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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 Oct 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The impact properties of strategic thinking in the stages of the application Business process re-engineering: A survey Study of the consultant of a sample of managers and their assistants and consultants in the General Company for Cotton Industries
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Need organizations today to move towards strategic thinking which means analyzing situations faced by particular challenges of change in the external environment, which makes it imperative for The Organization That to reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures, to try to achieve improvement root in the installation of the organization and methodscompletion of its work towards achieving high levels of performance and that is reflected to achieve its objectives, and this is what aims to Current search to deal with implications characteristics of strategic thinking in the stages of application re-engineering business of the company General Industries

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Publication Date
Thu Jun 01 2023
Journal Name
Iraqi Journal Of Physics
Monitoring Land Surface Temperature (LST) and Land Cover of Basra Province using Remote Sensing Technique and GIS
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This study investigates the changes occurring in the province of Basra using geospatial methods and analyzes the variations in land surface temperature among the various types of land cover. For the months of July and December in the years 2013 and 2021, Landsat images were used in Landsat 8 OLI/TIRS, and satellite images were processed using ArcGIS 10.8 software. The study's categories for land use and land cover were generated through the application of supervised classification techniques, and the land surface temperature was calculated using data from a satellite sensor's brightness temperature. According to the study's findings, there has been an increase in urban areas (including barren land). From 2013 to 2021, a greater correlati

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Publication Date
Fri Nov 15 2024
Journal Name
Iraqi Journal Of Science
Comparative Analysis for the Seasonal Variations of the IF2 and T Ionospheric Indices during Solar Cycles 23 and 24
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In this work, a comparative analysis for the behavior and pattern of the variations of the IF2 and T Ionospheric indices was conducted for the minimum and maximum years of solar cycles 23 and 24. Also, the correlative relationship between the two ionospheric indices was examined for the seasonal periods spanning from August 1996 to November 2008 for solar cycle 23 and from December 2008 to November 2019 for solar cycle 24. Statistical calculations were performed to compare predicted values with observed values for the selected indices during the tested timeframes. The study's findings revealed that the behavior of the examined indices exhibited almost similar variations throughout the studied timeframe. The seasonal variations were

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Compare Prediction by Autoregressive Integrated Moving Average Model from first order with Exponential Weighted Moving Average
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The prediction process of time series for some time-related phenomena, in particular, the autoregressive integrated moving average(ARIMA) models is one of the important topics in the theory of time series analysis in the applied statistics. Perhaps its importance lies in the basic stages in analyzing of the structure or modeling and the conditions that must be provided in the stochastic process. This paper deals with two methods of predicting the first was a special case of autoregressive integrated moving average which is ARIMA (0,1,1) if the value of the parameter equal to zero, then it is called Random Walk model, the second was the exponential weighted moving average (EWMA). It was implemented in the data of the monthly traff

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Publication Date
Sat Jan 01 2022
Journal Name
Middle East African Journal Of Ophthalmology
Obstacles and challenges facing Iraqi women ophthalmologists
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Publication Date
Sat Nov 01 2014
Journal Name
International Journal Of Statistics
Single and Double Stage Shrinkage Estimators for the Normal Mean with the Variance Cases
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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The impact of wages and benefits systems on the performance of employees A field study in the General Company for Food Industries in the city of Baghdad
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The research aims to find out the impact of wages and benefits systems on the performance of employees, which included the research community on a sample of employees in the company, and the sample consisted of (50) employees and an employee, A questionnaire composed as prepared (23) paragraph, use the promised statistically methods in data collected by the questionnaire analysis. The research reached a number of results, the most prominent of which were: There is a correlation between wage systems, benefits and performance of employees, and the presence of the impact of the systems of wages and benefits to the performance of employees. The research was presented a set of recommendations including: increasing the effectiveness of

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Publication Date
Wed Jan 01 2020
Journal Name
International Journal Of Innovation Creativity And Change.
The Role of Strategic Improvisation on the Entrepreneurial Orientation; a Field Study in a Sample from the Rafidain Bank
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The research aims to identify the role of strategic improvisation as an independent variable with its dimensions (Building the Solution, Intuition, Adaptation, and Spontaneity) and the Entrepreneurial Orientation as a dependent variable with its dimensions (Identifying Opportunities, Creativity, Adopting risk, and Vision). This research has been applied in the Rafidain Bank and its branches (Sunk, People, Al-Firdaws, and Alawiya); it used the questionnaire as a basic tool for collecting information. The sample was intentionality, which included all the heads of departments in the bank’s branches, which amounted to (33) workers, and data on the questionnaire paragraphs of 28 were processed using the SPSS V.23 and AMOS V.23). The most impor

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Publication Date
Wed May 17 2023
Journal Name
College Of Islamic Sciences
The origins of the structure of nominative pronouns, a linguistic study
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The Arabic pronouns received a lot of attention from the ancient Arab grammarians, so they explained their origins, the different forms of their structure, and the aspects of the Arabs’ use of them, and explained the aspects and reasons for these uses, with what they had of linguistic insight, which guided them to clarify the truth of these pronouns.
And recently, this research seeks new knowledge of the development of the structure of the nominative pronouns (he), (she), (them), (taa), and (waw) between dialects and towards classical Arabic, by analyzing the structure of these pronouns into their components. Its linguistic formulas are traced from the ancient Arabic texts, and by ancient I mean the texts of the era of linguistic ci

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Publication Date
Tue Jun 14 2016
Journal Name
Al-academy
Idealism and Realism in The Design: A Comparative Study
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At the beginning of the twentieth century distorting handling totalitarian phenomena of art, which can be called the stage of the test, transition from the theory of ideal theory and other realistic is not cushy, since it requires vision and reading and other concepts, and in light of this dialectic manifested research problem by asking the following Is affected by the design idealism and realism. Through the above mentioned questions, the researcher found rationale for addressing this problem, the study through his research, which is marked (idealism and realism in a comparative study design). And demonstrated the importance of research in the identification of the concept and the effectiveness of the two theories idealism and realism a

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