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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 Mar 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of Cost awareness of activation of strategic cost management techniques of industrial units: A prospective study at the General Company for the manufacture of medicines and medical supplies in the province of Mosul
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The last ten years observed a shift enormous scientific in the method and way that it deals professional with the cost accounting and reflected the result those shift enormous scientific of increase the competitive environmental that accompanied the emergence of a modern manufacturing environmental on surface the long roductive life and emergence advanced information technology that give a central focus of his important on client with growing global markets growth on a large scale.

        The research aim to define the concept of cost awareness, the concept and methods of  strategic cost management and the role of cost awareness for managers of industrial units in strategic of cost managem

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Publication Date
Tue Aug 01 2023
Journal Name
Baghdad Science Journal
First record of peregrine shrimp Metapenaeus stebbingi Nobili, 1904 (Crustacea, Decapoda: Penaeidae) in the Iraqi waters, North-West Arabian Gulf
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One male specimen of the species Metapenaeus stebbingi Nobili, 1904 was first recorded in November 2021 from the Iraqi territorial waters, Northwest of the Arabian Gulf. Therefore, the investigated shrimp species nominally corresponds to the original description of M. stebbing through the main diagnostic features. It must be adopted in the spread and expansion of species, a new record of the area, and a distinctive addition to the species of commercial shrimp within the Iraqi marine waters.

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Publication Date
Sun Jun 06 2010
Journal Name
Baghdad Science Journal
The contrast and illumination technique for image capturing under different Tungsten illumination
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The digital camera which contain light unit inside it is useful with low illumination but not for high. For different intensity; the quality of the image will not stay good but it will have dark or low intensity so we can not change the contrast and the intensity in order to increase the losses information in the bright and the dark regions. . In this search we study the regular illumination on the images using the tungsten light by changing the intensities. The result appears that the tungsten light gives nearly far intensity for the three color bands(RGB) and the illuminated band(L).the result depend on the statistical properties which represented by the voltage ,power and intensities and the effect of this parameter on the digital

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Publication Date
Sat Mar 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Strategic Performance Evaluation Using Benchmarking Technique: Applied Research In The Sample Of Offices Of Inspectors General
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In light of the rapid changes in the business environment and the entry of administrative leaders in the challenges of the atheist and twenty- increasing competition between sectors and the desire to acquire the skills, the traditional methods are no longer viable, which requires doing evaluates performance according to a more holistic, rather than limiting the performance evaluation on the financial hub that has not longer enough alone, as well as benchmarking method that has proven successful in developed countries as a way to develop and improve products and services.

I've touched your search to the development of indicators evaluating the performance and preparation of a mechanism for making comparisons of reference between o

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Publication Date
Sun Jan 03 2016
Journal Name
Journal Of The College Of Basic Education
Simultaneous determination of cephalexin and cefixime by first and second derivative ultraviolet spectrophotometry
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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of The College Of Basic Education
Simultaneous Determination of Cephalexin and Cefixime by First and Second Derivative Ultraviolet Spectrophotometry
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A new spectrophotometric method for individual and simultaneous determination of cefixime and cephalexin depending on the first and second derivative mode techniques. The first and second derivative spectra of these compounds permitted individual and simultaneous determination of cefixime and cephalexin in concentration interval of (4– 24μg.ml-1 ) by measuring the amplitude of peak-to-base line, pea to peak at certain wavelengths and the area under peak at selected spectrum intervals. The methods showed reasonable precision and accuracy and have been applied to determine cefixime and cephalexin in two different pharmaceutical preparations.

Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Dilemmas in teaching human rights and democracy between the current realityand the difficulties in seeking to spread a culture of human rights
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In the age of information and communication revolution, education as one of life
aspects has influenced with that revolution by integrating technology in education, which
have become as an important learning tools of the whole educational process . Technology,
when used appropriately, can help make science classroom a site of active learning and
critical thinking, furthering student inquiry and connections with different materials. It is
necessary to develop human rights education programs and materials for discretionary and
extracurricular activities as it provide them with the skills and tools so that they are
empowered to take action to realize their rights. Human rights education is a critical means of
instill

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Publication Date
Wed Mar 01 2023
Journal Name
Iranian Journal Of Materials Science And Engineering
First-Principles Analysis of Cr-Doped SrTiO3 Perovskite as Optoelectronic Materials
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The influence of Cr3+ doping on the ground state properties of SrTiO3 perovskite was evaluated using GGA-PBE approximation. Computational modeling results infered an agreement with the previously published literature. The modification of electronic structure and optical properties due to Cr3+ introducing into SrTiO3 were investigated. Structural parameters assumed that Cr3+ doping alters the electronic structures of SrTiO3 by shifting the conduction band through lower energies for the Sr and Ti sites. Besides, results showed that the band gap was reduced by approximately 50% when presenting one Cr3+ atom into the SrTiO3 system and particularly positioned at Sr sites. Interestingly, substituting Ti site by Cr3+ led to eliminating the band ga

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Publication Date
Sat Jan 01 2011
Journal Name
Iraqi Journal Of Science
A CRYPTOGRAPHIC TECHNIQUE BASED ON AVL TREE
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Publication Date
Sat Sep 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Difficulties of scientific research in the financial and administrative fieldaccording to the quality standardsfrom the point of view of the teachers
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The research aims to identify the most important difficulties facing the scientific research in the technical university in the financial, organizational and administrative according to the quality standards according to the paragraphs studied in the questionnaire questionnaire prepared for this purpose, including the research community on the Central Technical University, which includes several technical colleges and technical institutes were selected A sample of the researchers in the Institute of Technical Management where the number of training was 78 teachers took a random sample of researchers amounted to 40% of the questionnaire, and after the collection and classification of data were used statistical means, including the mean ar

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