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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
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Suggestion Plan for the Reclassification of U.N Publications in Central Library
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Suggestion Plan for the Reclassification of U.N Publications in Central Library

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Publication Date
Sat Sep 30 2023
Journal Name
Tikrit Journal Of Administrative And Economic Sciences
The impact of Outward bank transfers on exchange rates in Iraq
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The depreciation of the Iraqi dinar against the US dollar, reaching low levels and causing disruptions in the local markets, has had detrimental effects on individuals and companies, particularly those with limited income and the poor. The local currency approached around 1600 dinars per dollar, after the official exchange rate had stabilized at around 1450 dinars per US dollar. This depreciation in the value of the Iraqi dinar can be attributed to financial speculation among currency traders, which directly affected exchange rates and illicit dollar smuggling operations. Bank transfers are also important alongside financial transactions, especially in light of current economic developments in the 21st century. To prevent currency s

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
The state of Vitamin D in Iraqi Patients With Parkinson Disease
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Background: A role for vitamin D deficiency in Parkinson disease (PD) has recently been suggested.

Objective:: To estimate the state of vitamin D in PD with an age-matched healthy control.

Type of the study: A case control study.

Method: The study randomly comparison of plasma 25-hydroxyvitamin D (25[OH] D) concentrations of collected samples in a clinical neurology department ward / Baghdad teaching hospital / Medical City and Parkinson disease movement disorder clinic. Participants were registered into the study from October 2015 to October 2016. We was study   serum vitamin D level in 40 consecutive patients with

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The priority of government investment for companies manufacturing sector in Iraq
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The study aimed at clarifying the contradictions of the general industrial companies despite the investment allocations and the government investment expenditure on manufacturing activities under the so- called rehabilitation programs. However, this did not contribute to a certain extent in the growth and industrial leap in the direction of developing the activities of the sector Industrial sector in Iraq because of the lack of adoption of a number of basic principles towards the need to take priority of investment in the field of manufacturing and industrial decision-making in the restructuring of industry according to the priorities of investment in light of the international industrial trend, Tosmarah available to the manufact

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Role Of Cultural Intelligence In drawing Local Politics (Field Research)
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Abstract :

This research aims to examine the correlation and the impact of Cultural Intelligence with their dimensions (Strategy, Knowledge, Motivation, Behavior) on Drawing Local politics and their dimensions (Empowerment, Flexibility, Organizational Justice, Local Funding) In Dhi Qar Provincial Council To determine the extent of the presence of significant statistical differences between research variables Due to the recent experiment which requires clarification of the role of the pivotal and important carried out by the provincial council in the exercise of his work in light of the diversity of cultures and the peculiarities of the local community, which may impede the provision of equal services to all those parties

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Publication Date
Sun Apr 02 2023
Journal Name
Journal Of Survey In Fisheries Sciences
Evaluation of the Serum Asprosin Levels in Patients with Double Diabetes
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Background : Double diabetes (DD) is the term used to describe situations in which a patient exhibits characteristics that are a combination of type 1 diabetes mellitus(T1DM) and type 2 Diabetes Mellitus (T2DM) a large epidemiological study found that 25.5% of people with T1D also had the metabolic syndrome. A new protein hormone called asprosin is predominantly released by white adipose tissue. It was initially discovered in 2016 . Asprosin is important diagnoses marker for insulin resistant in diabetes patients ,additionally is very important denotation about early diagnoses of type 2 diabetes. Objectives: The current study aims to find predictive significance of diagnosis a double diabetes by evaluating the asprosin in the blood serum of

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of The College Of Education For Women
War in the Novels of Abroad Iraqi Women Between 2003 – 2010
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This research dealt eith the effect of wars experienced bythe Iraqi people in the abroad Iraq women novels between 2003 – 2010, where this issye dominated on Iraqi women novels at this stage until it became the main subject that events revolved aroud in the novels of this stage.
The research also highlighted on the impact of continuous tough wars in human life and psyche, especially in the lives of women – and this is the privacy of feminist novel – where the Iraqi women novels focused on the impact of war on psychological of women and what it caused of misfortunes as women. Iraqi women have suffered from the bitterness of the loss caused by war as – any loss – a natural of her – the loss of father, son, husband, brother a

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Publication Date
Fri Dec 15 2023
Journal Name
Al-adab Journal
The Portrayal of Serial Killers in Thomas Harris’ Novel Read Dragon
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This study aims to deeply analyze the character of serial killers in Thomas Harris’ novels and focuses on his novel Red Dragon. The Study searches in these complex and deep characters through the use of Erich Fromm's concepts about the destructive nature of the human psyche and what are the factors affecting serial killers in all social psychological, and biological aspects. This study Concluded: Thomas Harris portrayed the characters of serial killers in a professional and complex and made the reader go on a contemplative journey in the mind and soul of the serial killer, thus reaching the climax of artistic perfection.

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Publication Date
Thu Apr 13 2023
Journal Name
Journal Of Survey In Fisheries Sciences
The Elevation of Serum Subfatin Levels in Patients with Double Diabetes
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Background: Hybrid diabetes (or double diabetes, DD) occur when the patient which exhibits characteristics that combine type 1 diabetes (T1DM) and type 2 diabetes (T2DM). Formerly epidemiological studies found that quarter of people with T1D also had the metabolic syndrome. Subfatin, Also called cometin, it is a small (~27kDa) cytokine secreted by protein encoded by a gene called METRNL (simeler of meteorin). is much expressed in skin in the mucosal tissues and activated macrophages. Subfatin has also been described as a hormone that effected in some diseases such as metabolic diseases (including dyslipidemia), type 2 diabetes and obesity. Objectives: The current study objective is evaluating the subfatin in the blood serum of double diabet

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Publication Date
Tue Nov 11 2025
Journal Name
Journal Of Physical Education
Studying the Reality of Racket Sports&#39; Administrative Problems In Iraq
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