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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
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Suggestion Plan for the Reclassification of U.N Publications in Central Library
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Suggestion Plan for the Reclassification of U.N Publications in Central Library

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Publication Date
Sat Sep 30 2023
Journal Name
Tikrit Journal Of Administrative And Economic Sciences
The impact of Outward bank transfers on exchange rates in Iraq
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The depreciation of the Iraqi dinar against the US dollar, reaching low levels and causing disruptions in the local markets, has had detrimental effects on individuals and companies, particularly those with limited income and the poor. The local currency approached around 1600 dinars per dollar, after the official exchange rate had stabilized at around 1450 dinars per US dollar. This depreciation in the value of the Iraqi dinar can be attributed to financial speculation among currency traders, which directly affected exchange rates and illicit dollar smuggling operations. Bank transfers are also important alongside financial transactions, especially in light of current economic developments in the 21st century. To prevent currency s

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Role OF Human Resource managment Strategies In Enhancing Cognitive Skills.
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Abstract:

 In its theoretical farm, the research adobet  the subject of human resource management strategies  and the cognitive skills. It comes as result of the rapid development which considers it human resource. as main axis in organization , the research in includes ,connective analysis  , between  human resource management strategies  and cognitive skills which is considers one of the new concept that should  be  studied widly so that the organization can be able recognize it as concept and type and its importance for people in the organization.The study method was descriptive and  analytics , it identified collation of hypothesis which were by statist too

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
The state of Vitamin D in Iraqi Patients With Parkinson Disease
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Background: A role for vitamin D deficiency in Parkinson disease (PD) has recently been suggested.

Objective:: To estimate the state of vitamin D in PD with an age-matched healthy control.

Type of the study: A case control study.

Method: The study randomly comparison of plasma 25-hydroxyvitamin D (25[OH] D) concentrations of collected samples in a clinical neurology department ward / Baghdad teaching hospital / Medical City and Parkinson disease movement disorder clinic. Participants were registered into the study from October 2015 to October 2016. We was study   serum vitamin D level in 40 consecutive patients with

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Publication Date
Sat Sep 30 2017
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Enhancing the Lifting Capacity of Drilling Fluids in Vertical Oil Wells
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Of the many functions that are performed by the drilling fluid, the most important is to transport cuttings from the bit up the annulus to the surface. Various drilling fluid have been widely used in the oil industry to improve lifting capacity. In this study, three mud type have been used which they are, oil base mud, X-anthan polymer and a mixture of CMC and bentonite ,by using Carrying Capacity Index  calculation (CCI) , the Xanthan  gave good values of CCI than other studied drilling fluid. By using Sifferman chart and field data from well in south of Iraq and API equation to find cutting concentration in the annulus, The results showed that the used of thick mud increase the lifting capacity and decrease volumetric drill c

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Publication Date
Tue Oct 23 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Financial Analysis in Investors Decisions ( Iraqi Stock Exchange )
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  The research aims to reveal the role of financial analysis in rationalizing the investor decision on the Iraqi stock Exchange market, by studying the relationship and impact techniques and methods of financial analysis on the decisions of investors in the market. The most important techniques and methods discussed in this study were: analysis (financial ratios analysis, comparison of financial statements analysis, cash flow statement analysis) for companies listed in the Iraqi stock Exchange market. The researcher adopted the analytical descriptive method which depends on the collection of data on the phenomenon and its interpretation. The questionnaire wa

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The strategic role of human resource development in developing competitive advantage
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This research aims at highlighting the strategic role of human resource development in developing competitive advantage in light of the great challenges and rapid changes witnessed in recent years in the business world. The human element is the main engine of the organization's resources, especially when it possesses the skill quality and cognitive abilities commensurate with the nature of work. Therefore, this research focuses on the importance of human resources development strategy in contemporary organizations and reviews the summary of literature and theoretical foundations related to human resources development, as well as various philosophical concepts related to the competitive advantage and to indicate the important role

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Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Engineering
The Use of Bracing Dampers in Steel Buildings under Seismic Loading
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This study focuses on the modeling of manufactured damper when used in steel buildings. The main aim of the manufactured dampers is to protect the steel buildings from the damaging effects that may result due to earthquakes by introducing an extra damping in addition to the traditional damping.
Only Pure Manufactured Dampers, has been considered in this study. Viscous modeling of damping is generally preferred in structural engineering as it leads to a linear model then it has been used during this study to simulate the behavior of the Pure Manufactured Damper.
After definition of structural parameters of a manufactured damper (its stiffness and its damping) it can be used as a structural element that can be added to a mathematica

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
Body Language in the Poetry of Ibn Al-Jayab Al-Farnati
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Language is a means of communication among the human beings. Every language that distinguish them from others. However, there is language common that is common of all human beings without discrimination and expression of ideas. Perhaps it is more honest that the usual language.

            The research is divided into a preface which speaks about the meaning of body language. Then we speak about body gestures like the eyes, hand, the tongue the heart reaching up the conclusion in which we found that the body language is one of the terms included in the Holy Quran, which has original roots. But this term is recently common and spread in the present time. Most of those who tack

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Publication Date
Sat Feb 22 2020
Journal Name
Radiation And Environmental Biophysics
The photo-transferred thermoluminescence phenomenon in case of emergency dose assessment
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Abstract<p>A major disadvantage of dose reconstruction by means of thermoluminescence (TL) is the fact that during readout of any TL material exposed to ionizing radiation (i.e., during measuring the glow curve), the radiation-induced signal gets lost. Application of the photo-transferred thermoluminescence phenomenon (PTTL) may offer a solution to this problem. In PTTL, the residual signal that is not destroyed by conventional TL readout (because it comes from deeper electron traps) can be readout through simultaneous stimulation by UV light and heating, allowing to obtain information about the absorbed dose in a second run. The present paper describes the application of PTTL for emergency dose assessment. For</p> ... Show More
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