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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
Sun Jun 02 2019
Journal Name
Baghdad Science Journal
Thermoplasmonic of Single Au@SiO2 and SiO2@Au Core Shell Nanoparticles in Deionized Water and Poly-vinylpyrrolidoneMatrix
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Metal nanoparticles can serve as an efficient nano-heat source with confinement photothermal effects. Thermo-plasmonic technology allows researchers to control the temperature at a nanoscale due to the possibility of precise light propagation. The response of opto-thermal generation of single gold-silica core-shell nanoparticle immersed in water and Poly-vinylpyrrolidone surrounding media is theoretically investigated. Two lasers (CW and fs pulses) at the plasmonic resonance (532 nm) are utilized. For this purpose, finite element method is used via COMSOL multiphysics to find a numerical computation of absorption cross section for the proposed core –shell NP in different media. Thermo-plasmonic response for both lasers is studied. The

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Publication Date
Sat Dec 20 2025
Journal Name
Al–bahith Al–a'alami
The Challenges of Forming A Culture of Change in Iraq (Self-Obstacles to the Media Role)
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The Iraqi culture faced a set of challenges that can be diagnosed with the most prominent features as follows:

  1. The dominance of authoritarian political systems which entails authoritarian regimes with the absence of contemporary political concepts of human rights.
  2. The prevalence of non- informed cultural systems which have the shortage of capabilities that enable them to activate cultural elements in positive references, historical, or seclusion on itself and not be able to interact with the current active cultures.
  3. Stagnant economic conditions have not had a decent life for individuals, or a certain level of well-being, as well as poor services and others.
  4. Social life controlled by the prevai

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
Student Attitudes towards Rooting the Educational Administration Field: A Field Study for Phd Students in the Department of Educational Administration at Umm al-Qura University
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The study sought to identify the attitudes of PhD students towards establishing the field of educational administration. The study followed the descriptive survey method. The questionnaire was used to collect information from the study community consisting of (95) male and female students in the department of educational administration and Planning. Among the most important results about students ’attitudes towards establishing the educational administration field are the following: 1) identifying the necessity of establishing the educational administration field. 2) Encouraging students to attend seminars and scientific conferences in Islamic rooting. 3) there are no statistically significant differences in the attitudes of doctoral s

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Publication Date
Sun Oct 01 2023
Journal Name
Asian Pacific Journal Of Cancer Prevention
Immunohistochemical study of the expressed cluster differentiation markers proteins type 20 and 56 in breast tissues from a group of Iraqi patients with breast cancers
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Publication Date
Tue Mar 19 2019
Journal Name
Al-khwarizmi Engineering Journal
Optimization of Material Removal Rate and Temperature in Magnetic Abrasive Finishing Process for Stainless Steel 304
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The effect of the magnetic abrasive finishing (MAF) method on the temperature rise (TR), and material removal rate (MRR) has been investigated in this paper. Sixteen runs were to determine the optimum temperature in the contact area (between the abrasive powder and surface of workpiece) and the MRR according to Taguchi orthogonal array (OA). Four variable technological parameters (cutting speed, finishing time, working gap, and the current in the inductor) with four levels for each parameter were used, the matrix is known as a L16 (44) OA. The signal to noise ratio (S/N) ratio and analysis of the variance (ANOVA) were utilized to analyze the results using (MINITAB17) to find the optimum condition and identify the significant p

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Publication Date
Sat Dec 20 2025
Journal Name
Journal Of Economics And Administrative Sciences
Formulating a strategy for the Northern Oil Company(Case Study)
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يهدف البحث الى تقديم استراتيجية مقترحة لشركة نفط الشمال ، وأخذت الاستراتيجية المقترحة بنظر الاعتبار الظروف البيئية المحيطة واعتمدت في صياغتها على اسس وخطوات علمية تتسم بالشمولية والواقعية ، اذ انها غطت الانشطة الرئيسية في الشركة (نشاط الانتاج والاستكشاف , نشاط التكرير والتصفية , التصدير ونقل النفط , نشاط البحث والتطوير , النشاط المالي , تقنية المعلومات , الموارد البشرية ) وقد اعتمد نموذج (David) في التحليل البيئي

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Formulating a strategy for the Northern Oil Company(Case Study)
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                  The research aims to present a proposed strategy for the North Oil Company, and the proposed strategy took into account the surrounding environmental conditions and adopted in its formulation on the basis and scientific steps that are comprehensive and realistic, as it covered the main activities of the company (production and exploration activities, refining and refining activities, export and transport of oil, research and development activity, financial activity, information technology, human resources) and the (David) model has been adopted in the environmental analysis of the factors that have been diagnosed according to a

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Crossref
Publication Date
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
TV ADVERTISEMENT AND SERVICES OF MOBILE PHONE COMPANIES: (Analytical Study of the Trends of Companies and the Public towards Television Advertisement)
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An advertisement is a human activity as old as human societies. As it was practiced by each society in accordance with the circumstances of the times and the means of communication available. The evolution of advertisement in the modern era reflected many factors to become an essential part of the lives of individuals in the world. Interesting in television advertising has increased in particular because it is the first and most influential mass media in the minds of people.

Advertisements play a big role in our lives as individuals. As advertisements surround us where we have been found; and bring us many benefits; as well as their contribution to accelerate the process of economic development a

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Crossref
Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Effect The behavior of workers in the insurance companies in achieving competitive advantage: An Applied research in a sample of the general insurance companies
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Service companies always working to increase their competitiveness and efficiency of the survival, growth and development in the present and the future, including insurance companies, so as to increase competition, especially after the emergence of the civil companies dramatically after 2003, has become the goal of recent studies carried out by the organizations is the human capital, because its success and excellence and achievement its objectives depends on the human, and this does not mean that the other components are not important, but also rely on the rights which has increased interest in the search for the way in which they can guide the behaviors and values ​​and their own language in line with the organization's strategy an

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of a proposed program to solve the problem of mixing Arabic letters similar to the voice of students in the second grade primary
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The purpose of this research is to demonstrate the effectiveness of a program to address the problem of mixing similar letters in the Arabic language for students in the second grade of primary and to achieve the goal of the research. The researcher followed the experimental method to suit the nature of this research and found that there are statistically significant differences between the tribal and remote tests, The effectiveness of the proposed educational program. At the end of the research, the researcher recommends several recommendations, the most important of which are: 1 - Training students to correct pronunciation of the outlets, especially in the first three stages of primary education (primary) and the use of direct training

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