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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 Sep 08 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Obstacles facing the application of electronic banking An exploratory: study of the opinions of a sample of bank employees operating in the city of Nasiriyah
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Electronic banking plays a prominent role in providing the best banking services and upgrading the banking sector for the better, so this study aimed to shed light on the most prominent obstacles that prevent the application of electronic banking in banks operating in the city of Nasiriyah, and in order to achieve this goal the researcher used the descriptive analytical approach And through a questionnaire form that was distributed to a group of employees, numbering (60) employees in the upper, middle and operational departments in a number of branches of private banks operating in the city of Nasiriyah, namely (the Iraqi Trade Bank, the Gulf Commercial Bank, the Bank of Baghdad, the Union Bank of Iraq), which represented The stu

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Publication Date
Fri Aug 18 2023
Journal Name
Journal Of Research In Medical And Dental Science
Morphologic Evaluation of the Permanent Mandibular First Molar within an Iraqi Population Using Cone Beam Computed Tomography (Retrospective Study)
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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Using Project Management Maturity Model to Evaluate Construction Sector -Organizations. Case Study at the Department of buildings - Karkh first
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The education sector suffers from many problems, including the scarcity of schools that can absorb the increasing number of students in light of the increasing population growth rate, as some regions suffer from a lack of opening of new schools or the expansion of existing schools to increase their capacity so that attention is required. The research sought to identify the level of maturity of project management at the research site (Building Department in Al-Karkh I/ Ministry of Education) Being responsible for educational projects and their implementation and to know that, the ten areas of the knowledge guide to project management PMBOK have been adopted according to the PM3 model (one of the models of maturity

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of The Turkish-german Gynecological Association
Maternal and neonatal outcomes in adolescent pregnant women with one prior Cesarean section in Baghdad
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Publication Date
Tue Mar 21 2023
Journal Name
International Journal Of Interactive Mobile Technologies (ijim)
Study the Effect of Using Google Classroom on the Academic Performance Under the Covid19 Pandemic Using Data Mining Technique
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— In light of the pandemic that has swept the world, the use of e-learning in educational institutions has become an urgent necessity for continued knowledge communication with students. Educational institutions can benefit from the free tools that Google provide and from these applications, Google classroom which is characterized by ease of use, but the efficiency of using Google classroom is affected by several variables not studied in previous studies Clearly, this study aimed to identify the use of Google classroom as a system for managing e-learning and the factors affecting the performance of students and lecturer. The data of this study were collected from 219 members of the faculty and students at the College of Administra

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
DIFFICULTIES IN USING THE INTERNET IN THE TEACHING OF SCIENCES
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The present research aims at recognizing the difficulties and problems which hamper teachers and educators alike when using the internet for educational purposes.It discusses the benefits of the internet as a source of information or publication and as a communicative tool.Arandom sample of (30) teachers working at schools in Baghdad / Second Risafa,was selected.Three of the sample members use the internet for student project plans via internet centers, whereas 16 of them use it for chatting, emailing and research purposes.The rest of the sample have limited knowledge of the internet. The researcher used the interviewing method to gather data from

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Publication Date
Sat Dec 31 2016
Journal Name
Al-kindy College Medical Journal
Comparison between Open Mini-incision Thyroidectomy and Conventional Thyroidectomy: Clinical Experience and Literatures Review
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Background: Thyroid surgery is most common endocrine surgery in general surgical practice. Objectives: the aim of this work is to evaluate the feasibility, benefits and outcomes of open mini-incision thyroidectomy and compared the results with that of conventional thyroidectomy. The comparison between the two groups was in term of incision length, amount of blood loss, time of operation, postoperative pain, hospital stay and the cosmetic outcomes.Type of the study: this is a single-blinded randomized controlled studyMethods: This study compared the advantages and outcomes of 22 patients subjected to mini-incision thyroidectomy (Group A) with the equal numbers of patients subjected to conventional thyroidectomy (Group B).Results: the oper

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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Selection of the initial value of the time series generating the first-order self-regression model in simulation modeAnd their impact on the accuracy of the model
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In this paper, compared eight methods for generating the initial value and the impact of these methods to estimate the parameter of a autoregressive model, as was the use of three of the most popular methods to estimate the model and the most commonly used by researchers MLL method, Barg method  and the least squares method and that using the method of simulation model  first order autoregressive through the design of a number of simulation experiments and the different sizes of the samples.

                  

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Publication Date
Tue Aug 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Post a reflection on the capabilities of personnel programs A prospective study of a sample of the views of the staff at the Ministry of Higher Education and Scientific Research
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            This research aims to know the role and impact of participation in the capabilities of human resources programs, and for the purpose of measuring it has been determined the dimensions of these two variables by relying on standards for this purpose, was chosen as the Ministry of Higher Education and Scientific Research / device supervision and scientific calendar as one of the important departments in the ministry and includes a large number of individuals at different organizational levels for the purpose of answering a questionnaire prepared for the purpose of measurement and access to the results and the achievement of the objectives of the research and which ha

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Publication Date
Tue Sep 01 2020
Journal Name
Journal Of Engineering
Identify and Diagnose the Causes of Financial Funding using the Root Cause Analysis Technique
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The analysis of the root cause techniques is a reasonable option to be made to assess the root causes of the funding of construction projects. There are a variety of issues related to financing in construction industries in Iraq. The root,cause analysis is the impact of security and social conditions on financial funding. Variety tools of root cause analysis have originated from literature, as common methods for the detection of root causes. The purpose of this study was to identify and diagnose causes that lead to obstruction of financial funding in the construction projects in the republic of Iraq from the contractors' point of view and their interaction with a number of variables. The study diagnosed nine causes of fi

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