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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 Nov 17 2021
Journal Name
International Journal Of Knowledge Management
Assessing the Success of the Perceived Usefulness for Knowledge Management Systems
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Recently, Knowledge Management Systems (KMS) consider one of the major fields of study in educational institutions, caused by the necessity to identify their knowledge value and success. Hence, based on the updated DeLone and McLean’s Information Systems Success Model (DMISSM), this study set out to assess the success of the Perceived Usefulness of Knowledge Management Systems (PUKMS) in Iraqi universities. To achieve this objective, the quantitative method is selected as the research design. In total, 421 university administration staff members from 13 Iraqi private universities were conducted. This study highlights a number of significant results depending on structural equation modeling which confirms that system, information, and s

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Publication Date
Tue May 30 2006
Journal Name
Baghdad University
Unpublished Cuneiform Texts From The Reign Of The King Ammi Şaduqa
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The cuneiform texts considered one of the most important resources which play an important role help us to know how was the economic , politic and religious manner and every thing have relation of the history of Mesopotamia which contain many of information that enrich our knowldgement every side of Mesopotamia civilization since using writing as away to register the science and human knowldgement . The city of Sippar (Abu –Habba ) was one of most important city of ancient Mesopotamia which mentioned as one of first five Mesopotamian cities found before floating and it exposed through excavating rich one of them tablet which some of it dated to old Babylon period . The king Ammi-Saduqa has a big share of tablet we study number of thi

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Publication Date
Sat Oct 20 2018
Journal Name
Journal Of Economics And Administrative Sciences
The effect of The Organizational Agility On High Performance ( Applied Search )
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Abstract

The current research aims to know  the  reality of the  research's coefficients, to know  correlation and effectiveness  between  the  organizational  Agility  and high performance . The current research  has been applied on  the official banks , including  a sample of  senior administration  members  (120) ; besides , the research has used questionnaire  that being considered as the main tool for gathering  information  and data . It includes  59 questions  in addition to  the personal interviews  program  as to support  the questionnaire and to fulfill a great deal of reality. It has been anal

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Publication Date
Sun Mar 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Use the method of parsing anomalous valueIn estimating the character parameter
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In this paper the method of singular value decomposition  is used to estimate the ridge parameter of ridge regression estimator which is an alternative to ordinary least squares estimator when the general linear regression model suffer from near multicollinearity.

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Publication Date
Thu Nov 01 2018
Journal Name
International Journal Of Computing And Digital Systems
The Perception of Information Security Threats Surrounding the Cloud Computing Environment
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Publication Date
Fri Dec 31 2021
Journal Name
Political Sciences Journal
The development of Russian-Iraqi relations for the period (2011-2019)
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Receipt date: 12/28/2020 accepted date: 20/1/2021 Publication date: 12/31/2021

Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

Russia has emerged as a rising and influential power in the international arena, especially with Vladimir Putin's assumption of power and his desire for the rise of Russia and the end of the "unipolarism" represented by the hegemony of the United States of

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Publication Date
Fri Jan 01 2021
Journal Name
دراسات قانونية
The Legal Nature of the Build-Operate- transfer-Ownership Contract (B.O.T.)
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The legal nature of the Build-Operate-Transfer-Ownership Contract (B.O.T) The Build, Operate, and Transfer of Ownership Contract (BOT) has emerged as the most successful and safest method for involving the private sector in public sector services. The major infrastructure projects that are built through the BOT contract are no longer financed by the state and its budget, but the private sector has played a major role in financing These projects, especially developing countries that need to establish infrastructure or modernize their existing infrastructure, especially in the areas of transport, communications, services, electricity, water ..... and other public utilities.

Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of tax reform to increase the federal budget revenues
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The percentage contribution of tax revenue in the federal budget is verysmall compared with the revenue earned from oil revenues, as the dependenceon oil revenues mainly to finance the state budget, have a negative impact onthe national economy as it makes it a one-sided and prisoner of on revenue, thatis the revenue derived from oil which is unstable revenue for continuouschanging in the price of oil The oil revenues reached to (85.4%) in 2009 withpercentage (93.11%) in 2013, The research objective is to study the possibilityof increasing tax revenues in order to raise the proportion of its contribution infinancing the federal budget through effective tax reforms, The mainconclusion of the research is
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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of College Of Education
Recognition the Arabic Characters Based on the Characteristics of Arabic Language
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Publication Date
Sun Mar 05 2017
Journal Name
Baghdad Science Journal
Study a concentration of Uranium for samples of soil from Falluja City using PM-355
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In this study a concentration of uranium was measured for twenty two samples of soil distributed in many regions (algolan, almoalmeen, alaskary and nasal streets) from Falluja Cityin AL-Anbar Governorate in addition to other region (alandlos street) as a back ground on the Falluja City that there is no military operations happened on it. The uranium concentrations in soil samples measured by using fission tracks registration in (PM-355) track detector that caused by the bombardment of (U) with thermal neutrons from (241Am-Be) neutron source that has flux of (5×103n cm-2 s-1). The concentrations values were calculated by a comparison with standard samples. The results shows that the uranium concentrations algolan street varies from(1.

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