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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
Sat Dec 01 2012
Journal Name
Iraqi Journal Of Physics
A computer experiment to study the charging process of dust grains in negative ion plasma
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This work presents a computer studying to simulate the charging process of a dust grain immersed in plasma with negative ions. The study based on the discrete charging model. The model was developed to take into account the effect of negative ions on charging process of dust grain.
The model was translated to a numerical calculation by using computer programs. The program of model has been written with FORTRAN programming language to calculate the charging process for a dust particle in plasma with negative ion, the time distribution of a dust charge, number charge equilibrium and charging time for different value of ηe (ratio of number density of electron to number density of positive ion).

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of strategic Supremacy on strategic success A case study in Thi Qar Governorate
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Purpose To test the effect of strategic Supremacy on strategic success A case study in Thi Qar Governorate, methodology/approach – this is a mandatory entry.

a case study was used and applied to the Department managers of Government of the province of Thi Qar, Research limitations/implications – It is clear that the strategic Supremacy variable is not being used effectively to achieve strategic success.

Practical implications – use strategic supremacy positively to Support for strategic success. implementing and monitoring ignorance of them in how to use thi

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Publication Date
Sun Dec 01 2024
Journal Name
Frontiers Of Nursing
A qualitative study to explain the criteria of nursing managers in selecting effective nursing diagnosis
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Abstract<sec> <title>Objective

This study aimed to explain the criteria of managers at different levels of nursing in selecting effective nursing diagnosis.

Methods

In conventional content analysis, 10 nursing managers at different levels including head nurse, supervisor, and nursing manager were interviewed. Data was collected with semi-structured interviews and a narrative approach. Data analysis was performed using the Zhang–Wildemuth method simultaneously with sampling.

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Publication Date
Wed Sep 09 2020
Journal Name
Academic Journal Of Legal And Political Research
Unilateral Contracts – A Comparative Study under the Anglo-American System and the Iraqi Civil Law
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At a time when the general rules in the different legal systems require the presence of two parties to the contract, one of which is issued the first expression of the will and is called the offer, and the other is issued from the other and is called the acceptance. A special type of contracts emerged in the beginning of the last century called the “unilateral contracts”. The side sparked a major jurisprudential dispute, as well as the issuance of several contradictory judicial rulings on it. Hence, this research came to highlight this special type of contract. Key words: the definition of a unilateral contract, its distinction from other legal situations, and its effects.

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of College Of Education For Women
The Decisive Answers: A Pragmatic Linguistic Study
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يهتم هذا البحث بدراسة الأجوبة المسكتة,وهي أجوبة سريعة وحاسمة تقطع حجة الخصم وتفحمه وتغلقالحوار.وقد أرتكز البحث على منهجية تداولية تنظرإلى فاعلية الجواب المسكت في المحاورة وإنهائها من زواياإنجازية و حجاجية.وقد تكون البحث من ديباجة ممهدةوثلاثة مباحث.وسلطتالديباجةالممهدةالضوء علىمفهومالجواب المسكتوشيوعهفي كتب الأدبوالأخبارونوادر الكلاموكيف يمكن النظر لهبوصفه وحدة حوارية تنبنيمنها المحادثة؟أما المبحث ا

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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
The Decisive Answers: A Pragmatic Linguistic Study
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The current research is concerned with studying the decisive answers which are considered quick and conclusive. These answers can effectively interrupt the opponent's argument and close the dialogue.This research is concentrated on deliberative methodology focusing on the decisive answer's activity and ending them through several completing and argument sides. This research consists of an introduction and three parts, the current introduction is focused the light on the concept of decisive answers and its uses in literature and the scarce of speech, and how to consider it with one dialogue description,that dialogue constitute by ? The first part is concerned with those answers through the deliberative methodology and classifying decisive

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of the Banking Capital on Finance Fixed Assets of the Bank: An Applied Study on a Sample of Iraqi Private Banks
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To the Banks capital several uses, including the protection of deposits and this was approved by the Basel Committee, And Finance long-term investments which intended to investment in fixed assets that are essential to the continuation of banking activity, Fixed assets not financed from the funds of the deposit, but the owner equity do this jop. the current research tries to prove the effect of banks capital on fixed assets for a sample of iraqi private banks (bank of baghdad and Iraqi middle east Investment bank), for the period from 2011 until 2014. The research concluded that the capital of bank of baghdad affect on his total fixed assets by (84%), and the capital of Iraqi middle east Investment bank affect on his total fixed assets b

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Publication Date
Thu Jun 15 2017
Journal Name
International Journal Of Computer Applications
Analytical and Numerical Study of the Temperature Distribution for a Solid Sphere subjected to a Uniform Heat Generation
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Publication Date
Wed May 17 2023
Journal Name
College Of Islamic Sciences
A stylistic vision of the objection in the Quranic discourse
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The modern stylistic lesson has become more committed to the scientific limits in which it believed, and more confident in itself, and it is no longer just a scientific procedure that helps other curricula and sciences that preceded it.

Based on this, our modest research ((a stylistic vision of the objection in the Quranic discourse)) arose to explore an artistic rhetorical phenomenon that was included in the Holy Quran text. ; Because analysis is a situation that allows us to see a lot and absorb the stranger more clearly.

And since the horizontal arrangement of the linguistic elements in which stylistically undistinguished elements meet with distinct ones, the other trend has emerged that believes that the stylistic dis

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Media in Developing the Tax Awareness of the Iraqi Citizen: Applied Study in the General Commission for Taxes
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 Interested in many scholars and reseachers  the subject of the media and means varied his roleinfluential in the definition of the public of issues and political, cultural, social and because of its spread wide and ability to address the people of all levels effect them  in the formation consciousness of those issues and types of this awareness is an awareness of the tax, contribute to media formation consciousness tax through the definition of people what tax and importance of the role of its revenues to supplement the state budget by posting tax laws and regulations of applied and all what respect process account tax, to be in charge of the tax familiar enough about this, which avoid being cheated taxmisleading when rev

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