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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 Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Social intelligence and its role in demonstration the Potential abilities for individuals
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Abstract

          The following research is marked by "social intelligence and its role in demonstration the potential abilities for individuals." The discussion dealt with the concepts of contemporary is very important because of their significant role in influencing the work of the Organization, as adopted link between the concepts of social intelligence and the potential role of the first to show the second .The research hypotheses tested in three health institutions in the city of Mosul, the research community is represented (Al-Salam Hospital and General Hospital and the son of ether), while the sample were the leaders of these institutio

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Analysis the Causal Relationship between Oil Exports and Economic Growth in Iraq
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The oil exports play a vital role in supporting economic development and raise the economic growth. The oil exports can increase the economic growth via three main channels which are supporting the productive, distributive and service sectors; increasing the investment and capital formation; and increasing the employment rate.

However, the oil exports did not have an important role in increasing the economic growth in Iraq. Therefore, it also did not provide the required support to other economic sectors, neither participated in increase the employees’ skills nor increase the investment rate. It may slightly contribute in enhancement the infrastructure that can attract the public and private investments

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Publication Date
Tue Jan 30 2024
Journal Name
International Journal Of Engineering Pedagogy (ijep)
E-learning in the Cloud Computing Environment: Features, Architecture, Challenges and Solutions
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The need to constantly and consistently improve the quality and quantity of the educational system is essential. E-learning has emerged from the rapid cycle of change and the expansion of new technologies. Advances in information technology have increased network bandwidth, data access speed, and reduced data storage costs. In recent years, the implementation of cloud computing in educational settings has garnered the interest of major companies, leading to substantial investments in this area. Cloud computing improves engineering education by providing an environment that can be accessed from anywhere and allowing access to educational resources on demand. Cloud computing is a term used to describe the provision of hosting services

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Publication Date
Thu Mar 19 2015
Journal Name
Al-academy
The technical and conceptional changing in post modern art: شيماء وهيب خضير
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The art has been turned its subject in the post modern thinking . this turning is aresult to the turning in the role of the art it self. Across its history the art was basing its subject on a universal unite it the phenomenenon which is the most elevated . that the artist try to activate the role of the subject as a axial which compose the plastic art them. Because of the history of art full with subjects which consider in alarg part of it, have relation ship with elite and aesthetics , and from the begening of renaissance the central activity of the art was based on opoint which has concentrated reaction or it going in away belong to the state in that time.so renaissance was in relegous axial and romantisim on a dream axial, classisisim

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Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
The Idea and Creative Imagination in Mind Maps Designs: ثامر حميد رزوقي
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  The mind map represents a system to solve problems including design problems, because it depends on employing the complex and purposeful mental activity, which starts from a desire based on the search and investigation in order to reach integrated results of scientific thinking, utilizing the objective view of the scientific and practical aspects from various angles. This visual system can develop thinking and shorten the retrieval time of the previous information in order to employ it in the solution finding system, that it evokes past experiences and relates them to current situations, then enables the user to choose a suitable solution for the problems. This visual, educational and circulatory means, at the same time, has speci

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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Asthma and Inhaled Corticosteroid Effect on the Dental Arch Morphology in Children
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Background: asthma has an influence on craniofacial development. Recently evidences show that there is an association between oral health problems and chronic lung disease. The present study was designed to estimate the changes in arch dimension measurements among asthmatic children aged 12 years old who were collected from AL- Zahra Center Advisory for Allergy and Asthma and compare them with the non-asthmatic children of the same age and gender. Material and Methods: Fifty children (25 asthmatic and 25 non- asthmatic children) were included for the odontometric measurement. For both upper and lower study models, photographs were taken using special photographic apparatus for each child, and the statistical analysis were done by using SPSS

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Publication Date
Tue Jun 01 2021
Journal Name
Political Sciences Journal
The security environment in Northeast Asia between American authority and Chinese influence
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The security environment for Northeast Asia is extremely important, as it includes most of the international actors (United States of America, China, Russian Federation and Japan), which gives the nature of the interactions of these forces a special importance for the region.

Because of the multiplicity of policies and interests of the active forces in the region, the result has been an unstable regional environment where the interests of the major powers often clash repeatedly on many related issues, which is coupled with the growing efforts of many powers to adopt policies that differ from what they did in the past This resulted in different patterns of relations, which were mainly characterized by competition over regional lea

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Publication Date
Tue Dec 30 2014
Journal Name
College Of Islamic Sciences
Memorizer Keeper      And his method in his masterpiece      Supervision by the parties
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What has reached us from this great heritage left by our scientists book ((masterpiece of honor by knowing the parties)) to the conservative privilege, which Imam Safadi said ((Sheikh of time, and the preservation of the era, and critic of the time, if his son Ibn Makola had a drink and eaten, and make it to him So, after trusting in God, I thought that I should write a paper highlighting the life of this great world and explaining its methodology in this useful book in which Imam Ibn Hajar al-Asqalani said: `` The use of it took place east and west, and the scholars competed in collecting it after. And soon)).

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Publication Date
Wed Oct 25 2023
Journal Name
College Of Islamic Sciences
The good and bad words in Surah Ibrahim, peace be upon him
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In the name of God, the Most Gracious, the Most Merciful

Praise be to God who revived Balu. And the good word brought hard hearts after removing from them what had almost killed them of ignorance, injustice, hatred, hostility, estrangement, and irritation... So God replaced for them what was best with what was best in terms of knowledge and fairness, and what was corrupt, love, and altruism. So the example of a believer and a good word is like a tree with good roots and branches. Then I pray and greet the one who watered it from the pure and inexhaustible spring of Islam, our Master Muhammad, so that the valleys flowed in their capacity, and the crops grew, then they became thicker and became even, and their good fruits in behavi

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
Sustainable design in the Iraqi craft industries and ways to develop them
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Research on sustainable design in Iraqi craft industries and ways to develop them is essential to preserving the cultural heritage and authenticity of these industries while promoting environmentally sustainable practices. Lack of access to modern technologies, knowledge and resources may hinder the growth of these industries and their ability to compete in the global market. The research problem revolves around finding ways to develop sustainable design in the Iraqi craft industries. The expected outcomes of this research include a clear definition of sustainable design, understanding the history of sustainable design in the craft industry, identifying different types of craft industries in Iraq, exploring the basic concepts of sustaina

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