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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
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
Towards a proposed conception of the role of the professional practice specialist for social work In the field of social care for corona patients (A field study at the Iraqi Ministry of Social Affairs)
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This study aimed to identidy the role of a professional social worker practice specialist in the field of social care for Corona patients, in light of some demographic variables such as (gender, marital status, economic status,), through a field study at the Iraqi Ministry of Social Affairs. A random sample of (50) social workers in the Iraqi Ministry of Social Affairs in various places affiliated with the ministry was chosen. a questionnaire developed by the researcher about the role of the social worker in the field of social care for Corona patients was administered to the study sample to collect the needed data. The results showed that there is a positive statistically significant correlation relationship at the level (0.01) between

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Publication Date
Thu Jan 20 2022
Journal Name
Webology
The Effect of Strategic Information System in Global Marketing Channel: A Case Study
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The research dealt with the issue of strategic information systems and its impact on the global marketing channel. As the research aims to know the strategic information systems used in the cement company. Which support the senior management in supporting decisions taken in the process of global orientation and moving to foreign markets by choosing the marketing channel that will suit the company. Product and competition with it. With other companies' products. The problem of the study focused on how to move to global markets, and any marketing channel that can be followed to move the cement product globally, what are the strategic information systems used in the company and how will it contribute to supporting senior management dec

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Publication Date
Mon Jan 01 2024
Journal Name
Corporate And Business Strategy Review
The role of strategic agility in promoting organizational excellence: A descriptive analytical study
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The study aims to build a model that revolves around the main question of the role of strategic agility (SA) in enhancing organizational excellence (OE). For the purpose of achieving OE and to determine the extent of interest and knowledge of managers at the Midwest Refineries Company (MRC) on the theoretical and practical implications, and on the performance foundations of these two vital variables with the aim of continuous improvement. A questionnaire was used and distributed to a random sample of 54 managers in this important energy production company. The study followed the descriptive analytical approach to answer the questions raised. The study model and dimensions were built according to reference models, most notably the mo

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
A Study of Person Deixis in J. M. Singe's Riders to the Sea
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This study deals with an important area in the field of linguistics, namely person deixis.
The study aims at: (1) Describing the notion of deixis, its importance, and its place in the field
of linguistics, (2) Presenting a detailed illustration of person deixis, and (3) Conducting an
analysis of person deixis in one of Synge‟s plays Riders to The Sea according to Levinson‟s
model. The most important aim of these three is the third one (the analysis). To achieve this
aim, the researcher depends on Levinson‟s (1983) descriptive approach. According to the
descriptive approach of deixis, the category of person deixis can be defined as the encoding of
the participant roles in the speech situation. This encoding is r

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Publication Date
Fri Apr 26 2024
Journal Name
Corporate And Business Strategy Review
THE ROLE OF STRATEGIC AGILITY IN PROMOTING ORGANIZATIONAL EXCELLENCE: A DESCRIPTIVE ANALYTICAL STUDY
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he study aims to build a model that revolves around the main question of the role of strategic agility (SA) in enhancing organizational excellence (OE). For the purpose of achieving OE and to determine the extent of interest and knowledge of managers at the Midwest Refineries Company (MRC) on the theoretical and practical implications, and on the performance foundations of these two vital variables with the aim of continuous improvement. A questionnaire was used and distributed to a random sample of 54 managers in this important energy production company. The study followed the descriptive analytical approach to answer the questions raised. The study model and dimensions were built according to reference models, most notably the models (Al-

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Publication Date
Thu Jun 29 2017
Journal Name
College Of Islamic Sciences
Fairness in explaining the provisions of endowments A study to clarify the provisions of endowments according to the views of the Jaafari school of thought compared to the provisions of Iraqi laws.
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In The Name of Allah Most Gracious Most Merciful

It is no secret to everyone that the endowment is an important nucleus for the prosperity of Islamic civilization, especially in the fields of education, health, economy, and defensive military actions that fall within the door of jihad, and so on. Al-Ashraf, Qom Al-Quds, Cairo, and other parts of the Islamic world. What we will see in the research.

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Publication Date
Mon Jan 01 2018
Journal Name
Aip Conference Proceedings
Theoretical study of electronic transfer current rate at dye-sensitized solar cells
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Publication Date
Sat Jan 01 2011
Journal Name
Iraqi Journal Of Physics
Single Particle Level Density in a Harmonic – Oscillator Potential Well
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The purpose of this paper is to study the properties of the
partial level density ( ) l g and the total level density g ( ),
numerically obtained as a l sum of ( ) l g up to 34 max l  , for
a Harmonic – Oscillator potential well. This method applied the
quantum – mechanical phase shift technique and concentrated
on the continuum region. Also a discussion of peculiarities of
quantal calculation for single particle level density of energy –
dependent potential

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Publication Date
Sun Nov 01 2020
Journal Name
The International Journal Of Oral &amp; Maxillofacial Implants
Early Failure Rate and Associated Risk Factors for Dental Implants Placed With and Without Maxillary Sinus Augmentation: A Retrospective Study
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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measuring the relationship between the skills required for the labor market and the employment of graduates of community colleges in KSA: An applied study on a sample of faculty members at KKU
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This study has aimed to measure the relationship between the skills required for the labor market and the employment of graduates of community colleges at King Khalid University. For gathering the required data, a questionnaire has been designed and distributed to the faculty members of community colleges at King Khalid University in a random sample method. The chosen sample size has covered (123) individuals. Questionnaire forms have been distributed and retrieved from (117) participants. Therefore, the estimated response has reached 95 % of the total sample size. The results of the study have shown that there is not any significant relationship between the skills which the graduates   acquire and the requirements of employmen

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