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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 Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Suggested Technique for Creating Physical Growth Curves Charts for Anthropometric Measurements in Admixed form in a sample of children under two years of age In Diyala Governorate
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Objective: This study aimed to assessing new suggested technique of Physical Growth Curves (PGC) charts in
children under two years old of a non-probability sample.
Methodology: A non-probability sample of size (420) children under two years selected from 12 Primary
Health Care Centers in Diyala governorate during the period from 15th Nov. 2010 to 13th Mar. 2011
according to admix of a different properties together in one chart/or growth curve chart included in at least
weight, Height, and Head circumference.
Results: the results showed different properties that can be admix together in one chart/or growth curve
chart included in at least weight, Height, and Head circumference. And to overtake the problem of the norm

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Publication Date
Fri Nov 09 2018
Journal Name
International Journal Of English Linguistics
A Discourse Analysis Study of Comic Words in the American and British Sitcoms
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DBN Rashid, International Journal of English Linguistics, 2019 - Cited by 2

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The impact of the RMB exchange rate on the value of Chinese exports For the period (1978-2017) using the Angel-Granger model
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In this research, we sought to identify the nature of the relationship between the exchange rate of the Chinese yuan and the value of Chinese exports, through the formulation of a standard model based on the model of common integration, and based on the data of the study and using the test "Angel-Granger" It reflects the relationship between the two research variables, through which the relationship between the RMB exchange rate and the value of Chinese exports was estimated during the period 1978-2017.

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Publication Date
Wed Jun 20 2018
Journal Name
Al-academy
Directed by Treatment for single-place events in the cinematographic medium
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The cinematographer mediates through the means of cinema and television a set of elements complementing each other in the light of developments in various sciences, culture and arts for the purpose of conveying the meaning to the recipient and achieve aesthetic taste. Despite the diversity of cinematographic media with its multiple forms, The researcher started from the principle of definition and knowledge of a technical phenomenon that emerged in the cinematographic medium through the treatment of dramatic events through the solutions of the exit line depends on the narrative of events in one place contributes to attract Mam spectator since this interesting phenomenon in the mediator, there .van question arises the adoption of that vis

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Publication Date
Tue Dec 01 2020
Journal Name
Baghdad Science Journal
The Numerical Technique Based on Shifted Jacobi-Gauss-Lobatto Polynomials for Solving Two Dimensional Multi-Space Fractional Bioheat Equations
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This article deals with the approximate algorithm for two dimensional multi-space fractional bioheat equations (M-SFBHE). The application of the collection method will be expanding for presenting a numerical technique for solving M-SFBHE based on “shifted Jacobi-Gauss-Labatto polynomials” (SJ-GL-Ps) in the matrix form. The Caputo formula has been utilized to approximate the fractional derivative and to demonstrate its usefulness and accuracy, the proposed methodology was applied in two examples. The numerical results revealed that the used approach is very effective and gives high accuracy and good convergence.

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Publication Date
Sat Jun 06 2020
Journal Name
Journal Of College Of Education For Women
Main Difficulties Faced by EFL Students in Language Learning
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Many undergraduate learners at English departments who study English as a foreign language are unable to speak and use language correctly in their post -graduate careers. This problem can be attributed to certain difficulties, which they faced throughout their education years that hinder their endeavors to learn. Therefore, this study aims to discover the main difficulties faced by EFL students in language learning and test the difficulty variable according to gender and college variables then find suitable solutions for enhancing learning. A questionnaire with 15 items and 5 scales were used to help in discovering the difficulties. The questionnaire was distributed to the selected sample of study which consists of 90 (male and female) stud

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Publication Date
Sat Jun 06 2020
Journal Name
Journal Of The College Of Education For Women
Main Difficulties Faced by EFL Students in Language Learning
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Many undergraduate learners at English departments who study English as a foreign language are unable to speak and use language correctly in their post -graduate careers.  This problem can be attributed to certain difficulties, which they faced throughout their education years that hinder their endeavors to learn. Therefore, this study aims to discover the main difficulties faced by EFL students in language learning and test the difficulty variable according to gender and college variables then find suitable solutions for enhancing learning.  A questionnaire with 15 items and 5 scales were used to help in discovering the difficulties. The questionnaire was distributed to the selected sample of study wh

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Publication Date
Sun May 18 2025
Journal Name
University Of Anbar Sport And Physical Education Science Journal
That the child is aged 7 years, surrounded by information, knowledge and skillsvaried,
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Abstract That the child is aged 7 years, surrounded by information, knowledge and skillsvaried, which constitute the raw material of experience teaching and is in the rule of inputlearning, if received by the student of these data are positive, these data require research and audit, the style becomes more positive, effective, and then becomes the explorer, butnot done exploration efficiency without the visual, auditory and sensory owned by thechildren. So study aimed to identify the values of the optical track and explore mathematical and find the relationship between them. And use the descriptive approach in a manner the linkon the children of the first year of primary school age (6-7) years in my school Waziriya and Karkh, during the peri

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Publication Date
Wed Jan 15 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The responsibility of the administration in compliance with the going concern assumption during the preparation for their financial statements: Research practically at muster of companies
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This research aims to demonstrate the impact of the going concern assumption in different accounting applications to provide a realistic look and more accurate result of activity and financial situation, as well as determining the responsibility of the Company's administration in compliance with the going concern assumption during the preparation for their financial statements, and to clarify the concept of integration between internal audit and external audit about going concern assumption, besides its importance and usefulness on the work of both of the internal auditor and the external auditor, as well as on the company under auditing process.This research purports preparing an internal audit program, including a set of auditing actio

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
A field study of the problems of queues at some checkpoints in the city of Baghdad
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Abstract

Due to the momentum of winning in the streets of the city of Baghdad as a result of the large number of checkpoints so felt researcher to conduct a field visit to find out the main reasons that led to this congestion and to find practical solutions to mitigate wastage winning the arrival time citizen to where you want the least possible time.

This research aims to overcome the difficulties experienced by citizens to reach their places of work and reduce waste at the time of service and waiting time as well as reduce the cost of waiting.

Has emerged study a set of conclusions, including the use of model queue (G / G / C) and the mome

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