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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
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
The Impact of Polia Strategy in the Achievement and Retention of the Grammar of the Arabic Language
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ABSTRACT
Threw this research to the following:
1 - Know the impact of strategy Puglia in the collection of the rules of the Arabic language
students at the Institute of preparation parameters .
2 - Know the impact of the retention strategy in Puglia collection rules Arabic language
students at the Institute of preparation parameters .
To verify the status Mmermaa Find researcher Elsafreeten following two hypotheses :
1 - There is no statistically significant difference between the average score for the collection
of the fourth grade students at the Institute for the preparation of material parameters who
were studying grammar strategy Puglia and average grades collectible fourth grade
students at the Institu

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Publication Date
Wed Sep 29 2021
Journal Name
College Of Islamic Sciences
Reading in the thought of Imam Ali The philosophy of dialogue and the unity of the nation,
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This study is taken from the doctoral thesis that I prepared in the year 2000 at the University of Bordeaux in France under the title “ Ali bin Abi Talib Imam and Calif “. This thesis was prepared as a continuation of what the French orientalism Louis Massignon wrote about Islam and his student Henry Corbin, who introduced Europeans to Shiism. This study represents the philosophy of dialogue and the unity of the Islamic Emma as one of the most important methods used by Imam Ali.

Imam Ali established the most beautiful, creative, and most complete rules of human dialogue that preserve the unity of the nation’s fabric and preserves human dignity. Imam Ali referred to basic principles foundations to reach this goals, including

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Evaluation the Effects of CO2 Laser on Soft and Hard Tissues (in vitro study)
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CO2 laser (10.6 μm) is the most often used laser in the oral surgery due to its high absorption by water of the oral tissues. Several benefits of the use of CO2 laser have been reported for oral surgical procedures. This study aims to evaluate the effect of CO2 laser on soft and hard oral tissues (in vitro study). This study was done on fresh tissues from sheep’s head. CO2Surgical Laser with different operation modes was used; 0.2 mm spot size using different laser parameters on the tongue, and bone making holes, incisions and cutting. The depths and widths of holes and incisions were measured using endodontic file under magnification. The speed of incisions was calculated and the required time for cutting was measured using sport clo

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Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
Analytical Study of Crude Oil Price Shocks in the Global, Market Reasons and Result
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The global oil market is one of the most important markets in the world and occupies especially for countries consuming and producing countries, and the status of understanding of the mechanism for determining prices in the market help to stand on many factors affecting oil demand and supply of oil and geopolitical factors, climate and alternative sources of energy .. etc. factors, and that the main objective of the research is to study the causes and results left behind by the oil price shocks in the world market, and the movement of these factors be through a cycle of energy that explain the strength of competition between these factors and their effects on prices, when demand increases evolution Large image leads to significan

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Publication Date
Sun Dec 06 2015
Journal Name
Baghdad Science Journal
The Study of Serum Complement C3, C4 and Immunoglobulin E IgE in Psoriasis Patients
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The present study was aimed to find out the role of humoral immunity in the pathogenesis of psoriasis. Complements C3, C4 and immunoglobulin IgE .The study included 55 Iraqi patients with psoriasis 30 (15 females ,15 males) were untreated with any drugs. The other patient group consisted of 25 (9 female and 16 male) treated with a biological treatment (infliximab) ,and 30 (13 males ,12 females) healthy control group. Blood sample were withdrawn (5) ml of venous blood for both patients and members of the control ,to conduct the Immunological tests to determine the quantitative for each of total IgE by using (ELISA) and C3,C4 by Single Radial Immunodiffuse (SIRD). The results showed significant increase in the level of probability (P <0.0

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Publication Date
Sun Jan 31 2016
Journal Name
Iraqi Journal Of Biotechnology
Morphological, Histological and Ultrustructural Study of the Tongue in House Geecko (Hemidactylus flaviviridis) Lizard
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The aim of this study to investigate the tongue morphology and histology in house gecko Hemidactylus flaviviridis using light and scanning electron –microscopy (SEM ) technique.The morphology result revealed the presence of three parts : apex , body and lingual root .The light microscopy result showed that the tongue is covered with mucous membrane composed of non keratinized stratified squamous epithelium based on lamina propria which contain bundles of striated muscles its fibers in different directions including connective tissue , blood vessels and nerves. The lingual mucosa of the dorsal surface is covered with different pattern of lingual papillae which are widely distributed all over the dorsal surface except the apex. Noticed on t

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Publication Date
Sun Oct 21 2018
Journal Name
Al–bahith Al–a'alami
The credibility of the official government spokesman to the Iraqi public / Survey Study
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The official spokesperson considered responsible for the transmission of information and communication messages that convey the government’s view on the various political and economic issues that affect the public opinion towards the performance achieved by the various governmental institutions and for the purpose of communicating with the media in a positive and effective manner, a number of institutions in the world in general and in Iraq in particular have nominated a spokesman to coordinate the efforts and the dissemination of news and the preparation of press conferences to contribute to the achievement of a positive and effective level between the government and the media, so this study has tackled to deal with the credibility of

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Publication Date
Tue Jun 22 2010
Journal Name
Journal Of Al-nahrain University
STUDY THE STRUCTURAL AND ELECTRICAL PROPERTIES OF CdTe:Ag THIN FILMS
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The influence of silver doped n-type polycrystalline CdTe film with thickness of 200 nm and rate deposition of 0.3 nm.s -1 prepared under high vacuum using thermal co-evaporation technique on its some structural and electrical properties was reported. The X- ray analysis showed that all samples are polycrystalline and have the cubic zinc blend structure with preferential orientation in the [111] direction. Films doping with impurity percentages (2, 3, and 4) %Ag lead to a significant increase in the carrier concentration, so it is found to change from 23.493 108 cm -3 to 59.297 108 cm -3 for pure and doped CdTe thin films with 4%Ag respectively. But films doping with impurity percentages above lead to a significant decrease in the electrica

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Publication Date
Tue Jan 01 2019
Journal Name
Aip Conference Proceedings
Study the nonlinear behavior of MWCNTs and ZnO/Se/MWCNTs
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MWCNTs and hybrid nanocomposite ZnO/Se/MWCNTs have been prepared via Solvothermal technique using Parr reactor at the temperature 180°C and SeCl2 as a catalyst. The obtained MWCNTs and ZnO/Se/MWCNTs are investigated using the FE-SEM, XRD, UV-VIS Spectroscopy and Z-Scan. The novelty of this research is studying the nonlinear optical properties for these prepared materials and the results exhibit that the thickness of the deposited film for hybrid nanocomposite ZnO/Se/MWCNTs is increased, which in turn, increase the nonlinear phase shift of the laser beam compared with the MWCNTs.

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Hearing and indoctrination of the deceased, an analytical explanatory study
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The study aims to clarify the truth of hearing the dead, and then the statement of the legitimate judgment of the indoctrination, by reference to the evidence contained in that regard, and try to combine and reconcile those evidence, and the study finds that the most correct in the matter of hearing is to say hearing the dead in the will of God and how Almighty teaches , As up to that indoctrination of the dead is permissible, so as to combine evidence.

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