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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
Thu Jun 10 2021
Journal Name
Engineering, Technology &amp; Applied Science Research
Corruption Risk Analysis at the Project Planning Stage in the Iraqi Construction Sector using the Bowtie Methodology
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In this paper, the bowtie method was utilized by a multidisciplinary team in the Federal Board of Supreme Audit (FBSA)for the purpose of managing corruption risks threatening the Iraqi construction sector. Corruption in Iraq is a widespread phenomenon that threatens to degrade society and halt the wheel of economic development, so it must be reduced through appropriate strategies. A total of eleven corruption risks have been identified by the involved parties in corruption and were analyzed by using probability and impact matrix and their priority has been ranked. Bowtie analysis was conducted on four factors with high score risk in causing corruption in the planning stage. The number and effectiveness of the existing proactive meas

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Publication Date
Wed Sep 30 2015
Journal Name
College Of Islamic Sciences
Fundamentalist detective On matters of consensus   Of Khala book complete the teacher benefits of Muslim Judge Ayaz (May God have mercy on him): Comparative fundamentalist study
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Fundamentalist detective
On matters of consensus
  Of Khala book complete the teacher benefits of Muslim
Judge Ayaz
(May God have mercy on him)

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Publication Date
Fri Sep 17 2021
Journal Name
Political Sciences Journal
Pending issues between the federal government and the Kurdistan region (Constitutional and legal solutions)
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The federal state is usually based on a number of regions because it is based on the multiplicity of political entities. The federal experiments were based on the existence of two or more regions and each federal system has its own peculiarities. Administrative authority between the federal government and local elected bodies of local people of absolute relative independence does not threaten the entity of the state according to the Constitution and the law and on a regional or reformer basis and exercise its powers within the legal scope prescribed The relationship between the federal authority and the Kurdistan region is the first level of the relationship on the real level, especially since no other region in Iraq has been formed exce

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Publication Date
Wed Dec 19 2018
Journal Name
Brazilian Journal Of Physics
The Induced Electron Density Effects of Swift Heavy Ions in Polymethyl Methacrylate
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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 Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Fuzzy logic in the estimate of reliability function for k - components systems
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Abstract:

One of the important things provided by fuzzy model is to identify the membership functions. In the fuzzy reliability applications with failure functions of the kind who cares that deals with positive variables .There are many types of membership functions studied by many researchers, including triangular membership function, trapezoidal membership function and bell-shaped membership function. In I research we used beta function. Based on this paper study classical method to obtain estimation fuzzy reliability function for both series and parallel systems.

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Publication Date
Wed Jun 30 2021
Journal Name
College Of Islamic Sciences
Technical image sources In the poetry of Muhammad Salih Bahr al-Ulum
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يتناول البحث شخصية شعرية وأدبية فذة هو محمد صالح بحر العلوم الشاعر العراقي المعروف والمولود في بيت ثوري من بيوتات النجف المعادية للاستعمار البريطاني في مطلع القرن العشرين، وينحدر من أسرة عريقة مشهورة بالعلم والأدب، عاش بحر العلوم شاعراً ينقل بصوره الجمالية كل ما يقع في حواسه، وتجربته تثري من اتصاله ببيئته فنجد الشاعر اشبه بالمصور يستمد صوره من واقع بيئته المتنوع. ونحن في بحثنا هذا نحاول أن نرصد أهم المصادر

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
The strategy of preventive war In US National Security Documents (2002-2006)
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The adoption of the concept of preventive war in any country especially in a country like the United States result in a lot of serious consequences, so that pre-emptive military action may alter certain regional arrangements based on the basis of political and security balance, and reduce the incidence of tensions that may worsen a sudden during the application of preventive war, so the concept is applicable to be a risk much more when you face the reality and that because the issues more importantly, it should prepare a detailed and careful study of the post –stage of the use of preventive military action and this requires realy no papers insist or documents discuss this but accurate this field study of the situation thereafter.

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Publication Date
Sun Sep 15 2019
Journal Name
Al-academy
The Problem of Meaning in Contemporary Iraqi Sculpture: عبد الله فوزي خورشيد
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The concept of meaning is one of the most important topics that have occupied the mind of the recipient and critic in all the arts, especially the plastic arts, where we find that the art of contemporary plastic art, in particular sculpture has multiple readings and many critics differed in terms of different reading and views of the same artistic achievement.

This research will identify the different works of contemporary Iraqi sculptors while presenting and studying their works, as well as (studying the problem of meaning) of the artistic achievements of the sculptors in particular. The various parties interested in Iraqi sculpture did not seize the problem of the objective and subjective meaning of contemporary Iraqi sculpture

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