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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
Fri Jul 01 2016
Journal Name
Al–bahith Al–a'alami
The Discourse of the Absent Woman Novel for Mahdi Issa Al-Saqr
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The semiotic trend of recent monetary trends task that took a wide range of attention of critics and readers alike, especially after the deployment, which accompanied him after widespread acts critic Grimas and powers applicable to the literary texts and is thus expanded its care circle, hence the choice of the novel (absent) woman Iraqi novelist (Mahdi ‘Issa falcon) model to be applied to the study chose to be a semiotic approach through the use of procedural mechanisms for its critical tool (Paris School of semiotics), cash and views of its founder critic Grimas.The research in the introduction and pave came we made it a vision for literary semiotic and its impact trend in cash and cash is and what it desire to clarify some poked suc

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Publication Date
Thu Dec 15 2022
Journal Name
Alustath Journal
''The Middle Poetry of John Clare: The Rural Muse's Mature Nature Poetry''
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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
The chronic effects of salinity on the Crustacean Moina affinis Birge (1893)
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Thi s study included the effect of chronic exposure of di fferent concentrations of Nan on the biology of fresh water zroDplonk ton species Moina 41.112' ( Cladcxe'ra The concentrations used for chronic exposure were 03, 0.75. 1 960 to investigate iI effects on the life cycle and la lables of this species after exposure period and the range of this exposure effects on the rate of expectation for further life, also the effect of salinity on reproduotive parameters was studied which included average of total number of eggs and young produced, volume clutch's (6.95. indiclutch for control group , 14.516 indi clutch for 0.596a ,3_65 ind./ clutch for (175 5(.. and 03 Ind} cruel] for 1960) and number of Clutch's (5.5 clutch/ female for control gr

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Publication Date
Tue Oct 30 2018
Journal Name
Https://www.researchgate.net/journal/civil-engineering-journal-2476-3055
Developing Water Quality Index to Assess the Quality of the Drinking Water
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In the present study, an attempt has been to develop a new water quality index (WQI) method that depends on the Iraqi specifications for drinking water (IQS 417, 2009)  to assess the validity of the Euphrates River for drinking by classifying the quality of the river water at different stations along its entire reach inside the Iraqi lands. The proposed classifications by this method are: Excellent, Good, Acceptable, Poor, and Very poor. Eight water quality parameters have been selected to represent the quality of the river water these are: Ion Hydrogen Concentration (pH), Calcium (Ca), Magnesium (Mg), Sodium (Na), Chloride (Cl), Sulphate (SO_4), Nitrate (NO_3), and Total Dissolved Solids (TDS). The variation of the water quality p

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Publication Date
Thu Jan 05 2012
Journal Name
مجلة كلية التربية الأساسية/ جامعة بابل / بحوث المؤتمر العلمي الرابع لكلية التربية الأساسية/جامعة بابل 2011 م
THE DYNAMIC EVOLUTION OF THE SHELL NEBULAE BY USING INTERACTING WIND MODEL
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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The relation of kindergartens teachers emotive equanimity with the kindergarten child's anxiety
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The researcher aims to  detect the emotive equanimity in kindergartens teachers,also to uncover the anxiousness in children of kindergartens,then to detect the relationship between them,then to choose the simple random way which is about(180) teachers and children,when the twore searchers made two tools to measure the emotive equanimity and the anxiety for both teachers and children,statistical methods had been used include:(pearsons correlation coefficient,t-test for one sample,t-test for two independent samples are individuals).the researcher led to multiple results:

1-the teacher has an emotive equanimity.

2-children has no anxiousness.

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Publication Date
Sat Oct 20 2018
Journal Name
Journal Of Economics And Administrative Sciences
Measuring the performance of government units according to the government accounting system
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Abstract

This study aims at clarifying the current performance appraisal system in government units and the extent to which they contribute to the development of the performance of these units by evaluating and measuring the performance of these units on an ongoing basis to subject their services to an assessment and measurement process in order to improve the efficiency of these units to reach their objectives efficiently and effectively. (Iraqi hospitals) by trying to determine the possibility of the government accounting system in the process of evaluating performance, through the comparison of financial performance for successive years and different hospitals using the financial and non-financial model of the evaluati

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Publication Date
Thu Mar 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
An Artificial Intelligence Algorithm to Optimize the Classification of the Hepatitis Type
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Hepatitis is one of the diseases that has become more developed in recent years in terms of the high number of infections. Hepatitis causes inflammation that destroys liver cells, and it occurs as a result of viruses, bacteria, blood transfusions, and others. There are five types of hepatitis viruses, which are (A, B, C, D, E) according to their severity. The disease varies by type. Accurate and early diagnosis is the best way to prevent disease, as it allows infected people to take preventive steps so that they do not transmit the difference to other people, and diagnosis using artificial intelligence gives an accurate and rapid diagnostic result. Where the analytical method of the data relied on the radial basis network to diagnose the

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The Educational Thought of the Chief Justice Badr Al-Din Ibn- Jamaah
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The ideas and principles formulated by Ibn-Jamaah in the field of education occupy a central place in the historical origins of education for Muslims. These views and principles have an active role in the educational reorganization that the Islamic world aspires to. These ideas have had a great impact on the educational process that had preceded the opinions of Russo, Pestalutzi, Fruel, Herbert, and Dewey. Moreover, we have seen that the Sheikh of Ibn-Jamaah has taken part in formulating the origins of education and leadership.

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Publication Date
Wed Dec 31 2025
Journal Name
Accounting And Financial Sciences Journal
The Analyze of the Available Strategic Choices for External Borrowing (Futuristic Vision)
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