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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
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
BUMPINESS IN THE ATMOSPHERE IN IRAQ STUDY IN THE GEOGRAPHY OF CLIMATE
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Bumpiness in the atmosphere is the vertical movement of air, whether
upward or downward movement and the bumpiness is accompanied by areas
of unrest in the air and wind. And contribute to each of the coups thermal
fronts, wind, wind and thunderstorms. Moreover, bumpiness is net of the
reasons that lead to circumstances is appropriate to cut the wind, and this
contributes to the formation of bumpiness in the atmosphere. The study found
that the noon of the times, which is expected to occur where clear-air
bumpiness during flights because of the warmth of the earth's surface. The
study found increased incidence of air hole during the summer, especially
July, due to increased incidence of coup surface, while the s

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
The efficiency of Using Attribute and Performance- Based Activity Methods to Raise the Level of Control Deviation A field study in Jaber Bin Hayyan Factory
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Cost is the essence of any production process for it is one of the requirements for the continuity of activities so as to increase the profitability of the economic unit and to support the competitive situation in the market. Therefore, there should be an overall control to reduce the cost without compromising the product quality; to achieve this, the management should have detailed credible and reliable information about the cost to be measured, collected, understood and to analyze the causes for the spread of deviations and obstacles the management faces, and to search for the factors that trigger the emergence of these deviations and obstacles

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Publication Date
Sat Sep 30 2023
Journal Name
Al–bahith Al–a'alami
Political Use of the Photograph: A Semiotic Study of the Photograph of Al-Kadhimi's Visit to Fallujah on the Anniversary of the Victory Over ISIS
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The research aims to determine what a photograph intends to convey as a visual text. Photographs are not captured randomly, especially those of politicians. Each photograph carries a message, even if interpretations of that message vary from person to person. The research adopts a methodology based on semiotic analysis, applying Laurent Gervero's model to analyze a photograph of the Iraqi Prime Minister Mustafa Al-Kadhimi's visit to Fallujah on the anniversary of the victory over ISIS. The photographs in question constitute a visual language built upon a sequence of iconic symbols and signs. These elements coalesce to give rise to an image centered around a particular theme, one designed to convey a precise messag

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Publication Date
Mon Jan 01 2018
Journal Name
African Journal Of Hospitality, Tourism And Leisure
An analytical study of the strategic flexibility variation as a function of the dynamic capabilities based on supply chain management (Case study: The General Petroleum Products Distribution Company in Baghdad)
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Scopus
Publication Date
Wed Jun 09 2021
Journal Name
Annals Of The Romanian Society For Cell Biology
The Effect of Brassinolide Application in the Anatomical and Physiological Characteristics of the Vegetative Parts of a Species from the Genous of Brassciaaleraceacabbage …
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The current study included details of the anatomical characteristics of vegetative parts including the root, stem, leaf in cultivated Iraq for the species Brassciaaleraceacabbage, where the study dealt with the stomatal index and the rate of both the length and width of the stomatal complex and the thickness of the periderm, the tissue, cortex, vascular cylinder and pith. The parts were taken and measured after the plant was treated with brassinolide and the treated species with brassinolide and non-treated were measured and the study showed that there was a clear variation in the properties above.

Publication Date
Tue May 27 2025
Journal Name
University Of Anbar Sport And Physical Education Science Journal
The study of comparing the cognitive teaching method effect ( total and analytic ) in teaching the counter- attack of Epee
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The research's aim is to place two teaching methods ( total and analytical method) and to know which one of them is better than the other in teaching the counter-attack with Epee. The researchers have used the experimental method for being considered suitable to solve the problem of the research. The sample of the research includes third –stage female students of college of physical education and sport sciences / Baghdad University in the subject of fencing, their number amounted 60 female students. It has been used SPSS for processing the results. They have concluded that the two groups of the research and the two methods (( total and analytical) have learnt the counter- attack of the two over mentioned groups. they have recommended to c

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Publication Date
Thu Oct 01 2009
Journal Name
Journal Of The College Of Languages (jcl)
A RAISIN IN THE SUN: the dream of RECOGNITION
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Lorraine Hansberry’s A Raisin in the Sun (1959) appeared at the beginning of renewed political activity on the part of the blacks; it is a pamphlet about the dream of recognition of black people and the confusion of purposes and means to reach such recognition. It embodies ideas that have been uncommon on the Broadway stage in any period. Situations such as a black family moving into an all-white neighborhood were not familiar before this time; they were just beginning to emerge. In depicting this so realistically, Hansberry depends more on her personal experience as an African American embittered by social prejudices and discrimination. 

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Publication Date
Sun Apr 09 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Morphological and Histological Study of the Pancreas Gland in the Local Bat ( Pipisterllus kuhlii)
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The present study aimed to investigate the morphological and histological structure of pancreas in the bat,(Pipistrellus kuhlii). Pancreas was represented by compact pancreatic tissue which is divided into three parts : head , body and tail, its color is whit to yellow. The pancreatic tissue is located in the abdominal cavity near to the mass of intestine in the mesenteric network , which is connected with the coiled region of the duodenum in one side and with the extended mesenteries between the dorsal part of stomach and the abdominal part of spleen from the other side. The pancreas gland is surrounded by a loose connective tissue, the trabeculae are extended from it and divided the gland into many lobules which are different in shape

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Publication Date
Fri Jan 05 2024
Journal Name
Al-academy
The Place in the work of artists Nuri Alrawi and Saad Altai (Comparison Study)
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The Transformation of environments surrounding human which called (place), formed an intermediate compresser in forming awareness pictures, human knowledge, culture and thought features, and changing the systems and contexts of human societies, which led to a change the rhythm of life as a whole. So according to that the place will be encodes according to these data for psychological connotations, lead to human sense of harmony with the place in different manner format, here the search problem lies when trying to detect how Iraqi artist deliberating with the place concept, wondering how to investing place in the contemporary Iraqi drawing within its reference dimension, and showing mechanisms from comparative study for the works of two a

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Publication Date
Sat Apr 25 2020
Journal Name
International Journal Of Research In Social Sciences And Humanities
THE EFFECT OF CAPITAL ADEQUACY AND ASSET QUALITY ON THE VALUE OF THE BANK AN APPLIED STUDY ON A SAMPLE OF IRAQI BANKS LISTED ON THE IRAQ STOCK EXCHANGE
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As the banking sector is a strong influence on the country's economic growth,The solid financial well-being of anybank does not mean only a guarantee for its investors, It is also important for both owners and workers and for theeconomy in all its joints.The elements of capital adequacy and quality of assets are important to the functioning of thebanking business.In this study, the research sample included four private banks. Quarterly data were used for the period(2011 - 2018).Moreover, data is also collected from articles, papers, the World Wide Web (the Internet) and specializedinternational journals.In this research, an effort was made to try to find out the effect of (the ratio of the capital owned todeposits on the value of the bank),

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