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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 Oct 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The role of organizational change in easing the organizational conflict: an exploratory study of the opinions of a sample of managers and workers in Iraq to EarthLink Network Services Company And communications
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Research on the role of organizational change in easing the organizational conflict focuses for being one of the important topics and relatively modern and which have a significant impact on the future of organizations, so this study was to identify the relationship and the impact of organizational change and of deportation (technological, organizational structure, human resources, the change in the task) at the organizational conflict in the Earth company link Iraq, in order to reach the goals of the research, it has been the development of a questionnaire distributed to a random sample of (100) composed employees from managers and heads of departments and the people and staff at the Earth company link Iraq, the study found: the

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Publication Date
Fri Sep 30 2022
Journal Name
Modern Sport
A historical study of the Iraqi national team’s participation in the blind men’s goalball in the Asian Championships for the period (2014-2022)
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من الاهمية دراسة التاريخ كونه يمدنا بحلول للمشكلات المعاصرة في ضوء خبرات الماضي، ودراسة سلبيات وايجابيات هذه الحلول، وانطلاقا من مبدأ أن ذوي الإعاقة البصرية طاقة بشرية لابد من استثمارها بما يخدم تقدم وازدهار المجتمع، فمن الأهمية تسليط الضوء على هذه الفئة والإسهام بنقل صورة مشرفة عنها، قد تكون دافعا للآخرين ممن اوقفهم انطفاء شعاع النور والبصيرة عن اكمال حياتهم لشرارة امل تعيد لهم شغفهم في الحياة، وته

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Publication Date
Thu Mar 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Electronic Customer Trust Building Tools On Excellent Performance An analytical study of the opinions of a sample of individuals in the administrative and leadership positions in the Northern Cement Company
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The current study aims to overcome the conflicts facing the company in its way of staying and continuing to maintain its performance excellent in light of the intense competition, which made it seek to find strong ways and links with its customers through electronic communication using electronic platforms, and this put confidence and safety in The place of suspicion and fear of not fulfilling credibility or violating the privacy, so this research comes to answer about the question:  “Can the company achieve an excellent performance by relying on the customer's electronic confidence?”.

The study followed the descriptive and analytical approaches by providing a virtual model and testing the zero hypotheses, which stipulat

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Role of E-Learning in enhancing Total Quality Management in Educational Institutions: an exploratory study of the opinions of a sample of the staff of the Directorate of Education in the province of Nineveh
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Purpose: The research aims to determine the relationship between E-Learning and Total Quality Management (TQM) in Educational institutions in Nineveh Governorates.

Methodology / Design: The researchers distributed (30) questionnaires to employees (teachers and administrators) of Nineveh Governorate education who represent the community of the research sample, as they were analyzed using the SPSS V.20

The importance of research: The importance of the research in the fact that it focuses on one of the educational methods represented in integrating the traditional method and relying on modern technologies using computers and the Internet in the field of education to improve the reali

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Publication Date
Thu Aug 21 2025
Journal Name
Al–bahith Al–a'alami
THE SEMIOTICS OF PROPAGANDA SPEECH IN SOCIAL MEDIA SITES (A Semiotic Study of the News Reports on the Israeli "Makan" Channel)
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Technological and digital development has allowed the emergence of many methods of producing semantics on social media sites within semiotic and propagandistic frameworks. This is what made the image appear in different molds and shapes, especially as it is the first material for visual perception.
This made the Israeli propaganda discourse use it as an important tool to manage the content of suggestive messages with semiological connotations. By doing so, such tool uses social networking sites as an appropriate environment to achieve those goals, which are related to cases of manipulating emotions and minds. It, moreover, changes convictions, attitudes, trends and behaviors according to what the propaganda planner wants.
Many Isra

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Publication Date
Thu Dec 24 2020
Journal Name
Psychology And Education
The Use of Ergative Verbs to Background the Role of the Agent in two Selected Short Stories: A Syntactico-Semantic Study
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The study explores the use of ergative verbs in constructing clauses and their impact on the backgrounding of the agent's role in two selected short stories. Contrary to hypothesis No. 1, the research indicates that changes in sentence patterns don't affect the meaning of the process. Additionally, hypothesis No. 2 is refuted as the middle structure is found to highlight the agent's role in the science fiction short story, Terra Infirmum, rather than concealing it as hypothesized for "The Invisible Man." The analysis uncovers that writers utilize ergative processes to narrate stories in various ways, including transitive/active voice, intransitive/active voice, and transitive/passive voice. Furthermore, the findings suggest that writers emp

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Triumph in the Glorious Qur’an: A Semiotic study
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Triump is a happy end and a positive outcome of any good deed on the part of a human
being, or of any competition or contest in any field. A human being’s life abounds with gain
and loss. If one succeeds one will be happy psychologieally, physieally, etc. if one the other
hard one loses, one wil be in a state. Between loss and gain there are many a step.
However humans work hard to be a great success and a read winner.The life of the world constitutes a huge race-track where people try hard to head towards
the hereafter. Therefore, we find people who succed and gain the Garden, and people whose
habitation is the fire, The Glorious Qur’an has shown us in many a surah the way to success
when Allah mentions ‘great

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Publication Date
Sun Jul 07 2019
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Chromogenic in Situ Hybridization Technique versus Immunohistochemistry in Assessment of HER2/neu Status in 448 Iraqi Patients with Invasive Breast Carcinoma
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BACKGROUND: The rapidly growing knowledge regarding factors controlling tumour growth, with the new modalities of therapy acting on the biological activity of the tumours draw the attention of most cancer researches nowadays and represent a major focus for clinical oncology practice. For the detection of HER2/neu protein overexpression and gene amplification, immunohistochemistry (IHC) and in-situ hybridisation (ISH) is the recommended techniques, respectively, with high concordance between the two techniques. The current United Kingdom recommendations for HER2/neu testing are either for a two-tier system using IHC with reflex ISH testing in equivocal positive cases, or a one-tier ISH strategy. AIM: To compare the results of HER2/neu gene s

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Publication Date
Wed Jan 01 2014
Journal Name
American Journal Of Mathematics And Statistics
Preliminary Test Single Stage Shrinkage Estimator for the Scale Parameter of Gamma Distribution
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Publication Date
Sat Aug 01 2015
Journal Name
Journal Of Engineering
Improving the productivity of single effect double slope solar still by modification simple
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The present paper is an experimental study to improve the productivity of the conventional solar still. This done by modifying conventional still in a way that the distilled basin is larger than distillation basin, thus providing an increase in the condensation surface and speeding up the condensation process. Moreover, increase in the dimensions of the distilled base helps coupling reflective panels to the distilled base to reflect incident solar radiation to the distillation basin. For this purpose , two solar stills were made, one conventional designand another made according to the proposed design. The two solar stills were tested during the period from February to July 2009 under varying weather conditions of Basra, Iraq (latitude o

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