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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 Mar 28 2021
Journal Name
Journal Of The College Of Education For Women
A Pragmatic Analysis of Personal Deixes in Lyrical Poetry: Ezra Pound's Lyrics "Girl" and "A Virginal": رماح محي مجيد
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Deixes belong to the field of both semantics and  pragmatics as they lie in the edge of these two fields. Pragmatically, they are concerned with the relationship between the structure of a language and the contexts. The present work aims at analyzing the use of deixes using Levinson’s (1983) and Yule's (1996) concept of deixes, where the latter maintained that the referents of the deixes cannot be realized apart from the context where they are used. He added that the contextual information of certain utterances involves information about the participants (the speaker and the addressee), the time and the place. Consequently, a qualitative- descriptive approach has been adopted to meet the objective of the study which reads, “exam

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Publication Date
Thu Dec 30 2021
Journal Name
Al-kindy College Medical Journal
COVID-19 and the Conspiracy Theories
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The first known use of the term conspiracy theory dated back to the nineteenth century. It is defined as a theory that explains an event or set of circumstances as the result of a secret plot by usually powerful conspirators. It is commonly used, but by no means limited to, extreme political groups. Since the emergence of COVID-19 as a global pandemic in December 2019, the conspiracy theory was present at all stages of the pandemic.

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Publication Date
Thu Dec 30 2021
Journal Name
Al-kindy College Medical Journal
COVID-19 and the Conspiracy Theories
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The first known use of the term conspiracy theory dated back to the nineteenth century. It is defined as a theory that explains an event or set of circumstances as the result of a secret plot by usually powerful conspirators. It is commonly used, but by no means limited to, extreme political groups. Since the emergence of COVID-19 as a global pandemic in December 2019, the conspiracy theory was present at all stages of the pandemic.

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Publication Date
Wed Aug 27 2025
Journal Name
Magazine Aldhakwat Albedh
Imam Hussain and the Great Conspiracy
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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of Educational And Psychological Researches
the university education and human development
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We notice that the issue of development is one of the most important issues in ourepoch especially in our country which classify within back ward countries.

When we talk here about the development we don’t mean only the development of capitals or the development of products.but the most important thing is the development of mind .if we notice the experience of  developits economy and it didn’t reach to the wanted aim.because these sides .  The highness of the meutal rate of the nation is the standard of of the nation is the standard of the sentific and cultural advance for this nation .And that is what we have noticed in human societies ingenerall .

We noticed that

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Publication Date
Sat Mar 26 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of applying the CAMELS banking assessment model asa control tool On Iraqi private commercial banks for the period 2016 -2020
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The banking sector is currently facing great challenges resulting from intense competition in the financial environment, and this is what makes the supreme audit bodies and the Central Bank audit as the highest supervisory authority on banks in order to achieve profit and not be exposed to loss, and this requires identifying the banking strengths and risks that constitute points Weakness that affects the future performance and the life of the bank, which requires special supervisory care, and from this point of view, the research aims to use the CAMELS model as a control tool in banks, through the use of its six indicators: capital adequacy, asset quality, management quality, profits, liquidity And sensitivity to market risks, th

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Publication Date
Mon Dec 31 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
THE ROLE OF MARKETING MIX AND INNOVATION ON SERVICE DESIGN EXPLORATORY RESEARCH AT COMPANY KOREK TELECOM.: THE ROLE OF MARKETING MIX AND INNOVATION ON SERVICE DESIGN EXPLORATORY RESEARCH AT COMPANY KOREK TELECOM.
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The success of the company's strategy depends to a large extent on the success of its functional areas, the marketing Mix makes the company more able to monitor the external environment and the rapid changes related to competitors and customers, as well as the innovation contributes to meet the needs of customers and the requirements of competition and try to find solutions to various problems in Innovation ways, and thus integrated marketing and Innovation efforts in the company towards the design of competitive services to meet the requirements of customers and competition. The research aims to determine how marketing Mix and innovation to design unique and distinct services compared to the competitors, through exporator a sample of en

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Publication Date
Mon Mar 25 2019
Journal Name
Al-academy
Digital Image Visual Communication in Internal Virtual Spaces between the Graphic Design and the Internal Design: وسام حسن هاشم - رغد منذر احمد
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The digital revolution had greatly affected the methods through which we communicate, starting from the basic concepts of the internet technology and the web content in addition to the important issues that concern the culture of the digital media, the internet governance and the variation in the digital age in general and the graphic and internal design in particular.
This research addresses an important topic that goes along with the scientific development in the field of the digital design, especially in the internal and graphic designs. This study consists of two sections: the first includes the problem of the study and the need for it. Starting from the problem of the research, there is no clear perception of the formal characte

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Publication Date
Tue Jan 01 2019
Journal Name
Annals Of Medicine And Surgery
The prevalence and correlation between subclinical hypothyroidism and gall stone disease in Baghdad teaching hospital
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Scopus
Publication Date
Wed Jan 06 2021
Journal Name
Journal Of Planner And Development
Environmental dimensions and administrative mechanisms for the territory planning in Algeria, between theory and reality.
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     In front of the serious deterioration of the elements of the environment, new convictions arose the need to integrate into the global environmental concerns as being one and the issue of shared responsibility and the impact of this conviction, the evolution of the environment protection law in many countries, including Algeria. Due to the multiplicity of perceptions about the environmental result of multiple scientific disciplines, the legislative concept emerged to protect the environment, which includes prevention and rational management and conservation and restoration and repair.

    Environmental planning for the various governments and countries aims to avert disasters and achieve the

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