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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 Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The use of green accounting information systems in the oil sector and its impact on reporting on sustainability - an applied study
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Abstract

                  The research seeks to shed light on green accounting information systems, analyze them, identify sustainability reporting and how to improve it, as well as study the importance of the Iraqi oil sector, analyze it, and work on applying green accounting information systems in order to improve the quality of sustainability reporting. Oil as a branch of the General Corporation for the Distribution of Oil and Gas Products to apply the practical aspect and prove the hypothesis of the research. Explaining the company's role in improving environmental conditions

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Publication Date
Sun Mar 01 2020
Journal Name
Iraqi Journal Of Physics
Study of the Nuclear Structure for 38Ar, 59Co, 124Sn, 146Nd, 153Eu and 203Tl Target Nuclei Used in Fabrication the Nuclear Batteries
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The nuclear structure of 38Ar, 59Co, 124Sn, 146Nd, 153Eu and 203Tl target nuclei used in technology for nuclear batteries have been investigation, in order that, these nuclei are very interesting for radioisotope thermo-electric generator (RTG) space studies and for betavoltaic battery microelectronic systems. The single particle radial density distribution, the corresponding root mean square radii (rms), neutron skin thicknesses and binding energies have been investigated within the framework of Hartree-Fock Approximation with Skyrme interaction. The bremsstrahlung spectrums produced by absorption of beta particles in betavoltaic process and backscattered p

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Publication Date
Tue Sep 19 2017
Journal Name
Al-academy
The Soul and Body Dichotomy in the Performance of the Iraqi Actors
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The body of the actor and its expressive significance is an essential topic in studying acting . it is not only confined to the study of soul and body from philosophical aesthetic perspective , but also to study the conception and mechanism of such a dichotomy followed by theatre directors and theorists , who are highly concerned with the creativity of actors . The researchers believe that such a study would be of benefit for actors as well as others working in theatre .                             

     The study falls into two sections . the first deals with the phi

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
Representations of the ego and the other In the Iraqi feminist novel
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The other is a problematic concept and can be achieved only by the existence of difference and differentiation between human groups in views and views, the other is out of the ego, which is different religiously, politically, socially, culturally, place and language.
We take from the Iraqi feminist novel analytical field to reflect the image of the other in the novelist world, and the models chosen for the study are: the novel granddaughter of American novelist Anaam Kjie Ji, and novel how the sky seemed close to the novelist Batoul al-Khudairi, and novel when you wake up the smell of novelist Dni Ghali, and the rope of the umbilical and the novel Shufuni Shufuni The novel by Samira Al-Manea, the novelist of the novelist Alia Mamdouh,

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Publication Date
Wed Sep 28 2022
Journal Name
Journal Of The College Of Education For Women
The I and the Other (Lenora) in the Poetry of Joseph III
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A literary text is not void of the use of the ego and the other while speaking or in a spoken communication. Such a usage is apparently outstanding in Arabic literature, and it reflects society in all its various cultural, social and political conditions. Therefore, the ego is one of the prominent concepts on which human personality is built, and its role in the formation of society and in communicating among all human societies. Accordingly, the present paper aims to clarify the duality of the ego and the other, where the ego starts from the poet himself to expand the circle of subjectivity by including his family, society, immediate surroundings, race and his religion. The other, on the other hand, that is separated from the poet,

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Publication Date
Mon Dec 22 2025
Journal Name
Sciences Journal Of Physical Education
The impact of a proposal for the curriculum dictated by some of the barriers to the development of motor skills
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The impact of a proposal for the curriculum dictated by some of the barriers to the development of motor skillsA. M. D. Huda Ibrahim RezoukiM. M. Susan Salim DawoodIs the childhood of the most important and most fertile stage of basic education because of their significant impact in building a base on which the stated origin of sound in the early stages older age because the baby at this stage be very vulnerability to environmental factors different surroundings in which to leave their mark on his life in the stages of life other.The Gymnastics of sports long-term training, which begins between the ages very early relative to the rest of other games to reach the stage of the tournament from the age of 13-17 years almost to the women, this a

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The impact of production elements responsible on the environmental management system requirements of ISO 14001 - 2004 field study in the North Gas Company
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Abstract

         Most of the industrial organization in the world became suffering from the problem of the pollution of the poisonous chemicals things, this urged to depend on the principle of the responsible production, because it has the positive role by dealing with these chemical things and to safe the health of the society, due to the main goal of this study is to restrict the role responsible production in accomplishing the system of the environmental management through an actual study in the northern gas company in Kirkuk province, the topic has acquired a big importance bacause there were a limited number of studies and res

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Publication Date
Sun Oct 21 2018
Journal Name
Al–bahith Al–a'alami
Islamic Knowledge and its role in the Development of the Culture and Values of the Islamic Community
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The human perception of science and knowledge is affected by the personal point of view, thus giving it its religious, mental and emotional dimensions to make that perception an effective tool for realizing the truth comprehensively in the delivery of knowledge to the depths of the human soul. The later is composed of multiple factors, which contributes to the human self-development with dimensions beyond the limits of mental logic and the perception of material and emotional situations. That knowledge in the perception of Islamic virtue, which must characterize each Muslim.
Human beings have been striving for knowledge and the understanding of the universe in which they live. For centuries, mankind has acquired knowledge directly an

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Publication Date
Mon Jul 01 2019
Journal Name
International Journal Of Swarm Intelligence Research
A New Strategy Based on GSABAT to Solve Single Objective Optimization Problem
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This article proposes a new strategy based on a hybrid method that combines the gravitational search algorithm (GSA) with the bat algorithm (BAT) to solve a single-objective optimization problem. It first runs GSA, followed by BAT as the second step. The proposed approach relies on a parameter between 0 and 1 to address the problem of falling into local research because the lack of a local search mechanism increases intensity search, whereas diversity remains high and easily falls into the local optimum. The improvement is equivalent to the speed of the original BAT. Access speed is increased for the best solution. All solutions in the population are updated before the end of the operation of the proposed algorithm. The diversification f

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Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Lightwave Technology
A Random Number Generator Based on Single-Photon Avalanche Photodiode Dark Counts
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