid urbanization and poor planning. It is considered one problem that threatens cities with environmental and health disasters. It also threatens agricultural life and the green belt surrounding cities. Changes in urban sprawl on agricultural land are associated with complex processes that lead to multiple social, economic, political, and environmental risks and thus pose a threat and an obstacle to the sustainability of cities. Aim: The research aims to study and evaluate the reality of the city of Baghdad and the extent of its ability and flexibility to withstand the disaster of urban sprawl on agricultural lands. T

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Publication Date
Fri Jul 05 2013
Journal Name
Hemoglobin
The Spectrum of β-Thalassemia Mutations in Baghdad, Central Iraq
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