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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
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Technique Features of the 1990s Prose Poem in Iraq: The Technique Features of the 1990s Prose Poem in Iraq
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Abstract:
The prose poem of the 1990s is considered one of the important
contributions of the Iraqi poetic scene. The poem found a position in the Iraqi
poetry because of the favor of a group of youth poets who lefty clear traces.
Their linguistic techniques often violate the domain o9f language, significance
and image.
The poems of those youth poets moved the verse towards reality to
drink from its abundant springs in order to stand on a rigid ground. Their
linguistic traces are characterized by paradox and astonishment that are used
by the poet to construct his poem.

The paradox was considered an ideal means for constructing a
poem by some of them. The poem moved towards definitions and these
de

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Publication Date
Sat May 02 2015
Journal Name
التربية العلمية
the effect of a strategy on the reading compreheehension of first-yearinter intermediate school students
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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
ON G-OPEN SET
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A new class of generalized open sets in a topological space, called G-open sets, is introduced and studied. This class contains all semi-open, preopen, b-open and semi-preopen sets. It is proved that the topology generated by G-open sets contains the topology generated by preopen,b-open and semi-preopen sets respectively.

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Publication Date
Wed Mar 08 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
List of Scorpions Recorded For the First Time in Iraq
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 The present study is the first taxonomic study on scorpions in Iraq. The specimens were collected from regions in the middle and south of Iraq, three families, seven genera and eight  species were recorded for the first time in Iraq and one new species of the world. 

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
The first recording of leaf blight disease Defla in Iraq
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The results showed the spread of disease blight leaves caused by injury fungus Alternaria in different areas of cultivation in the city of Baghdad where he was recording the highest rate and the severity of the disease of 100% and 80%, respectively, in the Abu Ghraib area and the least of 20% and 12% respectively in the Amiriya district results showed test pathogenicity of the fungus pathogen emergence of symptoms of the disease superficial discoloration Authority of black paper when wound areas and yellowing of leaves about race as centrist and leaky latest country clear ????? on Central race after 48 hours ....

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
The impact of Arab civilization   On the first century AH
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The influx of Arab Qahtani and Nizari tribes continued to the countries of Baluchistan and the Levant in pre-Islamic times until the Levant became open to the Arab-Islamic tide during the first century AH. The Islamic Orient until the early Islamic Arab Army reached the western borders of China. What we will see in the folds of the search.

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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Crisis management effective of business organizations in the era of managerial technique: a philosophical study
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At a time of increasing human potential in the face of crises and risks through the use of technology on a large scale and steadily in various fields of life, and the vulnerability of business organizations as a result of mistakes. The failure of a sudden these errors or omissions or symptoms. Also, some crises occur outside the control of management, others caused by leakage of important information and sometimes secret may be a strategy or a new plan or new project occurs outside the organization to the opposite of what is planned. Therefore, the crisis management are critical to all organizations, because the active management of the crisis helps to ensure the continued prosperity of the organization. Here comes from the resea

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Publication Date
Wed Mar 01 2023
Journal Name
Baghdad Science Journal
A Characterization of Maximal Outerplanar-Open Distance Pattern Uniform Graphs
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Let A ⊆ V(H) of any graph H, every node w of H be labeled using a set of numbers; , where d(w,v) denotes the distance between node w and the node v in H, known as its open A-distance pattern. A graph H is known as the open distance-pattern uniform (odpu)-graph, if there is a nonempty subset A ⊆V(H) together with  is the same for all . Here  is known as the open distance pattern uniform (odpu-) labeling of the graph H and A is known as an odpu-set of H. The minimum cardinality of vertices in any odpu-set of H, if it exists, will be known as the odpu-number of the graph H. This article gives a characterization of maximal outerplanar-odpu graphs. Also, it establishes that the possible odpu-number of an odpu-maximal outerplanar graph i

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Publication Date
Sun Dec 01 2024
Journal Name
Baghdad Science Journal
On pre- Open Regular Spaces
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In this paper, certain types of regularity of topological spaces have been highlighted, which fall within the study of generalizations of separation axioms. One of the important axioms of separation is what is called regularity, and the spaces that have this property are not few, and the most important of these spaces are Euclidean spaces. Therefore, limiting this important concept to topology is within a narrow framework, which necessitates the use of generalized open sets to obtain more good characteristics and preserve the properties achieved in general topology. Perhaps the reader will realize through the research that our generalization preserved most of the characteristics, the most important of which is the hereditary property. Two t

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Scopus
Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Study the Effect of Folic Acid as A supplement on Selected Oxidative Stress and Biochemical Parameters in First Trimester of Pregnancy
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Folic acid modulates several disorders in humans, pregnancy mostly because of the mitochondria-rich placenta, is a condition that favors oxidative stress.Transitional metals, especially iron, which are particularly abundant in the placenta, are important in the production of free radicals. Adenosine deaminase (ADA), an enzyme essential for the differentiation of lymphoid cells, has been used for monitoring diseases with altered immunity. In the present study we investigated the effect of regular and irregular administered folic acid in the first and second trimester of pregnancy to be compared with non-pregnant women ,and also the effect of regular and irregular using of folic acid  supplement on  oxidative stress parameters an

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