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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
Tue Jun 01 2010
Journal Name
Journal Of The College Of Languages (jcl)
Nature of a holy book in the poetry of Ibn Arabi Mohi
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The paper discusses the lack of a uniform definition of politeness due to the constant tension between its universality and language specificity, and argues that some of the theoretical debate could be resolved if the distinction between politeness as a commonsense notion and politeness as a theoretical construct were clearly addressed and acknowledged in the research.

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Publication Date
Mon Feb 25 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effectiveness of the financial analysis in the statement of the ability of financial ratios in the detection of fraud in the financial reports of industrial companies
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This research after financial ratios in the detection of fraud to the financial statements published which enables specialists from the work of their studies and their conclusions to obtain the information they seek on the activities of the entity. Has provided researchers what these relics They then field study to test the validity and sincerity of the findings of the suggestions that have been upheld the need to study all financial ratios extracted in general, organized and used in decision-making processes necessary administrative.And that the financial management attention more financial analysis and extraction of financial ratios and compare them with industry standards taken from historical norms

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Semantic features in the phenomena in the pottery of Dr. Ahmed Sulaiman Al-Ahmed / Trees behind fence as a sample: Semantic features in the phenomena in the pottery of Dr. Ahmed Sulaiman Al-Ahmed / Trees behind fence as a sample
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Abstract
This research deals with studying and analysis of a poetic group under the
title (Trees behind fence) of the great poet Dr. Ahmed Sulaiman AlAhmed
who is the some of the Shek , Sulaiman Al-Ahmed who is the linguist - poet
and famous jurist member in the Arabic scientific assemble in Damascus and
brother of the great poet Badawi Al-Jabal. This poetic group include two big
poetic legends : the first one is (Trees behind fence , ) which include one
hundred and eighty four line and the second one ( AZ-Mebadia ) which is
consists of one hundred and seventy eight line, both of them from the (Al-
Camil ) meter which is free rhyme which bears a many meaning and pictures
and just the great poet composite the

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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Impact assessment of strategic goods on government grants and as a result of activity: An analytical study at the General Company of grain trading
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  In Iraq,  government contributions to the public companies have become a very important aspect which contributes to the survival and sustainability of these institutions as it consider  one of the main sources of funding, if not it consider the basis of funding.

  According to  the vital roles assigned to these institutions to follow up, which usually  include important activities in the national economy, the research focused on studying the field reality of the method used in evaluating the stock of total production and purchases of goods for the purpose of selling the strategic commodities of the General Company for Grain Trade.  As a result, the aim of this study came to came to highlight&n

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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of tax exemption in attracting foreign investment and the possibility of activation in the Iraqi economy
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The tax exemption, whether wholly or partially, and for an unlimited duration of the investment or for a limited period of few years, is one of the encouraging things to the flow of foreign capital. And if necessary, impose tax on the profits of the invested capital, the promotion requires that not be discriminatory taxes or payments in the amount of money with the need to avoid double taxation. The tax exemption is granted by the government and the feature according to the law of a natural person or legal entity seeking from the government purports to achieve a set of political goals, economic and  social development. The reduction of taxes or grants partial exemption is one of the factors that encourage attract of direct foreign i

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Publication Date
Wed Sep 08 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the Central Bank of Iraq in housing finance and reducing the housing crisis in Iraq
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Finance is an essential element when developing any housing policy because of its role in providing funds to institutions concerned with housing lending. Therefore, the research aims to evaluate the financial aid provided by the Central Bank of Iraq in solving the housing crisis through the adoption of the Central Bank of Iraq initiatives to support the financing of the housing sector, and here The importance of the research is highlighted to determine the role of the initiative by drawing an effective strategy aimed at providing the housing sector with the necessary funding. By providing financing to financial institutions directed towards providing real estate credit, and that the percentage of the contribution of the implement

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
The Technicality and Spontaneity Paradoxes in the Art of the Playwright -Examples of Improvisation in Modern European Theater
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The research deals with the problems of improvisation in two basic subjects and applied a samples  and conclusion. The first topic focuses on the concept of improvisation and spontaneity and clarifies the confusion between them. The second topic deals with the foundations and principles on which the actor is based in his artistic preparation for the purpose of developing his improvisational abilities.

The research focuses on clarifying the dimensions of improvisational techniques and its multiplicity in the modern theater. It analyzes the method of improvisation and its use in the construction and composition of the theatrical performance. It deals with two important experiments, such as the experience of the Russian directo

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Publication Date
Fri Mar 25 2022
Journal Name
Nasaq Journal
A Linguistic Study of Paronomasia (Al-Jinās ) in Arabic and English
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Paronomasia is a recognized rhetorical device by which poets could play with words that are similar or identical in form but different in meaning. The present study aims to identify paronomasia in Arabic and English. To achieve the aim of the study, a corpus of selected verses chosen from two famous figures in Arabic and English literatures and analyzed thoroughly. The analysis of data under investigation reveals that paronomasia is a crucial aid used by poets to portrait the real world as imaginative. It further shows that the concept of paronomasia in English is not the same as in Arabic. In English, there are echoes of the Arabic jinās, i.e., there are counterpart usages of similar devices, yet English rhetoricians have not defined or c

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Publication Date
Wed Nov 17 2021
Journal Name
7th International Conference On Multidisciplinary Sciences (7th Icomus)
A Critical Pragmatic Study of Sarcasms in American and British Interviews
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APDBN Rashid, 7th International Conference on Multidisciplinary Sciences (7th ICOMUS), 2021

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Publication Date
Thu Feb 07 2013
Journal Name
Iraqi Journal Of Medical Science
A study of serum magnesium and calcium levels in missed abortion
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