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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
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
The Difficulties which Face Public Basic School Principals in Jarash Governorate in Editing Formal Letters and Correspondence and Means of Dealing With These Problems as Perceived by Them
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This study aimed at identity baying the difficulties which face public basic school
principals in jar ash governorate in editing formal letters and correspondence and means of
debating with these problems to collect data the researchers developed a question air were
established the population of the study which represents its sample consisted of 129 principals
65 males and 64 females
The results of the study revealed that the principals face difficulties in office and file
management in preparing plans and reports and writing formal letters and answering them
saved recommendations were presented among which were organizing training sessions and
workshops to train the principals on how to dead with there problems.<

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Sustainable Accounting indicators that related with create value for the firm
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The business environment is witnessing great and rapid developments due to the economic and technological development that has caused damage to human beings, which requires the need to reduce this damage and work to protect the environment and participate in supporting the social aspects. This requires economic resources to be realized by the economic units. Economic development in preserving the environment that has caused damage and supporting the social aspects that preserve human rights, enhance their position and satisfy their needs in society. Global professional organizations, the United Nations and stakeholder representatives have been issuing the Global Reporting Initiative (GRI) to find guidelines for the preparation of

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Publication Date
Tue Oct 18 2022
Journal Name
Arab World English Journal For Translation & Literary Studiesissn: 2550-1542 |www.awej-tls.org17awej For Translation & Literary Studies,
The impact of landscape on the emotional shift in Tayo’s Character: A Study of memory and displacement in Leslie Marmon Silko’s Ceremony
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This paper examines the decolonizing methods used by Leslie Marmon Silko in her novel Ceremony (1977) to heal the indigenous people from the patriarchal traditions of the white hegemony. This study aims to emphasize the vulnerable responses of the Pueblo people to the memories of the clan and to highlight Silko’s methods to sustain the history and lifestyle of the indigenous people. Therefore, Silko’s novel can be situated historically and culturally within memory-studies. To analyze the contrasting behaviors of characters, this paper projects the relationship between the collective patriarchal doctrines and that of the individual within the framework of memory studies. Theories of Jan and Aleida Assmann are used here to explore the

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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of Engineering
Experimental Investigation of a Single Basin -Single Slope Solar Still Coupled with Evacuated Tube Solar Collector
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This work is an experimental investigation for single basin-single slope solar still coupled with an evacuated tube solar collector. The work is carried out under the climatic conditions of Baghdad city (33.2456º North and East latitude, 44.3337º longitude) through certain days of the months of the year 2019 to study the impact of using evacuated tube solar collector on the daily productivity and efficiency under the outdoors climatic conditions. It was found that using the evacuated tube solar collector increase daily productivity from 2.175 kg/  to 2.95 kg/ for 9 hours (35.63 %) for clear days, also an enhancement about 10.97 % in daily efficiency.

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the forensic accounting philosophy in the transparency and quality of financial statements: : An applied study on a sample of workers at the Trade bank of Iraq and the Gulf Commercial Bank in Babylon
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This research aims to identify the role that forensic accounting plays on the transparency and quality of the financial statements in trade bank of Iraq and the Gulf Commercial Bank in Babylon. This research came to address the problem that most financial institutions suffer from, which is represented by the lack of transparency and the quality of the financial statements issued in a manner. Annual also the manipulation and fraud in the financial data, which causes a big gap between that institutions and organizational stakeholders. According to the implementation of the research hypothesis and the objectives of the research, a questionnaire was prepared consisting of three axes, the first axis dealing with the demographic distri

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Publication Date
Wed Feb 28 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
The Effects of -806 T/C and -857 T/C Single Nucleotide Polymorphisms in the TNF-α Gene on Rheumatoid Arthritis Severity and Inflammatory Markers
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Background: Polymorphisms in the TNF-α gene affect the development and progression of rheumatoid arthritis. Objective: To investigate the associations between (-806 T/C) and (-857 T/C) SNPs with rheumatoid arthritis severity and susceptibility in a sample of Iraqi patients. Methods: A case-control study was conducted in Baghdad, Iraq. Twenty healthy controls and 63 patients confirmed to be newly diagnosed with rheumatoid arthritis were included. Those are divided into two groups (patients and controls), and the patients were further subdivided into severe and mild-moderate groups. Samples from those participants were analyzed for clinical and inflammatory parameter measurements. Genotyping by the Sanger method was performed to stu

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Publication Date
Fri Jan 01 2021
Journal Name
Clinical And Experimental Hepatology
The association between juvenile autoimmune hepatitis and HLA-DRB1 alleles: Iraqi tertiary center experience
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Publication Date
Wed Sep 15 2021
Journal Name
Al-academy
Designing Clothes that Meet the Functional and Aesthetic Needs of Children with Hip Dislocation: تهاني عبد الله القديري
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Children who have a health problem need special requirements for their clothes. The purpose of the study is to design functional and aesthetic clothes to meet their needs. The research used the applied descriptive approach. The research sample comprised 120 women whose children suffered from hip dislocation. Designs for injured children presented and submitted to the arbitrators for evaluation regarding the functional and aesthetic aspects. The finding was achieving the design solutions. The most important recommendations are to increase attention to designing clothes to suit all the needs of society.

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
The phenomenon of building the act of the actor and the effect in the Quranic readings                          (Structural and semantic study)
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After this systematic presentation of the phenomenon of rotation of formulas, ie the construction of the verb and the verb, and the narrated narratives therein differed among the readers, it became clear to us how the difference was clear between reading and the other, and how readers have varied in their readings of the verb, As we have noted through our modest research that the phenomenon of building the verb for the actor and the effect have included the act of both past and present tense, and not limited to a specific time, and this difference in reading was not limited to a particular environment, but beyond To more than one environment This is evidenced by the readings of various readers from the environment of Kufa, Basra, Mecca,

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Publication Date
Tue Oct 01 2024
Journal Name
Results In Engineering
Nanomaterials in asphalt cement: exploring their single and combined effects on the physical and rheological properties
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