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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
Wed Feb 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The role of accounting responsibility in the success of the reform of financial and administrative / applied research in high School
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The reform process is a dynamic process going on, especially the administrative and financial reform, which contributes to the work and directing operations towards success and continuous development, which requires determining the validity and the responsibility and the rights and duties of all officials in the school settings (within the formations educational institutions) for the purpose of reducing the administrative and financial corruption, and then ensure management efficient and effective way by taking advantage of the physical, financial and human resources available to achieve the greatest benefit at the lowest cost to the fact that the follow-up performance on an ongoing basis in accordance with the specific of powers

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Publication Date
Sun Sep 15 2019
Journal Name
Al-academy
Use of Multimedia in the Design of Educational Websites and their Role in Enhancing the Cognitive Aspect of the Learner
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Multimedia is one of the most important elements of modern educational media and must be used in educational websites in order to disseminate knowledge on a large scale and should be used to provide scientific information to all, as the current research tried to explore the possibilities of employing them in the design of educational websites and highlight their role in promoting the scientific aspects of the user. This study included four axes, the first of which was devoted to the introduction which includes the problem of research, its importance, objectives and its objective, temporal and spatial limitations, which were limited to the study of the main pages of Arabic educational websites published in 2019. The second axis contained th

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Publication Date
Fri Jan 15 2021
Journal Name
Plant Archives
AN ECONOMIC STUDY TO MEASURE THE IMPACT OF THE MAIN VARIABLES ON RURAL POVERTY IN IRAQ FOR THE PERIOD 1990-2019
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Publication Date
Sun Feb 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
An analytical study at the General Company for the manufacture of batteries
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    This study carry’s out the correlation and the effect of two main variables, these variables are Job Satisfaction included six sub: wages - salaries and justice and yield, working  conditions    and services, pattern of supervision and the relationship with the manger, Relationship with colleagues, the content of the work and the variety of tasks, development and  promotion  opportunities available  to  an individual,   and Organizational Performance included  two sub variables:  Efficiency, Effectiveness.  This research was conducted using a questioner as a main tool, This questioner was distributed randomly to a research community composed of

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Publication Date
Wed Feb 03 2016
Journal Name
Iraqi Journal Of Physics
Study the variation of synodic month for the moon through 2000-2100
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In this research study the synodic month for the moon and theirrelationship with the mean anomaly for the moon orbit and date A.Dand for long periods of time (100 years), we was design a computerprogram that calculates the period of synodic months, and thecoordinates of the moon at the moment of the new moon with highaccuracy. During the 100 year, there are 1236 period of synodicmonths.We found that the when New Moon occurs near perigee (meananomaly = 0°), the length of the synodic month at a minimum.Similarly, when New Moon occurs near apogee (mean anomaly =180°), the length of the synodic month reaches a maximum. Theshortest synodic month on 2053 /1/ 16 and lasted (29.27436) days.The longest synodic month began on 2008 /11/ 27 a

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Publication Date
Sun Feb 03 2019
Journal Name
Iraqi Journal Of Physics
Study the variation of synodic month for the moon through 2000-2100
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In this research study the synodic month for the moon and their
relationship with the mean anomaly for the moon orbit and date A.D
and for long periods of time (100 years), we was design a computer
program that calculates the period of synodic months, and the
coordinates of the moon at the moment of the new moon with high
accuracy. During the 100 year, there are 1236 period of synodic
months.
We found that the when New Moon occurs near perigee (mean
anomaly = 0°), the length of the synodic month at a minimum.
Similarly, when New Moon occurs near apogee (mean anomaly =
180°), the length of the synodic month reaches a maximum. The
shortest synodic month on 2053 /1/ 16 and lasted (29.27436) days.
The lo

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Crossref
Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Institutional Performance Assessment using a model of the European Foundation for Quality Management (EFQM) A case study at an organization
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The study aims to use the European Excellence Model (EFQM) in assessing the institutional performance of the National Center for Administrative Development and Information Technology in order to determine the gap between the actual reality of the performance of the Center and the standards adopted in the model, in order to know the extent to which the Center seeks to achieve excellence in performance to improve the level of services provided and the adoption of methods Modern and contemporary management in the evaluation of its institutional performance.

The problem of the study was the absence of an institutional performance evaluation system at the centre whereby weaknesses (areas of improvement) and st

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Crossref
Publication Date
Mon Jun 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
independence of the central banks with a focus on measuring the independence of the central bank of Jordan
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The main topic of this study is central around the independence of Jordanian central bank and the extent of the effectiveness at the bank in leading the monetary policy without interferences or pressures from side of the government.  the degree of independence of Jordanian central bank was  based on the following based hypothesis following ,there is relationship between the independence of the central bank and the legislative and economical indices. the most important recommendations are degree of independence of the Jordan central bank 43.5% is a good one, but it possible to reach a higher degree than this one by to making some modification on the Jordanian central bank law and by the central bank should be more rigid

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Crossref
Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Analysis of the performance of a fiber optic sensor used to measure the intensity of the electric field
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In this research was conducted to provide a product to analyze the performance sensor fiber optic used to measure and feel the intensity of the electric field results showed obtained that use sensor long gives reactive high electric field strength and a high value for allergic sensor, but that is at the expense of reducing the intensity of the electric field that is detected

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Publication Date
Sun May 01 2022
Journal Name
International Journal Of Early Childhood Special Education (int-jecs)
Study of some visual functions and functional variables of the respiratory and nervous systems and their relationship to the level of achievement of air rifle shooting
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The purpose of this paper is to identifying the relationship between some visual functions and the level of achievement of air rifle shooting among young Iraqi female, and identifying the relationship between some functional variables of the respiratory and nervous systems at the level of achievement of air rifle shooting among young Iraqi female. The researchers used the descriptive approach in the correlative relationships style for its suitability and the research problem. The researchers determined the research community by the intentional method represented by (10) young female shooters who represent the national team with air rifle shooting effectiveness, and who represent (100%) of the research community. One of the most important re

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