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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 Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Role of the School Garden, and its Importance in the school Building - A field study in the social school service
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This research concerns the fact of the school garden and how can we tackle this issue. The research starts with a question forwarded to those who are interested in the ministry of education matters; the question is that how is the extent of interest in the school garden project? And how it is activated in the Iraqi Educational Institution program? In addition, the analysis reveals the importance of the school garden since we, as teachers and students, suffer from seeing the view of the trashes, the wastes of school furniture, the stinking water and the weeds and how it is accumulated in the back yard of the school. To add fuel to the fire, the increase in number of the students; year after year. This increase leads to adding more classes

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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
The optical properties of mawsonite Cu6Fe2SNS8 [CFTS] thin films effected by red laser irradiation deposited via semi-computerized spray pyrolysis technique
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Publication Date
Tue Oct 25 2022
Journal Name
Aip Conference Proceedings
The structural properties of mawsoniteCu6Fe2 S8Sn[CFTS] thin films effected by violet laser irradiation deposited via semi-computerized spray pyrolysis technique
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Publication Date
Tue Nov 30 2021
Journal Name
Research Journal Of Pharmacy And Technology
Diagnostic approach to Perimenopausal bleeding by Pipelle or Dilatation and Curettage
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Perimenopausal bleeding, is a very common problem, which is an alarming symptom for both; women and their doctors because of the rising fears of cellular changes or tumor of endometrium. In our study we tried to prove that collecting endometrial samples using the outpatient method of Pipelle is as effective as collecting the endometrial samples in the traditional method of Dilation and Curettage (DandC) in operation theatre which necessitates general anesthesia. Ninety four patients more than 40 years old were included in the study, all of them were complaining of abnormal uterine bleeding (pregnant ladies and ladies using hormonal contraception were excluded from the study) and endometrial samples were collected first in outpatient

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Publication Date
Sun Oct 01 2017
Journal Name
Diyala Journal For Pure Science
Employing difference technique in some Liu estimators to semiparametric regression model
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Semiparametric methods combined parametric methods and nonparametric methods ,it is important in most of studies which take in it's nature more progress in the procedure of accurate statistical analysis which aim getting estimators efficient, the partial linear regression model is considered the most popular type of semiparametric models, which consisted of parametric component and nonparametric component in order to estimate the parametric component that have certain properties depend on the assumptions concerning the parametric component, where the absence of assumptions, parametric component will have several problems for example multicollinearity means (explanatory variables are interrelated to each other) , To treat this problem we use

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Publication Date
Thu Jun 20 2019
Journal Name
Baghdad Science Journal
Social Worked-Examples Technique to Enhance Student Engagement in Program Visualization
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Learning programming is among the top challenges in computer science education. A part of that, program visualization (PV) is used as a tool to overcome the high failure and drop-out rates in an introductory programming course. Nevertheless, there are rising concerns about the effectiveness of the existing PV tools following the mixed results derived from various studies. Student engagement is also considered a vital factor in building a successful PV, while it is also an important part of the learning process in general. Several techniques have been introduced to enhance PV engagement; however, student engagement with PV is still challenging. This paper employed three theories—constructivism, social constructivism and cognitive load t

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Publication Date
Mon Feb 01 2016
Journal Name
Al-academy
Impact organization of configuration for still life in paintings of first grade students for department of Art Education in subject of colors: احمد مطشر لطيف السبتي
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Problem of research as defined, including the following:what is impact organizing of configuration for still life in paintings of students in the Department of Art Education in subject of colors ?Study of well training for organized in painting of still life is necessary for a teacher of art education to contribute effectively to the performance of his letter, so is this research in response to the public goals for a subject of art education. The current research aims to:1. Impact organization of configuration for still life in paintings of students in the Department of Art Education for the first grade in subject of colors2. Role organization of configuration for still life in the painting to serve the educational process in subject of

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of The College Of Languages (jcl)
The Intellectual as an Alien: A Study of Henry James's The Beast in the Jungle and James Joyce's "A Painful Case"
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This research paper studies the alienation of the intellectuals in the modern novel through the study of two alienated characters, John Marcher in Henry James's The Beast in the Jungle, and Mr. Duffy in James's Joyce's "A Painful Case." As a result of the complexity of life in the industrial societies, the individuals, especially the intellectual ones, feel themselves unable to integrate into social life; they fear society and feel that it endangers their individuality and independence. Thus, these characters live on the fringe of the societ

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Publication Date
Wed Mar 16 2022
Journal Name
International Academic Journal Of Accounting And Financial Management
Analyzing and Measuring the Relationship between Public Spending and the Parallel Exchange Rate in the Iraqi Economy for the Period 2004-2022
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Public spending represents the government’s financial leverage and has a significant impact on real and monetary economic variables, and one of these effects is the effect of public spending on the exchange rate as an important monetary variable for monetary policy, As we know that public spending in Iraq is financed from oil revenues sold in US dollars, and the Ministry of Finance converts the US dollar into Iraqi dinars to finance the government's need to spend within the requirements and obligations of the state's general budget, And converting the US dollar into Iraqi dinars has an impact on the parallel exchange market, even if there is a contractual exchange rate between the Ministry of Finance and the Central Bank of Iraq to

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Publication Date
Wed Aug 06 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Factors associated with facial swelling severity following impacted lower third molar surgery: A prospective study
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Background: The ultimate purpose of this prospective study is to estimate and measure swelling associated with surgical extrac¬tion of impacted mandibular third molars in different four post-operative times and to identify the risk factors associated with determination of their risk degree. Material and Methods: In this prospective cohort study 159 consecutive cases in which removal of impacted lower third molars in 107outpatients were evaluated. Five groups of variables have been studied which are regarded as a potential factor for swelling after mandibular third removal which will enable the surgeon to predict and counsel high risk patients in order to offer a preventive strategy. Results: Facial measurements were carried out on 1st, 2

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