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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.

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 Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of voluntary accounting disclosure in enhancing information confidence in

 

ABSTRACT:

The study aimed to identify the impact of the role of voluntary accounting disclosure in enhancing confidence in the informational content of financial reports. Correlation - Spearman to measure the degree of correlation, as well as the method of simple linear regression analysis, and the study reached several results, including: The level of enhancing the information content in the annual financial reports of the Palestinian banks listed on the Palestine Exchange under study reached the overall average (total) (94.1%), and also Voluntary Accounting Disclosure in Enhancing Confidence in the Informational Content of the List of Change in Ownership Equity of Listed

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Publication Date
Sun Jun 05 2011
Journal Name
Baghdad Science Journal
The origin of bacterial contamination in AL-Habania reservoir in Iraq

Bacterial contamination of AL-Habania reservoir was studied during the period from February 2005 to January 2006; samples were collected from four stations (AL-Warrar, AL-Theban regulator, middle of the reservoir and the fourth was towards AL-Razzaza reservoir). Coliform bacteria, faecal Coliforms, Streptococci, and faecal Streptococci were used as parameters of bacterial contamination in waters through calculating the most probable number. Highest count of Coliform bacteria (1500 cell/100ml) was recorded at AL-Razaza during August, and the lowest count was less than (300 cell/100ml) in the rest of the collection stations for all months. Fecal Coliform bacteria ranged between less than 300 cells/100ml in all stations for all months to 700 c

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Publication Date
Mon Aug 02 2021
Journal Name
Al Ustath
Normalizing Society in George Lamming’s In the Castle of My Skin

This study examines the effect of colonialism on Caribbean society during the colonial period. Through normalization, the British colonial power diminished Caribbean identity and planted a new hybrid identity. Discipline institutions and surveillance techniques had a vital role in normalizing Caribbean society. Caribbean authors have adopted this notion of normalization to represent the reality of colonialism and its consequences. George Lamming, one of the Caribbean political activist and influential novelist in his novel In the Castle of My Skin (1953), reflects normalization as theorized by Michael Foucault. Lamming depicts the story of villagers and their life under colonial domination. Through discipline institution, like school, colo

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Publication Date
Sun Mar 12 2017
Journal Name
Al-academy
Functions of Repetition in Deeping the Esthetic Meaning in Television Drama

The audio-visual arts are considered modern arts compared to theater, plastic arts, and music. It proved its distinguished presences among other arts. It was capable of forming a huge audience and took television from cinema, literature, theater, type of narration, and narrative instructor. Also, it took symbolism and metaphorical repetition from literature. As for the importance of the functions that repetition has the research concentrated on the importance of function of repetition in deeping the esthetic meaning in television drama. The research was limited by:1.Objective limit: functions of repetition in deeping the esthetic meaning in series of (Harem Al-Sultan).2.Place where it was showed: series of (Harem Al-Sultan) part four on

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of The College Of Education For Women
Humanize nature in the poetry of childhood in Iraq (2003-2015)

That the nature of an important role in children's lives, Including offer them fun and freedom of thinking and capacity in the imagination. And its effective role of poets in general and especially apoet of childhood Selecting from diverse elements, And the rise to the level of human nature In order to enrich the child's imagination And the delivery of various ideas and information in a surprising. And are far from the decision-making and direct screed.this importance we set off For the study of poetic texts for children in Iraq During the research stage. Those texts in which the humanization began clearly,and our offer to these texts in style of detail and precision Not without expressing an my opinion during the research We finished th

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Publication Date
Sat Apr 30 2016
Journal Name
Environmental Science And Pollution Research
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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
Standarized Basics in Depicting Walis in the Early Age of Islam

Despite the simplicity that characterized the administration in the era of the Prophet
(peace be upon him), but it put the Muslim community nucleus Administrative Organization
who walked Garret Caliphs (RIP) and came after them, who added to this organization what
they found necessary and dictated by their conditions of life has begun regulation Managing
this appoint leaders and armies of workers on the state and various tribes to spread the Islamic
religion and to teach people the provisions of the Koran and Altfvh in religion and establish
prayer and collect Zakat money so you do not appoint leaders and workers and governors
followed random, but it is in an objective manner takes reasons to meet expectations.

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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
The frequency of hypoglycemia in macrosomic neonates in Amarah governorate, Iraq

Background: Neonatal macrosomia is defined as a birth weight of more than 4000 g. Significant maternal and neonatal complications can result from the birth of macrosomic infants like hypoglycemia and birth injuries.Objectives: To determine the frequency of hypoglycemia in neonates with macrosomia in Amarah, IraqMethods: The study involved 146 macrosomic newborn neonates delivered in 2 maternity hospitals in Amarah, Iraq during a period from June 2011 to June 2014.Results: Hypoglycemia was observed in 16% of neonates affected by macrosomia. Maternal diabetes was the most common cause of fetal macrosomia (28%).Our results were compared with those from other parts of the world.Conclusion Macrosomia is associated with increase rate ofneonata

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Publication Date
Wed Jan 13 2021
Journal Name
Iraqi Journal Of Science
The Role of Quality Management System in Promoting Innovation in Companies

This article makes it possible to verify the role of quality management in strengthening the innovation process. The first hypothesis, according to which the quality (certification ISO 9001) influences the innovation positively, is confirmed for certain innovation indicators. Another hypothesis indicates that there are the levels of quality which develop the innovation process in diverse ways. The results indicate that for some domains of innovation, the performance of innovation of enterprises that have a very increased level of quality is higher than those of enterprises with an average quality, which in return is higher than those enterprises having a low quality level. Therefore, we discovered that the difference of performance innov

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The incidence of thyroid malignancy in multinodulargoiter in Alkindy teaching hospital.

Back ground: The incidence of malignancy in multi-nodular goiter is thought to be low as compared with solitary thyroid nodule.
Objectives: Identifying incidence of malignancy in multi-nodular goiter.
Patients and Methods: This is a prospective study at Al-kindy teaching hospital from January 2013 to September 2015. 160 patient with multi-nodular goiter were included in the study (132females,28 males)  their ages ranged between 17-75 years with a mean age of 35.88 years. Each of the patients had special form of detailed information including history and physical examination ,results of investigations; all the patients had near total thyroidectomy. All the specimens were fixed in formalin and sent for histo-pathological evaluat

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