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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 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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Publication Date
Wed Jan 01 2014
Journal Name
International Journal Of Computer Applications
Enhancing the Delta Training Rule for a Single Layer Feedforward Heteroassociative Memory Neural Network
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In this paper, an algorithm is suggested to train a single layer feedforward neural network to function as a heteroassociative memory. This algorithm enhances the ability of the memory to recall the stored patterns when partially described noisy inputs patterns are presented. The algorithm relies on adapting the standard delta rule by introducing new terms, first order term and second order term to it. Results show that the heteroassociative neural network trained with this algorithm perfectly recalls the desired stored pattern when 1.6% and 3.2% special partially described noisy inputs patterns are presented.

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
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
Fri Feb 05 2021
Journal Name
Proceeding Of The 1st Conference On Dust Storms And Their Environmental Effects
Deposition of Major and Trace Elements From Atmosphere Over Baghdad During the Year of 2010.
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Publication Date
Sun Jun 05 2022
Journal Name
Sport Tk-revista Euroamericana De Ciencias Del Deporte
Level of professional pressures during the use of e-learning teaching method among teachers of the Faculties of Physical Education and Sports Sciences in Baghdad
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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
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Role of the values of accounting culture in maximizing financial performance - A field study in a sample of Iraqi banks
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The influence of culture on accounting systems and practices, including financial reports and accounting information through the values ​​identified by Gray and derived from social-cultural values, and the four accounting values ​​were derived from generally accepted accounting principles represented by (Conservatism, Uniformity, Secrecy, and Professionalism). Important and significant in maximizing financial performance, and measuring the extent of the role of these values ​​in improving financial performance through attention to the values ​​of accounting culture, this research

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Publication Date
Wed Jan 15 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The responsibility of the administration in compliance with the going concern assumption during the preparation for their financial statements: Research practically at muster of companies
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This research aims to demonstrate the impact of the going concern assumption in different accounting applications to provide a realistic look and more accurate result of activity and financial situation, as well as determining the responsibility of the Company's administration in compliance with the going concern assumption during the preparation for their financial statements, and to clarify the concept of integration between internal audit and external audit about going concern assumption, besides its importance and usefulness on the work of both of the internal auditor and the external auditor, as well as on the company under auditing process.This research purports preparing an internal audit program, including a set of auditing actio

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Publication Date
Thu Aug 16 2018
Journal Name
International Journal Of Research In Social Sciences And Humanities
The Social Interaction of Langauge in a Comic Series: A Sociolinguistic Study
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DBNRAHA Hameed, IJRSSH PUBLICATION, 2018

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