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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
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of marketing recovery in improving the organization's reputation An applied study of a sample of private bank managers in Baghdad
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This research aims to know and the role of the marketing recovery dimensions in improving the organization's reputation through an exploratory study of private banks in the city of Baghdad. The aim of the research is to define the role of the marketing recovery through its dimensions (compensation, apology, speed of response, assistance and problem solving), in improving the organization's reputation, as the research will attempt to provide a theoretical framework for the dimensions studied through the most important of what researchers presented and then conduct the applied aspect of the research. Data were collected using a questionnaire-based survey consisting of 35 questions and distributed to 110 managers of private banks in

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Publication Date
Fri Apr 04 2025
Journal Name
لارك
Difficulties in Forming Compound Sentences in Spanish for Arabic Speakers
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A sentence is a key part of Spanish grammar and serves as the fundamental unit in constructing discourse. However, foreign language learners, particularly Arabic speakers, may face complex aspects that hinder their understanding and correct use of sentences. Additionally, there are at least two linguistic approaches that describe the use of compound sentences: one considers the sentence as the basic unit for discourse analysis, while other studies, starting with Van Dijk (2003), emphasize the importance of understanding both the partial and holistic structure of discourse. Therefore, we consider the significance of reviewing the linguistic differences between the native language and Spanish as a potential cause of misunderstanding a

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Publication Date
Sun Jun 01 2025
Journal Name
Journal Of Physics: Conference Series
Studies on The Effect of Temperature on The Charge Transfer Reaction Rate of N3 Dye When Contacted With Zinc Sulfide Semiconductor
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Abstract<p>In this paper, the effect of temperature on the charge transfer rate of dye (N3) in contact with ZnS semiconductors is discussed and studied when electrons move from the excited N3 dye to the conduction band of ZnS based on quantum shift theory. In a heterogeneous system, the energy levels are assumed to be continuous, and the N3-ZnS system is surrounded by a variety of polar solvent media. The transition energy of the N3/ZnS heterojunction was calculated using seven different solvents at room temperature, considering the refractive index and dielectric constant of the solvents and the ZnS semiconductor, respectively. The charge-transport reaction rate was calculated over different te</p> ... Show More
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Publication Date
Thu Nov 03 2016
Journal Name
Int. J. Pharm. Sci. Rev. Res.
Impacts of simultaneous administration of omega-3 fatty acids with amoxicillin/clavulanic acid on albino rats' liver and bile
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Most drugs undergo some metabolism in the liver before excretion by the kidneys or bile. Thus, it is not surprising that liver injury may be provoked due to its exposure to various drugs and compounds. Drug-induced cholestatic liver injury may occur particularly under conditions of increased drug concentrations, genetic alterations in expression of enzymes or transporters. Additionally, the drug-induced cholestasis can be caused by direct toxic effects of drugs or their metabolites on different hepatic cell types or through an immune-mediated process. Amoxicillin/ clavulanic acid, an antibiotic that is therapeutically utilized for the treatment of a number of bacterial infections. Omega-3 fatty acids are unsaturated fatty acids that have ro

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Publication Date
Wed Dec 30 2020
Journal Name
Modern Sport
An analytical study of the vitality of the conscience of the senior leaderships in the boards of colleges and departments of physical education and sports science in Baghdad
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The problem of research lies in answering some of the question: What is the reality of (vital conscience) in some colleges and departments of physical education and sports science in Baghdad from the viewpoint of the teachers? And The aim of the research is to prepare a scale (the vitality of the conscience) and learn about its reality in colleges and departments of physical education and sports science in Baghdad from the viewpoint of teachers and The researcher relied on the descriptive method in the survey method and the relationships related to the nature of the research problem and The sample of the research was senior administrators teaching some colleges and departments of physical education and sports science in Baghdad , Th

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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
Terrorism and its impact on the right of Human in development - A study case of ISIS (Daesh) in Iraq
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       Iraq is one of the most important countries in the world that has received its share of terrorist acts by the terrorist organization the Islamic State of Iraq and al-Sham (ISIS), which has caused instability, especially during the period of ISIS's control of seven Iraqi provinces (2014-2017). This stage has caused a decline in the levels of human and economic development and its inconsistency with the capabilities and needs of the Iraqi population. Therefore, this study aims to investigate the hypothesis that there is a close relationship between the decline in development in Iraq and the brutal practices of ISIS that it committed during his period of control over many Iraqi cities and regions. This study used several method

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
The role of GRI standards in reporting the dimensions of sustainable development - An applied study in a number of local companies on the Iraq Stock Exchange
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The current research aims to shed light on the Global Reporting Initiative (GRI), which helps to report financial and non-financial information by economic units in general and listed on the Iraq Stock Exchange in particular. The research was based on a main premise that apply the criteria of the Global Reporting Initiative (GRI) would provide useful information to users to help them make appropriate decisions. To achieve the goal of the research, the descriptive analysis method was used, and quantitative analysis was used. At the level of the descriptive analysis method, a desk survey was conducted. As for the quantitative analysis, it relied on applied data through a questionnaire form (Questioners) as a research tool, and the

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Publication Date
Wed Jan 15 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of credit policies in agricultural development: The activity of co-operative agricultural bank as a case study
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The objective of this study is to explain the role of credit policies in agricultural development of Iraq during the period 1979-1989 which were represented by the policy of co-operative agricultural bank the organization that responsible to finance agricultural sector for various reasons. It has been shown that there was no clear credit policy existed during the period concerned due to the differences between loans from year. The loan growth rate was low in general comparing with objectives of the agricultural development plans, a low production rates comparing with loans paid, the growth rate of average number of trees in each donum and the growth rate of livestock number was also low.In conclusion there should be a clear plan for cred

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Publication Date
Tue Jun 28 2022
Journal Name
College Of Islamic Sciences
The impact of sins and disobedience on the individual and society in the Holy Quran objective study
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     The Noble Qur’an is the book of God, the Blessed and Exalted, in which is the teachings of God Almighty’s religion, which is Islam, in order for people to unite it and establish servitude to it. The individual and the society alike saw it appropriate to make my opinion alerting the seriousness of this matter, so the research was entitled (The Impact of Sins and Disobedience on the Individual and Society in the Holy Qur’an - Objective Study), knowing that we touched upon some of the effects, which we found it appropriate to mention in this research in the service of the good. Its details came in the Holy Qur’an without referring to others, noting their arrangement in the Holy Qur’an..

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Comparative Effects of Fentanyl, Medazolam, Lignocaine and Propranolol on Controlling the Hemodynamic Pressor Response during Laryngoscopy and Intubation
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Laryngoscopy and tracheal intubation are considered the most invasive stimuli in anesthesia. They provoked cardiovascular responses that include hypertension, tachycardia and dysrhythmias. Various pharmacological approaches have been used to blunt or attenuate such pressor responses. The present study was designed to evaluate the effect of medazolom, lignocaine and propranolol as a valuable adjuvant to fentanyl in attenuating hemodynamic responses to endotracheal intubation in normotensive patients. Thirty two patient with physical status I or II according to the score of American Society of Anesthesiologist (ASA), scheduled for elective surgery under standard general anesthesia, were randomly allocated into four groups (8 patients in ea

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