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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 Dec 15 2019
Journal Name
Al-academy
Environmental References in the Drawings of Ismael Al-Shaikhli: محمد مشعل حبيب
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              The environmental references represented by the intellectual, social, economic, political and religious pressures are considered fundamental factors for the artistic achievement whose importance comes from their multiplicity and branching into natural and psychological pressures that affect the multiplicity, diversity and variability of the artistic and performative methods.  Thus they determine the artist's orientations and the creative artistic visions are summoned through symbols and semantic signs of the visual surface, because the societal thought  in   art in general and the fine art in specific occupies an influential position 

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Publication Date
Wed Oct 02 2024
Journal Name
Anggaran Jurnal Publikasi Ekonomi Dan Akuntansi
Do Iraqi Ceo Depending On Strategic Planning In The Face Of Crises
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Abstract.The goal of this article is to find the CEO of Iraqi companies that use strategic planning and determine if they are capable of diagnosing the traits of strategic planning systems that improve these companies' capacity to successfully address crisis-related needs. The capacity of the company to successfully react to crisis needs and demands is enhanced by the use of strategic planning, according to a review of data from 64 enterprises utilizing statistical analysis. Furthermore, top and division or unit managers must be involved and committed for strategic planning to be successful. It also has to be planned with an external orientation and get more than just lip service from top and unit or division level managers. In other words,

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Publication Date
Mon Sep 22 2025
Journal Name
Journal Of Physical Education
The Effect of Using Mental Maps On Cognitive Achievement In Rhythmic Gymnastics
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Publication Date
Thu Oct 01 2015
Journal Name
International Journal Of Engineering Sciences & Research Technology
IMPROVEMENT THE MECHANICAL WEAR RESISTANCE OF METAL KNIFE USED IN HARVESTER MACHINE
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SKF Dr. Abbas S. Alwan, Dhurgham I. Khudher, INTERNATIONAL JOURNAL OF ENGINEERING SCIENCES & RESEARCH TECHNOLOGY, 2015

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Publication Date
Thu Jan 01 2015
Journal Name
Al-ustath
Figuring Out the Intended Meaning of Intonation in Some English Conversational Utterances
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The study aims at figuring out the intended meaning of intonation in some English conversational utterances together with identifying pitch variations that are determined by various syntactic constructions that impart the same illocutionary force of utterances. However, intonation is needed to delimit the communicative forces of utterances by virtue of its structure which the speakers intend to convey .This paper consists of four sections .Section one deals with phonology and its types .Section two discusses intonation in relation to style , forms and functions. Section three sheds some light on pragmatics. Section four deals in details with the intended meaning of intonation in some English conversational utterances. This paper comes up wi

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Publication Date
Sun Feb 03 2019
Journal Name
Iraqi Journal Of Physics
Determination the concentration of radon in human urine using LR-115 detector
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In the present study twenty samples of human urine were taken
from healthy male and female with different of: ages, occupation and
place of residence. These samples were collected from the hospital to
measure the concentration of radon gas in human urine by using one
of solid state nuclear track detectors LR-115.
The results obtained of the concentrations of radon in healthy human
urine are varying from 2.12×10-3 Bq.l-1 to 4.42×10-3 Bq.l-1 and
these values are less than the allowed limits 12.3×10-3 Bq.l-1.

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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
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
Sun Mar 01 2009
Journal Name
Baghdad Science Journal
Evaluation of the electron correlation for lithium atom (Li) in ground state
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The aim of this work is to study the correlation between the electrons for Li atom in ground state through the calculation of the inter-particle distribution function f (r12) and inter-particle expectation values . By using the f(r12) function for KL shell in both singlet and triplet state .The Fermi hole have been evaluated .In this work the Hartree-Fock wave function (1993) have been used.

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Publication Date
Sat May 30 2020
Journal Name
Neuroquantology
Desertification Monitoring in the South-West of Iraqi Using Fuzzy Inference System
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In this research, the region in the south-west of Iraq is classified using a fuzzy inference system to estimate its desertification degree. Three land cover indices are used which are the Normalized Difference Vegetation Index, Normalized Multi-Band Drought Index and the top of atmosphere surface temperature to build a fuzzy decision about the desertification degree using eight decision roles. The study covers a temporal period of 38 years, where about every 10 years a sample is elected to verify the desertification status of the region, starting from 1990 to 2018. The results show that the desertification status varied every 10 years, wherein 2000 encountered the highest desertification in the south-west of Iraq.

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