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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
Tue Jan 08 2019
Journal Name
Iraqi Journal Of Physics
Effect of TiO2 on the sintering behavior and microstructure of stoichiometric spinel (MgAl2O4)
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In this work, magnesium aluminate spinel (MA) (MgO 28 wt%, Al2O3 72 wt%) stoichiometric compound , were synthesized via solid state reaction (SSR) Single firing stage, and the impact of sintering on the physical properties and thermal properties as well as the fine structure and morphology of the ceramic product were examined. The Spinel samples were pressed at of (14 MPa) and sintering soaking time (2h). The effect of adding oxide titania (TiO2) was studied. The obtained powders were calcined at a temperature range of 1200 and 1400 °C. The calcined samples spinel were characterized by XRD, it showed the presence of developed spinel phase end also showed that the best catalyst is titania. The SEM image showed the high sintering temperat

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Publication Date
Wed Jan 01 2025
Journal Name
International Journal Of Applied Science And Engineering
Assessment of the properties of asphalt mixtures modified with LDPE and HDPE polymers
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The performance of asphalt pavements is crucial due to heavy traffic loads from civil and industrial developments. Various additives and modifiers are used in flexible roads to improve their resistance to deterioration caused by climatic changes. From this context, modifying the asphalt binder with polymers is popular in asphalt pavement construction. The present research investigates the effect of Polyethylene (PE) polymers in powder form on the characteristics of asphalt mixtures since these polymers are composed of hydrocarbons. It is similar to asphalt binders, making them very effective in enhancing the performance of neat asphalt produced from the oil refinery. To confirm this, two types of PE, High-Density PE (HDPE) and Low-Density P

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Publication Date
Wed Jan 01 2025
Journal Name
Journal Of Advanced Transportation
Resilience and Environmental Performance of SMEs: The Mediating Role of Ambidextrous Green Innovation
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The disruptions in supply chains have put small‐ and medium‐sized enterprises (SMEs) in dire need of resilient supply chains through which they can improve their performance. Based on the resource dependence theory, this study proposes a mediation model to improve the environmental performance (EP) of SMEs. The purpose of this study is to investigate the effect of supply chain resilience (SCR) on EP mediated by ambidextrous green innovation (AMGI). We proved a structural equation model based on questionnaire data from 261 companies in Iraq to test our hypotheses. The results show that SCR has a positive effect on AMGI for proactive and exploitative green innovation dimensions and positive impact on SMEs’ EP. AMGI plays a media

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Publication Date
Sat Dec 31 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
AREAS OF ORGANIZATIONAL CHANGE AND THEIR IMPACT ON THE STRATEGIC MARKETING PLANNING PROCESS: AREAS OF ORGANIZATIONAL CHANGE AND THEIR IMPACT ON THE STRATEGIC MARKETING PLANNING PROCESS
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ABSTRACT

            The aim of the research is to identify the impact of the areas of organizational change in strategic marketing planning in cement factories operating within the city of Al-Khums, and this effect was measured using a questionnaire consisting of 28 phrases, and it was relied on the descriptive approach that suits the nature of the subject of the research, while the research community consists of heads And members of the board of directors, authorized managers, unit managers and heads of departments in the factories under study, which numbered 55 respondents, during the month of September of the year 2021, and a sample of the compreh

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Publication Date
Sat Nov 12 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of government investment spending on tax revenue in Iraq from( 2008 – 2020) : Applied research in The General Authority for Taxes.
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The expenditures of the general budget, in its operational and investment divisions, are a basic factor in the economic and social growth of any country, and its impact on various economic activities such as income, employees , and the standard of living of members of society. This was based on a basic premise: Does increasing or decreasing investment expenditures have an effect on increasing or decreasing the tax proceeds, What is the level of relationship between them? and to achieve the goal of the research, an inductive and analytical method was chosen to measure the impact of the investment budget expenditures on the tax outcome quantitatively using the financial data obtained from The General Authority for Taxes, Ministry of Financ

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Sport Sciences
The effect of using the McCarthy model according to cognitive style (rigid- flexibility) in learning some skills in artistic gymnastics for women
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The aim of the research is to identify the cognitive method (rigidity flexibility) of third-stage students in the collage of Physical Education and Sports Sciences at The University of Baghdad, as well as to recognize the impact of using the McCarthy model in learning some of skills in gymnastics, as well as to identify the best groups in learning skills, the experimental curriculum was used to design equal groups with pre test and post test and the research community was identified by third-stage students in academic year (2020-2021), the subject was randomly selected two divisions after which the measure of cognitive method was distributed to the sample, so the subject (32) students were distributed in four groups, and which the pre te

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Publication Date
Thu Dec 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Organizational Transparency influence in reducing administrative corruption financially studing analytcal analysts of the same man from the upper leaders in iraqi Organizations
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The Organizational Transparency is regarded one of the effective means in the attempts of the restoration and working to prevent the corruption and reduce the negative managerial economic social and political effects.

Accordingly, this study aims at importance of performing an explorative analytical study in order to stand on the effect of the Organizational Transparency in the reduction of environment of Iraqi Organizations.

To achieve this study, three hypotheses were chosen; the first is the correlation relation and the second is the effect and the third is the differences, and statistical means represented by correlation coefficient "Spearman", "", "Mann- Whit

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Quality Function Deployment in Evaluating The Product Applied Research in General Company For Vegetable Oil Industry- Al-M'amoon Factory
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The Quality  function deployment (QFD)  tool is an important  tool of total quality management because its a link between two important parts customer and production process of the product, using advanced House of quality, which contributed to provide more details about improving the product before it had a vision for the future of the product be improved. Also the identification of the two competitors (Alwazeer , Altouri) bases on the survey of retailers  which they identified five competitors products (Alwazeer , Altouri , Ferry , Jif , Dina)for the product (Zahi). Then House of quality  to product (Zahi) has been developed  By using a Kano Model  to classify of customer's requirements for the

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Publication Date
Sun Mar 15 2020
Journal Name
Al-academy
The Role of the Passive Conditioning in Achieving Thermal Comfort in Temporary Hotel Units: سماح محمد طالب الدويك-سامي أبوطالب-محمد صابر
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This research is based on monitoring the local and environmental technologies in the design of the temporary hotel units (nomadic tents) in the desert in the south of Jordan in order to air condition them in summer and winter, maintaining the Jordanian identity, that they are presented with the form and technologies of the age in order to get to the universality.
The research adopted the descriptive analytical method and the researcher conducted the analysis of SWOT specified for the analysis of the positive and negative aspects in the design of the temporary hotel units and comparing them with the case studies available in the chosen research area "the Jordanian golden triangle", through the elements of the case under study. The res

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Comparison Between Nelson-Olson Method and Two-Stage Limited Dependent Variables (2SLDV ) Method for the Estimation of a Simultaneous Equations System (Tobit Model)
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This study relates to  the estimation of  a simultaneous equations system for the Tobit model where the dependent variables  ( )  are limited, and this will affect the method to choose the good estimator. So, we will use new estimations methods  different from the classical methods, which if used in such a case, will produce biased and inconsistent estimators which is (Nelson-Olson) method  and  Two- Stage limited dependent variables(2SLDV) method  to get of estimators that hold characteristics the good estimator .

That is , parameters will be estim

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