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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
Fri Dec 30 2022
Journal Name
Journal Of The College Of Education For Women
The Death Scene in the "Ayniyah" Poems of Abi Thuayib Al-Huthali and Suda bint Shamardal: A Contrastive Study
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This study is an objective literary study of the poems of Abu Dhu'ayb Al-Hudhali and Su'da Bint Al-Shamrdal. It aims to shed light on the philosophy of death in the poems, and the way this philosophy is treated by both poets. Thus, the main prominent poetic images have been addressed and the outstanding ones have been singled out. The study further investigates the intertextuality with other poetic verses and Quranic verses and reviews the deviation in their semantic, syntactic, and phonetic types. The study adopts the historical approach to examine the occasion of the poems by referring to several historical sources that indicate the seniority. It also adopts the and descriptive-analytical approach represented by the use of content anal

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Managerial Skills and It`s Role in Strengthening the Competitive Edge of Companies: A Case Study in the General Company for Construction Industries
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This research tries to reveal how to manage and control the competitive edge for business by building managerial skills in various organizational levels. Our research aims at finding out the nature of various technical, human and in tellectual skills of a new president whose superiority is his competitive ness in the application field at general company for construe tioual  industriesand testing the surveyed minor and major changes through a questionnaire to collect information from officials. The sample was composed of (45) director. The data was analyzed  using some methods and statistical programs. The most prominent of these is (SPSS) that was used to extract the arithmetic mean, standard deviation, correlation coefficient

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Publication Date
Sat Apr 10 2021
Journal Name
المؤتمر العلمي الدولي الثالث - المجلة الامريكية الدولية للعلوم الانسانية والاجتماعية
Public Governance and Sustainable Development - A descriptive study of the reality of public institutions in Iraq
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In light of crises, the need for efficient and flexible public administrations to make quick and decisive decisions, also institutions capable of directing the internal elements and components of them and adapting them to the requirements of rapid change due to crises and disasters, which led to scarce resources becoming scarcer and economic, political and social problems becomes more prominent. For the majority of developing countries, including Iraq, the increasing need for the importance of moving towards enhancing the efficiency of the performance of public institutions while trying to predict their future, can only be achieved. Through solid mechanisms and principles of governance that enhance the ability of institutions and make them

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Publication Date
Wed Feb 22 2023
Journal Name
Iraqi Journal Of Agricultural Sciences
A STUDY OF ECONOMIC, SOCIAL, AND INSTITUTIONAL FACTORS AFFECTING THE ADOPTION OF THE HIGH-RANK WHEAT SEEDS
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The aim of this research is to investigate the effect of economic, social and institutional factors on adoption within the national program for the propagation of high-rank seeds of wheat crop. 170 questionnaires were collected, 50% of them were participants in the program from Wasit and Babil governorates. Probabilistic regression models were used to know this effect, and the possibility of adopting Farmers of improved seeds produced from the national program for the multiplication of seeds of higher grades using the (ADOPT) program. The adoption rate was 0.12%, and the total number of adopters were 12 farmers, at a rate of 14.2%. Tobit model was estimated  to find out the impact of the profitability of the dunum, capital, farm si

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Publication Date
Wed Dec 15 2021
Journal Name
Al-academy
Realism in the painting of Iraqi Kurdistan artists "A Study in methods of expression"
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The tagged research (realism in the Paintings of Iraqi Kurdistan artists, “a study of expression methods”) dealt with realism in an objective way, as well as the complexity of its concepts through its formations and formations. On realism and its historical dimension in concept and meaning, as for the second chapter, the research was focused on the methods of expression in painting, while the third chapter was concerned with the procedural applications of realistic methods of expression in the drawings of Iraqi Kurdistan, and according to these axes and to achieve the goal of the research, a number of Among the results are:
1- Realism documented the life of the Kurdish society in line with the developments of the era, as the sty

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
Semantic Exchange A study of rooting the term
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The term "semantic exchange" was popularized in Arabic, especially in derivatives, grammatical structures, etc., but it came under different names or terms, including deviation, deviation, transition, displacement, tooth breach, replacement, attention, etc. In the rooting of this term through its study in language and terminology, and among linguists, grammar and others, we have reached a number of results, including The existence of a harmonization between the lexical and idiomatic meaning of the term exchange, and the phenomenon of semantic exchange is a form of expansion in language, and that the first language scientists They had turned to this And studied under Cairo for different names, as noted above.

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Publication Date
Thu Oct 01 2020
Journal Name
International Communications In Heat And Mass Transfer
Thermal behaviour of the flow boiling of a complex nanofluid in a rectangular channel: An experimental and numerical study
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Publication Date
Wed Jan 01 2020
Journal Name
Indian Journal Of Dental Research
Biomechanical finite element analysis of a single implant threaded in anterior and posterior regions of maxilla bone
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Context: The ability of implant dentistry to be a successful alternative for edentulous patients has increased in the last decade. Clinical features such as osseointegration and stability, in addition to the endurance of the integration urged the researchers towards a better understanding of the design parameters that control long term success of the implants. It is therefore necessary to quantify the effect of changing implant design parameters on interface stress distribution within the maxilla bone. Methods and Materials: A 3D-finite element study was conducted to investigate the effect of changing implant shape parameters (implant body design and implant thread depth) on stress distribution while insertion of the implant in two diff

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Publication Date
Sun Jan 01 2012
Journal Name
Journal Of The College Of Languages (jcl)
Difficulties Faced by Engineering Students in Reading and Comprehending English Texts
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Reading is an interactive process that goes on between the reader and the text, resulting in comprehension. The text presents letters, words, sentences, and paragraphs that encode meaning. The reader uses knowledge, skills, and strategies to determine what that meaning is. Reading comprehension is much more than decoding; it results when the reader knows which skills and strategies are appropriate for the type oftext, and understands how to apply them to accomplish the reading purpose.Reading comprehension is important because without it reading is nothing more than tracking symbols on a page with your eyes and sounding them out leaving the reader with no information. Instead of promoting traditional approaches, reading should be ta

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Publication Date
Wed Jun 01 2005
Journal Name
Journal Of The College Of Languages (jcl)
Difficulties Faced by Engineering Students in Reading and Comprehending English Texts
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Reading is an interactive process that goes on between the reader and the text, resulting in comprehension. The text presents letters, words, sentences, and paragraphs that encode meaning. The reader uses knowledge, skills, and strategies to determine what that meaning is. Reading comprehension is much more than decoding; it results when the reader knows which skills and strategies are appropriate for the type oftext, and understands how to apply them to accomplish the reading purpose.Reading comprehension is important because without it reading is nothing more than tracking symbols on a page with your eyes and sounding them out leaving the reader with no information. Instead of promoting traditional approaches, reading should be taught

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