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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 Sep 04 2016
Journal Name
Baghdad Science Journal
Study of the Immunological Status of Iraqi Vitiligo Patients
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Vitiligo is an acquired idiopathic skin disorder characterized by depigmented macules due to loss of cutaneous melanocytes. A potential role of the immune dysfunction has been suggested in vitiligo, so to test this hypothesis, certain cytokines (IL-17A and TNF-?) and immunoglobulins (IgM, IgG, IgA and total IgE) were investigated in all participants. The study included: 60 patients with age range between (6-55) year; 30(11 males and 19 females) were untreated and 30(12 males and 18 females) were treated with Narrow Band Ultraviolet-B (NB-UVB) and 30 (14 males and 16 females) apparently healthy control. Serum was separated and cytokines (IL-17A and TNF-?) and total immunoglobulin E (IgE) were detected by using Enzyme Linked Immunosorbent Ass

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Adultery in the Ancient near east from the standpoint of the customs and traditions and the old laws
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Publication Date
Tue May 07 2019
Journal Name
Journal Of Planner And Development
the role of the economy in protecting the environment from pollution and decision_making
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The economic dimensions of environmental issues are complex and unclear in many cases, there is a kind of confusion in the real relationship between economic growth and environmental regulations. Many of the negative environmental impacts are accompanied by human activities and urban and industrial development in the city, and that many of the projects that did not take into account the environmental factors during the planning and implementation of them can be detrimental, as well as natural environments, archeological sites, historical or scientific value, aesthetic or educational. It also describes the Global Environment Outlook that if current trends continue, population growth, economic growth and consumption patterns, the p

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Publication Date
Thu Dec 31 2020
Journal Name
Political Sciences Journal
The influence of the political and social socialization in the trend towards extremism
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The research deals with the impact of the nature of social and political formation in the orientation towards extremism through tracking the institutions and beliefs that the individual is going through. The role of the family, the group, the school, education, and religion has been touched upon in acquiring the trends of extremism, whether publicly or covertly, Focusing on the social and economic contexts that are an incubator environment for extremism supported by the form of the group and the beliefs it espouses, whether direct through religion or indirectly through the nature of education, this study relied on political literature that addressed this The topic, which focused on the phenomenon of extremism that swept the world recentl

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Publication Date
Mon Apr 04 2022
Journal Name
Vegueta
the role of religious satellite channels in adopting the values of moderation and moderation among the audience of the city of bghdad
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Wed Mar 15 2023
Journal Name
Al-academy
Visual Appeal and Reflection in the Design of the Advertising
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Advertising is an important and influential tool in various commercial operations, as it represents a means of communication that depends on influencing individuals or society as a whole, working on a link between the producer and the consumer, so the importance of advertising appears in two dimensions, the first is economic represented in its role in achieving economic growth for the facility, while the social dimension lies in its role By influencing the behaviors and ideas of individuals, and from here it appears to us the importance of formulating, organizing and designing the advertising message that advertising agencies resort to in their advertising campaigns. Orientation, definition, and raising the level of the advertising messa

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Publication Date
Fri Jan 05 2024
Journal Name
Al-academy
Reading in the Scenery of the performance and its developments
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The importance of this research in studying the actor life existence on the stage through the performance art;where as all the literary theatrical dimensions didn't ignore the importance of the actor's performance.
So, it is shed a light on the nature of the scenery in the actor's performance and what its representations in the temporary directions ……..
The research set off from the imitation as a human instinct to the performance of the actor in post-modernity theater; so the researcher found that there is a question must be answered which is :Is the actor live a regression state in his theatrical performance ,or that the performance of the actor connect with collective conscience of human being which is repeated in certain

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Publication Date
Wed Mar 15 2023
Journal Name
Al-academy
Scenography and the effectiveness of meaning in the theatrical space
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The elements of theater formation that fall within the spatial experience of the scenography of the show, which the directors work in in the imaginary theater, are important and have an aesthetic, intellectual and cognitive dimension, working to highlight reality in an aesthetic image surrounding space and space. And its relationship to the distinct, multiple and variable spaces above the stage, to produce theatrical signals and endless meanings through the possibility of infinite reconfiguration of the theater's space and its public and private space through the distribution of a group of blocks within the scenic image.
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Publication Date
Wed Sep 30 2015
Journal Name
College Of Islamic Sciences
The Ethics and Restrictions of the Islamic Economy in Ownership
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The search for wealth and money is a matter of ethics in the Islamic economy
God Almighty said: "We have honored the sons of Adam (and ridiculed the universe and what he said) mocked you
He said, "He who created you from the earth."
And he commanded you, and he said to him, "He who made you."
Land, and the amount of Rezko and
He said: "You love the money with great love."
And then guide him by exaggerating the ethics of Islam and its legislation in Tamkak and not exceeding it.
 In order to darken the doors of inflation with wealth Vakar
And the hereafter and achieve satisfaction and fairness in all actions
To ensure that society has a right not to harm others and to abuse the interests of the economy
Is

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Publication Date
Wed Mar 24 2021
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Study of Epstein - Barr virus Infection in Relation to the Immunohistochemical Expression of Bcl-2 gene in Tissues of Patients with Adenocarcinoma of the Colon
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Background: EBV infection in tissue micro-environment is challenged by the precisely regulated survivaland apoptosis mechanisms. Abnormal bcl-2 proto-oncogene expression in colonic carcinomas allowsaccumulation and propagation of these genetically altered cells.Objective: To analyze the relevant concordance of BCL-2 gene , EBNA1 s and LMP-1-EBV expression inissues from a group of Iraqi patients with colonic adenocarcinomas.Patients and Methods: One hundred (100) tissue biopsies, belonged to (40) patients with colorectalcancers, (40) patients with benign colon tumors, and (20) apparently normal colorectal control tissues,were enrolled in this study. The detection of EBNA1 s and LMP-1-EBV as well as BCL-2 was done byimmunohistochemist

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