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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 Jan 28 2019
Journal Name
Journal Of The College Of Education For Women
The RoleThe Role of the Arbitration Treaty and Decisiveness in the Consolidation of Relations Between Britain and France (1903-1904) of the Arbitration Treaty and Decisiveness in the Consolidation of Relations Between Britain and France (1903-1904)
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The Risks Faced by Britain in their Areas of Influence at the Beginning of the Twentieth Century Drove her to the Alliance with the State of European such as France, and Contributed to the Tireless and made by the British and French Politicians in the Consolidation of Friendly Relations between the two Countries Efforts and Strengthened Cooperation in a Positive Way to Visit the king of Britain's Edward VII to France, Offset by Visit French President Loubet to Britain in the Same Year, those Negotiations Bore Fruit between the two Countries for Reaching a Contract Arbitration and Decisiveness between Britain and France Treaty on the Fourteenth of November 1903, Promised that Treaty First Step that Paved the Way for a General Agreement be

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Publication Date
Tue Sep 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Evaluating the quality of educational services according to the modified Servqual modelStudy of a sample of students of the Faculty of Management and Economics / University of Baghdad
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The research aims to apply a modified SERVQUAL model to evaluate the quality of the educational services via conducting exploratory research for students from the College of Administration and Economics- Department of Business Administration- Evening studies at the University of Baghdad. Questionnaire of two parts was distributed to a sample of (72) students out of (720) students of the 2nd.,3rd. and 4th. year in the beginning of the second semester of the year 2008-2009 to measure the expectations and perceptions to the quality of the educational services. Five major dimensions were analyzed to see the gaps for (22) variables. The study concluded that there were (13) variables confirmed that the

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Publication Date
Sat Apr 13 2024
Journal Name
مجلة واسط للعلوم الریاضیة
The development of the leading Arab scouting movements and their role in the development of youth and society
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the history of the Scouting movement reflects the global social cultural and technological change over more than a century. scouting aims to develop young people worldwide through educational programs based on specific principles and values. in arab countries, the scouting movement is considered one of the most important platforms contributing to developing young people and enhancing their rule. positive in society, began with the establishment of the first Scout camp in the region and witnessed great growth and prosperity over the decades the research reveals the historical roots and development of the scout movement in the leading arab countries and analyzes the positive impact of scout movement in the leading arab countries on the develo

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Use some probability amputated models to study the characteristics of health payments in the Iraqi Insurance Company
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Abstract

Due to the lack of previous statistical study of the behavior of payments, specifically health insurance, which represents the largest proportion of payments in the general insurance companies in Iraq, this study was selected and applied in the Iraqi insurance company.

In order to find the convenient model representing the health insurance payments, we initially detected two probability models by using (Easy Fit) software:

First, a single Lognormal for the whole sample and the other is a Compound Weibull  for the two Sub samples (small payments and large payments), and we focused on the compoun

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Publication Date
Mon Jan 13 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Capital Adequacy Standards According to Basel Accords (1,2) In the Credit Risks: Case Study
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Commercial banks represent the main pivot in financing national economic activity and its development. The capital represents safety margin to depositors and represents a defense line that protects bank work from dangers. Basel committee requirements represent protection and comprehensive supervision to bank activities for depositors, debtors and the bank. It provides trust in bank dealings and tackles activities of high dangers. The most prominent of these requirements are capital adequacy that concerns bank management and supervision and auditing bodies such as the central bank and protecting banks that suffer weakness in its vital important borrowing activity that reflects weakness in implementing borrowing policy .The purpose

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Publication Date
Mon Dec 11 2017
Journal Name
Al-khwarizmi Engineering Journal
Study the Characterization of Adding Polymer-Surfactant Agent on the Drag Reduction Phenomena in Pipeline Flow System
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  Abstract    

In this study, the effect of carboxylic methyl cellulose (CMC), and sodium dodcyl benzene sulfonate (SDBS) as an aqueous solution on the drag reduction was investigated. Different concentrations of (CMC) and (SDBS) such as (50, 100, 150, 200, 250, 300, 350, 400, 450, and 500 ppm) were used to analyze the aqueous solution properties, including surface tension, conductivity, and shear viscosity. The optimum four concentrations (i.e., 50, 100, 200, and 300 ppm) of fluid properties were utilized to find their effect on the drag reduction. Two different PVC pipe diameters (i.e., 1" and 3/4") were used in this work. The  results showed that blending CMC with SDBS gives

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Publication Date
Wed Feb 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Workplace spiritual influence in the attitudes of worker At a number of hospitals, health department BAGHDAD/ Rusafa
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Spiritual is one of modern subjects gained importance of their role in the meaning imparted to work and to promote a sense of belonging to the group and the community, including support personnel positive attitudes towards their work. The research aims to highlight the impact of the relationship between workplace spiritual and variable working attitudes to sample variant of the hospitals, health department BAGHDAD / Rusafa, and in order to achieve this, the researcher is based on the descriptive and analytical approach adopted for the analysis of the questionnaire and to test relations research and its variables. The research community (4) of hospitals in Sadr City, included've targeted 106 doctors and 222 nurses formed a whole (

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Use of Principal Components Analysis in the Formation of a Sustainable Human Development Index for Arab Countries
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This study aims to derive a sustainable human development index for the Arab countries by using the principal components analysis, which can help in reducing the number of data in the case of multiple variables.  This can be relied upon in the interpretation and tracking sustainable human development in the Arab countries in the view of the multiplicity of sustainable human development indicators and its huge data, beside the heterogeneity of countries in a range of characteristics associated with indicators of sustainable human development such as area, population, and economic activity. The study attempted to use the available data to the selected Arab countries for the recent years. This study concluded that a single inde

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Publication Date
Sat Jul 30 2022
Journal Name
Global Academic Journal Of Linguistics And Literature
A Critical Stylistic Analysis of Transcultural Identity in Lyer’s The Global Soul (2001) Using the Tool of Negation
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This study is intended to examine the concept of transcultural identity in the travel book The Global Soul: Jet Lag, Shopping Malls, and the Search for Home by (Iyer, 2001). Jeffries’ model of critical stylistics (2010) (henceforth, CS) has been selected to analyze the book. To be more specific, Negation is selected to analyze the concept under study. As such, the study aims at finding out how Negation is used to portray ideological meanings representing the concept of transcultural identity in one non-fictional travel book; and finding out the ideologies related to the concept analyzed. The analysis of the data shows that Negation is a suitable analytical tool to reach the ideational meaning of the text towards the concept of tra

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Publication Date
Tue Dec 22 2020
Journal Name
Lecture Notes In Civil Engineering
Evaluating the Performance of Flexible Passive Pile Group in Cohesionless Soil Under the Effect of a Nearby Embankment
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