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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
Thu Feb 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Insights of Experienced Pharmacists Regarding the Iraqi health Insurance Program: A Qualitative Study(Conference Paper )#
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The aim of study was to explore pharmacist insights toward the impact of prospective implementation of the national health insurance program on patients, providers and Iraqi health system.

This was a qualitative study including semi-structured face-to-face (mostly) interviews with experienced pharmacists. The interview guide included open-ended questions about the impact of the national health insurance program on patients and healthcare providers at three levels: quality of services, costs, and frequency of visits. Potential challenges were also discussed. Interviews were conducted in four provinces from March to May 2022. Thematic analysis was used to analyze the interview findings and generate themes and subthemes.

The

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Publication Date
Mon Jul 01 2024
Journal Name
Iop Conference Series: Earth And Environmental Science
An Economic Study of the Margins and Profits of Middlemen in the Marketing of Chicken Meat Marketing Channels in Baghdad Province for the Season 2023
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Abstract<p>Marketing studies are important to researchers and policy makers. The study of marketing margins and efficiency is important to understand the marketing problems that face parties of the marketing process. The aim of the research is to measure the efficiency margins and the most important marketing channels for marketing chicken meat in the province of Baghdad and to identify the most important marketing problems facing marketers of the commodity. The absolute marketing margins were (0, 1360, 1570, 1545) for the four channels respectively, while the price paid by the consumer was variable according to the marketing channel (3150, 3790, 3920, 4065) for the four channels respectively. T</p> ... Show More
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Publication Date
Mon Jul 04 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of agricultural insurance in the prevention of financing risks in the form of slam : "An Empirical Study on Shikan Insurance and Reinsurance Company
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The aim of this research is to introduce agricultural insurance, to define financing in the form of salam and the role of agricultural insurance in the prevention of risks to agricultural finance operations in the form of salam by verifying the hypotheses through which to reach the results, including the imposition of risks for agricultural finance in the form of salam, The study of agricultural finance in the form of salm, the deductive approach to the development of the problem of research and hypotheses, and the inductive method to extrapolate the results through analysis and brother The researcher concluded that agricultural insurance works to bridge the risks facing agricultural finance in the form of the ladder in cases of

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Publication Date
Mon Jun 26 2023
Journal Name
International Conference On Scientific Research &amp; Innovation (icsri 2022)
Age and gender profile of coronavirus disease 2019 (COVID 19) in Quarantine Center in Baghdad, Iraq
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Publication Date
Mon Jun 26 2023
Journal Name
International Conference On Scientific Research &amp; Innovation (icsri 2022)
Age and gender profile of coronavirus disease 2019 (COVID 19) in Quarantine Center in Baghdad, Iraq
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Publication Date
Thu Nov 01 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Factors That Contribute to Bladder Cancer
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Abstract Objective: The study aimed to assess the factors contributes of patient with bladder cancer and to find out the relationship between the factors of bladder cancer with certain variable. Methodology: A descriptive study to assessment of factors that contribute to bladder cancer that was carried out Al-Karama teaching hospital, Al-Kendy teaching hospital, Specialty Surgery teaching hospital and Al-Yarmok teaching hospital for the period of November 2003 to August 2004. A purposive (non-probability) sample of (100) patients with bladder cancer. An assessment from was constructed for the purpose of the st

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
Federated states of monks in the holy Quran (Study and analysis)
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Thank God also taught us that thanks . thank meets the blessings and rewards mazidk glory we have no knowledge except what you have taught you Alim hakim , not counted praise you as yourself praised and pray and to recognize the envoy mercy to the worlds , prophet Mohammed and his family and companions and guided to the day of judgment .
But after :
Aware of the interpretation of the most important science needed by Muslims because God Almighty sent down the Quraan to be a way of the life for Muslims is subject to a healing for what is in the breasts and it slaham and flaham and has spared the nation from crisisThe stats of the monks , like other verses talking about Christians and Jews and what they have invented in the religion o

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Timings of people and their significance in the Koran: (Objective study)
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We try through this research to show the relationship between the crescent and the month in the Koran, and then their importance and their relationship to timing, and the timing of this relationship with people, and the significance of these timings, so we gathered verses that spoke about the family and the month, and we tried to study them in a detailed objective study, so this came The research of five subjects was the first topic introductory research and the time and month, while the remaining four detectives on the verses that talked about the timing of the month, and we have explained the relationship of this timing with people and the significance of these times.

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Publication Date
Wed Dec 29 2021
Journal Name
Journal Of The College Of Education For Women
Difficulties of Understanding English Breaking News Headlines by Iraqi EFL Learners at the University Level: عبد القادر طالب نعيم, و جمعة قادر حسين
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Understanding breaking news necessitates a special attention, since they are written with a special style. The study aims at identifying the difficulties faced by the Iraqi university EFL learners in comprehending English breaking news. The study included 10 fourth year students enrolled at the Department of English, College of Education for Humanities, University of Anbar. Thus, a questionnaire as a research instrument, was sent online to the students. The questionnaire points were related to the identification of difficulties faced by the learners in comprehending English breaking news. The data of the study were (10) headlines selected purposively from Euronews website. The data were qualitatively analyzed based on quantifying the qua

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Publication Date
Thu Jul 30 2020
Journal Name
Journal Of Sustainability Science And Management
THE DIFFERENTIATION IN WORK ENRICHMENT STRATEGIES AND ORGANIZATIONAL CREATIVITY FUNCTION: A PERSPECTIVE FROM THE LEADERS OF THE MINISTRY OF OIL IN IRAQ
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