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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 Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of the procedures of the Banking Compliance Controller on the decision to grant credit and default: Applied research in a sample of Iraqi banks
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Abstracts:

The Central Bank is the backbone of the banking system as a whole, and in order to maintain the banking system, one of the most important functions that the Central Bank performs is the function of supervising and controlling banks, with several tools and methods, and one of the most important of these tools is its creation of the function of a compliance observer, which obligated commercial banks to appoint a person in A bank that performs this function according to certain conditions and granting it some powers that would build a sound and compliant banking system. The function of the compliance observer is to follow up on the bank’s compliance with the instructions and decisions issued by

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Publication Date
Thu Sep 01 2016
Journal Name
Journal Of Engineering
Improvement of Traffic Movement for Roads Network in Al-Kadhimiya City Center
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Numerous regions in the city of Baghdad experience the congestion and traffic problems. Due to the religious and economic significance, Al-Kadhimiya city (inside the metropolitan range of Baghdad) was chosen as study area. The data gathering stage was separated into two branches: the questionnaire method which is utilized to estimate the traffic volumes for the chosen roads and field data collection method which included video recording and manual counting for the volumes entering the selected signal intersections. The stage of analysis and evaluation for the seventeen urban roads, one highway, and three intersections was performed by HCS-2000 software.The presented work plots a system for assessing the level of service

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Organizational Red Tapes and their Reflections on Entrepreneurial Orientation: an Exploratory Study of a Sample of Employees in Some Organizations in the Province of Ninewah
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Organizations adopt a number of procedures and instructions in their field of activities in order to aid their resources development   and energies to serve their entrepreneurial orientations. This calls for preparing a range of mechanisms to mitigate the strictness and complexity of procedures. The ambiguity and severe  complexity  of procedures means acknowledging the loss in energy and this in turn  impedes the hopes while in the same time weakens the  enthusiasm in these organizations and an impedes the possibility to achieve continues innovation, thereby losing opportunities to the level of surrender to the risks and  assuming them to be unconquered obstacles.

There

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Publication Date
Sat Dec 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Quality of Work Life in Reinforcing Core Competencies: A Descriptive and analytical research in the Ministry of Health
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The research aims to diagnose the shortcomings and weaknesses in applying the dimensions of the quality of work life and the extent of their impact on employees’ attitudes and behaviors, and thus their relationship to enhancing their core competencies. The scientific value of the research stems from highlighting the importance of the dimensions of the quality of professional life in improving the productive efficiency of workers in the public sector and raising the level of organizational performance. Because the quality of working life plays an important role in enhancing the core competencies of employees in the public sector, it can also be an incentive or a disincentive for any employee by adapting to the economic and social condition

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Publication Date
Tue Mar 05 2024
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Quality of Work Life in Reinforcing Core Competencies: A Descriptive and analytical research in the Ministry of Health
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يهدف البحث إلى تشخيص أوجه القصور ونقاط الضعف في تطبيق أبعاد جودة الحياة الوظيفية ومدى تأثيرها على اتجاهات وسلوكيات الموظفين، وبالتالي علاقتها بتعزيز مقدراتهم الجوهرية. وتنبع القيمة العلمية للبحث من إبراز أهمية أبعاد جودة حياة العمل في تحسين الكفاءة الإنتاجية للعاملين في القطاع العام ورفع مستوى الأداء التنظيمي. ولأن جودة الحياة العملية تلعب دوراً مهماً في تعزيز المقدرات الأساسية للموظفين في القطاع الع

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Crossref
Publication Date
Sat Dec 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Quality of Work Life in Reinforcing Core Competencies: A Descriptive and analytical research in the Ministry of Health
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The research aims to diagnose the shortcomings and weaknesses in applying the dimensions of the quality of work life and the extent of their impact on employees’ attitudes and behaviors, and thus their relationship to enhancing their core competencies. The scientific value of the research stems from highlighting the importance of the dimensions of the quality of professional life in improving the productive efficiency of workers in the public sector and raising the level of organizational performance. Because the quality of working life plays an important role in enhancing the core competencies of employees in the public sector, it can also be an incentive or a disincentive for any employee by adapting to the economic and social condit

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Publication Date
Mon Jun 06 2022
Journal Name
International Journal Of Health Sciences
effect of a training curriculum for the development of some functional variables and the level of achievement in the effectiveness of air rifle shooting
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There are significant differences between the pre and post-tests in favor of the post-test in the tests) stroke volume (S.V), cardiac thrust (C.O.P), left ventricular volume, maximum oxygen consumption Vo2max), which indicates the effect of the proposed training approach.There are significant differences between the pre and post-tests in favor of the post-test in the achievement level test with air rifle shooting for young female shooters, which indicates the effect of the proposed training curriculum.There are no significant differences between the pre and post-tests in the tests (heart rate (HR) before exercise, heart rate (HR) after exercise, systolic blood pressure rate before exercise, systolic blood pressure rate after exercis

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Publication Date
Tue Mar 20 2018
Journal Name
Mustansiria Dental Journal
A comparative Study in the Antibacterial effect of Eugenol as Hand Wash Material with two Types of Soap
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Hands have consistently been an important vehicle in the transmission of disease (1). Thus, thorough hand-washing remains the single most important factor in preventing infection specially in hospitals and labs.Twenty-nine non-clinical volunteers (do not work or come in contact with a clinical or hospital setting) that lacked visible skin injuries, eczema or apparent skin disease were used, those subjects were all tested by a material of each of the three used in the study weekly and laboratory tests were done pre- and post washing.All three material were effective , Eugenol extract as effective as the bar and lotion soap. And this was confirmed statistically.Eugenol has a great antibacterial action even in small concentration and t

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Publication Date
Fri Dec 31 2021
Journal Name
Review Of International Geographical Education
Investing Organizational Identity in Improving Work Teams: An Exploratory Study of a Sample of The Capital's Traffic Directorates
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The research aims to identify the role of organizational identity in improving work teams, and to suggest ways to deal with the outputs of work teams in a way that achieves the goals of the Baghdad Traffic Directorate as it is the subject of the application of the research, while the research community was represented by its officers, while the research sample was embodied in (General Director, Associate The Director General, the directors of Rusafa and Karkh traffic and their assistants, as well as the heads of the divisions and the officials of the departments) in it. The sample was (200) observations. The descriptive exploratory approach was devoted to conducting the research, relying on the questionnaire in data collection, as well as e

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Publication Date
Thu Jan 10 2019
Journal Name
Journal Of The College Of Education For Women
Tribal separation and its relation to the organization of the community from the point of view of tribal sheikhs Field study in the City of Baghdad Sadr City model))
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One of topics that occupied alarge area  in Iraqi  society  at the moment is the  issue( of tribal  separation and its  relation  to the organization of  the community ) so we see in the civilizations and heritage  of each community aset  of provisions and laws that take the form of status   customary or religious it is indicative of the great interest in Iraqi society in cotrolling the behavior of individuals to comply with values and social laws and become their behavior is consistent with the behavior of the total and adhere to the social values and be productive individuals within  the subject and this can only be  achieved  from the social co

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