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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 Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
Analytical Study of Mathematics Textbooks in the Basic Education Stage in the Sultanate of Oman According to NCTM Standards
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The present study aimed to identify the availability of the National Council of Teachers of Mathematics (NCTM) standards in the content of mathematics textbooks at the basic education stage in the Sultanate of Oman. The study used the descriptive-analytical approach, adopting the method of content analysis through using a content analysis tool that included (43) indicators distributed on the four NCTM standards related to the field of geometry, after verifying their validity and reliability. The study population consisted of mathematics textbooks (first and second semesters) for ninth-grade students in the Sultanate of Oman in the academic year 2018/2019, while the sample consisted of Geometry units in the content of those books, which a

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Publication Date
Sat Oct 20 2018
Journal Name
Journal Of Economics And Administrative Sciences
Fluctuations of global crude oil prices and their effect on inflation and economic growth in Iraq " A standard study for the period 1988– 2015
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Abstract

That Iraq's dependence on the revenues of the oil product in financing its development programs and growth rates , Making the economy affected by external forces represented by fluctuations in crude oil prices in the global market, Which is directly reflected on the performance and efficiency of the Iraqi economy.

The study adopted its objectives to analyze the time series for the period (1988 - 2015) through the use of standard and statistical methods, Four standard models were estimated to reach those targets, Where the results of the stability test showed instability of most variables at their original level, But to achieve stability when taking the first differences, While the result

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Publication Date
Wed Dec 30 2020
Journal Name
Journal Of Planner And Development
The Infrastructure and the Potential of the Tourism Industry in the Holy City of Najaf.
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The infrastructure is one of the basic components of the tourism industry in Iraq in general and in Najaf in particular, in spite of there are obstacles and problems that which are hindered the development of tourism in Iraq, some of them are related to the  tourism industry itself, some are related to the security and political situation, and some are related to poor management of tourism. However, the infrastructure is considered the cornerstone of the success of the tourism industry in Iraq and other countries, if it is available, it can be a potential indicator of success, and on the contrary, it is a hindrance to go forward. The aim of this research is to shed light on the availability of requirements for the s

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Publication Date
Sat Mar 30 2013
Journal Name
College Of Islamic Sciences
هامات The contributions of the Kurdish scholars in the science of the Qur’an in the seventh and eighth Hijri centuries
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This research sheds light on the contributions of a group of scientific Kurdish scholars in the seventh and eighth Hijri centuries, who devoted themselves to serving science with the bad political and economic conditions at the time, and the research pointed to the flowering of science and how students travel in order to provide them with science, obtain a scientific certificate, then take up The research efforts of the scholars in the two Hijri century mentioned in the science of the Qur’an, whether in the field of recitations, intonation or interpretation, and the research ends with a conclusion in which I mentioned the most important conclusions reached in this research.

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Publication Date
Sat Jan 05 2019
Journal Name
Iraqi Journal Of Physics
Functionalization of single and multi-walled carbon nanotubes by chemical treatment
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In this work we experimentally investigated SWCNTs and MWCNTs to increase their thermal conductivity and electrically functionalization process using different reagents ((nitric acid, HNO3 followed by acid treatment with H2SO4), then washed with deionized water (DW) and then treated with H2O2 via ultrasonic technique. Then repeated the steps with MWCNTs and compare their results in an effort to improve experimental conditions that efficiently differentiate the surface of the single walled carbon nanotubes (SWCNTs) and multi walled carbon nanotubesi(MWCNTs) that less nanotubes destroy and to enhance the properties of them and also to reduce aggregation in liquid. the results were prove by XRD, and infrared spectroscopy (FTIR). The FTIR sp

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Publication Date
Thu Sep 30 2004
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Adsorption of Hydrogen and Methane as Single Gases on Activated Carbon
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Publication Date
Mon Jun 30 2025
Journal Name
Scripta Medica
Case Report: A Rare Presentation of Sigmoid Volvulus During Pregnancy With an Integrative Postoperative Approach
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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
The nature of the relationship between the states and the union in the United States of America
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Knowing the nature of the relationship in federal systems lies in studying the political, social, economic and cultural forces, for their role in laying the foundations and the federal system. No matter how important the pillars of that system are, and through this research, we will learn how the political elites were able to crystallize this unique system, until it became one of the political systems that some countries seek to copy and apply its experience.

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Publication Date
Sun Dec 01 2013
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of the strengths and weaknesses in Iraqi newspapers: The evolution of the consumer - the reader
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The first section of this research discussed  the manner of the research from many sides like the problem it faces, importance of it , its targets ,boundaries, the way to collect and get information's and its assumption.

When the second chapter discussed the press – manufacturing and the development ,importance and types of newspapers, also its merits and weaknesses.

The third chapter talked about the scientific side and how to choose an assumption for the research . as it talked also about the apparent honest and stability tests that help in analyzing the research until getting results and so the right assumption for  the research will be chosen.

And finally, the fourth chapter put highlight on the be

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Publication Date
Sat Jun 12 2021
Journal Name
Biochemical And Cellular Archives
EFFECT OF SINGLE ORAL DOSE OF FUMONISIN B1 ON IMMUNOHISTOCHEMICAL EXPRESSION OF TLR-2 AND 4 IN MICE
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Fumonisin B1 is toxic secondary metabolites compound produced by Fusarium spp. on maize and maize products causes health problems to human and animal. Therefore, this research is planned to study the effect of FB1 on the expression of TLR-2 & 4 in liver and kidney cells of mice. Four group of male mice were orally administrated with single dose of FB1 toxin as the following: 0 ppb, 800 ppb, 1200 ppb and 1600 ppb. After two weeks all animals were sacrificed, liver and kidney autopsies were taken and the level of TLR-2 & 4 detected in each four group by immunohistochemistry technique (IHC). According to the IHC examination of groups (1, 2, 3 and 4) strong expression of TLR2 in liver and kidney were (0%, 33.3%, 100%, 100%), respectively. This

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