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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 Mar 08 2021
Journal Name
Baghdad Science Journal
Manufacturing concentrates Alholucramih for use in increasing the efficiency of solar cell
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A new way to Systems concentrates have been clarified and that allows a concentration high and analysis to automatically wavelengths of the spectrum of this system analyst of the spectrum and the center is built on Holucram Nafez gives less absorbency with efficient diffraction high when the wavelength (900 nm), which will be useful for Khallaya solar

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
The educational means used by teachers of art education in primary schools
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      Education varies in terms of form and content between verbal and abstract education through the delivery of knowledge and enriching experiences through verbal communication and ephemeral learning and based on sensory experiences that provide visual and audio visualizations that make it imperative to install and retain knowledge and experience. It is obvious that meanings And the concepts grow the more tangible sensory experiences that make the process of communication highly efficient, and the more the learner's acquisition of direct sensory experiences, ie the first source is the life situations and normal circumstances of the process of communication, but if these can not be available It is necessary to a

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Publication Date
Wed Jun 28 2023
Journal Name
Al–bahith Al–a'alami
The Role of Ethnographic Programs on Documentary Channels in Enhancing Audience Knowledge
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This research investigates the engagement of the Iraqi audience with ethnographic programs and their impact on knowledge enhancement and intellectual perspectives. A questionnaire consisting of closed-ended questions was designed and administered to a purposive sample of 400 participants who exclusively follow ethnographic programs and documentary channels. The data were transcribed and subjected to statistical analysis using the SPSS software to ensure reliability and test hypotheses. The findings revealed that Al Jazeera Documentary Channel had the highest viewership percentage among respondents for ethnographic programs, while DW (Deutsche Welle) had the lowest viewership percentage. This suggests that Al Jazee

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Publication Date
Fri Mar 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Improving the Effectiveness of Internal Control System In Accordance with COSO Model
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        The research aims to improve the effectiveness of internal control system according to a model COSO, by identifying the availability of system components according to the model and then improve the effectiveness of each component by focusing on areas for improvement in each component, as it was addressed to a model COSO and then Maamth with the environment, the current Iraqi by introducing some improvements on the form of some mechanisms of corporate governance of the Council of Directors, and senior management, the Audit Committee, Committee appointments, especially that supplies application available in the laws and legislation, the current Iraqi, taking into consideration to make some

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Publication Date
Sat Sep 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The effect of strategic decisions for operations management in performance excellence organizational.
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This research focused on clarifying the relationship strategic decisions for operations management & performance excellence organizational, The research emerges from a problem which explained by many application questions. Special questionnaire has been prepared for this purpose distributed (72) to sample of  management levels (Top, middle) in the General company for mining industries and aquatic Insullation & the General company of batteries industry, The research has tried to test a number hypotheses related to the relation and regression among the variables of the research, and the differences among the <

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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of The College Of Languages (jcl)
The mechanism of irony in political discourse: Механизм иронии в политическом дискурсе
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         The present paper sheds light on irony as one of the most important and most common linguistic phenomena in modern linguistics, in general ,and in discourse in particular, whether it is (political, literary, journalistic, etc.). When irony is used correctly or positively, it paves the way for the speaker to gain the approval of other parties participating in the dialogue and dissolve barriers between them. It is a simple multi-functional linguistic style and an expression of one’s meaning by using language that normally signifies the opposite according to the context and the situation. Therefore, it is necessary to study its characteristics, define its functions and traces the extent of

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Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Economics And Administrative Sciences
Statistical Methods for Controlling the Quality of Crude Oil Products in Iraq
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The purpose of this study is to measure the levels of quality control for some crude oil products in Iraqi refineries, and how they are close to the international standards, through the application of statistical methods in quality control of oil products in Iraqi refineries. Where the answers of the study sample were applied to a group of Iraqi refinery employees (Al-Dora refinery, Al-Nasiriyah refinery, and Al-Basra refinery) on the principles of quality management control, and according to the different personal characteristics (gender, age, academic qualification, number of years of experience, job level). In order to achieve the objectives of the study, a questionnaire that included (12) items, in order to collect preliminary inform

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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Effect of Discussion Techniques in Composition performance for The fifth preparatory student
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The present study aims at knowing the effect of discussion method for students of fifth grade in preparatory school.

Methodology of the Study:

          In order to achieve the objective of the study, the researcher chooses non-randomly the preparatory school affiliated to the District Chamchamal \ Suliemnaniya. The sample attained 64 students in 32 per group (control and experimental) groups. The researcher used the discussion method which was applied on experimental group. She uses the traditional method on the control group.

The researcher matched the two group in ago, intelligence, marks at the Kurdish Language in the previous year , pretest and posts for the indepe

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Publication Date
Tue Apr 01 2025
Journal Name
Mesopotamian Journal Of Cybersecurity
The Impact of Feature Importance on Spoofing Attack Detection in IoT Environment
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The Internet of Things (IoT) is an expanding domain that can revolutionize different industries. Nevertheless, security is among the multiple challenges that it encounters. A major threat in the IoT environment is spoofing attacks, a type of cyber threat in which malicious actors masquerade as legitimate entities. This research aims to develop an effective technique for detecting spoofing attacks for IoT security by utilizing feature-importance methods. The suggested methodology involves three stages: preprocessing, selection of important features, and classification. The feature importance determines the most significant characteristics that play a role in detecting spoofing attacks. This is achieved via two techniques: decision tr

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Publication Date
Sat Sep 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Knowledge Economy in Financial Reporting System Development proposed model ""
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This  world is moving towards knowledge economy which basically depends on knowledge and information. So, the economic units need to develop its financial reporting system which helps to provide useful information in timeliness for investors in accordance with the requirements of  the knowledge economy and meets the needs of those investors. This  research aims to revealing the reflects of knowledge economy on the approaches of financial reporting and suggesting a financial reporting model in the environment of knowledge economy,  depending on combining the value approach with the events approach using database and communication technology and providing useful accounting information for all users regardless of

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