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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 Jan 01 2014
Journal Name
Int. J. Adv. Res
Antibacterial activity of parsley and celery aqueous extract on the isolated bacteria from children UTI in Erbil city‏
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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Using median rule in determining the establishment of service station between Al hasaka and Al kamishly serian cities
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Research indicates that the second half of the twentieth century marked large interests in the service industry by government and private organizations in that one, and the service industry has become the bedrock of plans in achieving economic and social development. From this standpoint felt specialists and researchers the importance of transport modes, including rail, which should be available between Almnltq Civil populated as services organized by the competent authorities to achieve the active participation of citizens in economic and social development in the region and that the term services means economic activities, which are the results Pollack concrete such as accepting the situation and satisfaction them or satisfacti

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Publication Date
Sun Aug 23 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Development Accounting Rule disclosure by accounting policies in the light of Islamic and electronic banking Activities: Proposal pattern
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the bank sect for any country  is very important  because  its represent a major  nerve   to feed a verity economic and finance activities .development any state measure by development  banking  sets and its represent  important  factor to investors attract . and because  important  of this subject ,teen accounting rule is a specialized for it .its related by  Disclosures in the Financial Statements Of Banks and The Similar Institutions, its accredit  by auditing and accounting standard  consul in republic of Iraq.in date 10/28/1998.                      &

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Publication Date
Sun Jan 01 2017
Journal Name
Research Journal Of Pharmacy And Technology
The Lived Experience of Iraqi Nurses who Live and Work in Communities Impacted by War or Terrorist Threat
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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Efficiency of public investment spending and its impact on economic growth in Iraq For the period 2003- 2013
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Occupy public investment spending, a great deal of attention since the thirties of the last century, to play important role in economic and social development process and therefore most of the countries are trying different degree of economic development to the completion of the largest amount of public investment, especially in infrastructure, which is one of the pillars essential to economic development, and in order to maximize utilization of the completion of public investment should focus on achieving efficiency in completion.
    The current reality of public projects in Iraq, indicating the absence of several key characteristics that must be provided if these proje

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Property Tax and its Effect in increasing Tax outcome: (An applied Research at The General Commission of Taxes)
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The Search stressed on the importance of the role of property tax as a tributaries of the state budget that depend on it to cover the side of public expenditures, along with the rest of the other types of taxes through a review of the tax  framework and tax proceeds and stand on the research problem and its effects, according to the following logic  questions : -

  1. What is the contribution of property tax in the overall tax revenue?
  2. Are there any certain problems in collection of property tax?
    3. What are the factors that lead to a negative impact on the outcome of the property tax?
    4. How do we strengthen the role of the property tax in the overall tax revenue?

   This r

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Publication Date
Sun Mar 01 2020
Journal Name
Iraqi Journal Of Physics
The DC electrical Conductivity of prepared pure polypyrrole and polypyrrole /graphene (PPY/GN) nanocomposite by in-situ polymerization
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Abstract

 In this work, pure Polypyrrole (PPy) and Polypyrrole (PPy)/Graphene (GN) was synthesized by in-situ polymerization in different weight percentages (0.1, 0.3, 0.5, 1, 3 and 5 wt.% (g)) of GN nano particles using chemical oxidation method at room temperature. The FTIR, SEM and electrical properties were studies for the nano composites. The result show that when concentration of GN Nano particle increase, the electrical conductivity increased and the graphene sheets were merging to form a continuous area of the GN through the polypyrrole base material. The FTIR spectra shows that the characteristics absorption peaks of polypyrrole that is, 1546.80, 1463.87 and 3400.27 cm-1(stretching vibration in the pyrrol

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Publication Date
Sat Feb 27 2021
Journal Name
Journal Of Engineering
Physical Simulation for the Flow in Straight and Rectangular Loop Manifolds
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The flow in a manifolds considered as an advanced problem in hydraulic engineering applications. The objectives of this study are to determine; the uniformity qn/q1 (ratio of the discharge at last outlet, qn to the discharge at first outlet, q1) and total head losses of the flow along straight and rectangular loop manifolds with different flow conditions. The straight pipes were with 18 m and 19 m long and with of 25.4 mm (1.0 in) in diameter each. While, the rectangular close loop configuration was with length of 19 m and with diameter of 25.4 mm (1.0 in) also. Constant head in the supply tank was used and the head is 2.10 m. It is found that outlets spacing and manifold configuration are the main factors aff

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Educational Planning, it's Importance in the Social, Economical and Educational Development
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Educational Planning, it's Importance in the Social, Economical and Educational Development

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Publication Date
Tue Jun 20 2023
Journal Name
Baghdad Science Journal
Zooplankton composition and structure in the Indus River Estuary, Sindh, Pakistan
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In this study abundance and composition of zooplanktons in the Indus River Estuary was conducted to examine habitat characteristics and its impact on tiny organisms. Overall 30,656 individuals were identified and segregated into seven major groups including Copepods, Cnidarians, Decapods, Mollusk, Pisces, Amphipods and Chaetognaths. For better understanding they were further divided into eighteen planktonic categories. Among them Lucifer spp. comprises of 52.21% was the most abundant group with a peak appeared in March whereas Chaetognaths were rarely observed in the entire study period. Species diversity exhibited a mixed trend with the highest values (0.776) of dominance observed in spring (March). The results of Canonical Corresponden

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