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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 Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Institutional Structures and the Transformation of the Private Sector in Iraq
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            Requires economic work finding built institutional paint strategies and policies are formulated general economic and clarity in its stated objectives and the involvement of all economic institutions, political and stakeholders to discuss all the issues of economic, financial, monetary and analyzed for the purpose of renewal energies and determine the duties and responsibilities, leaving full freedom to the private sector in the formation of institutions to carry out his duties economic, and that the institutional structures to create the right climate for the implementation of its economic policies, which would facilitate the task of the private sector, and this h

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Publication Date
Wed Aug 10 2022
Journal Name
Journal Of Positive School Psychology
The Need And Its Significance In The Novelist Discourse Of Naguib
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This study is at the heart of the pragmatic theory, as this research seeks to highlight the concept of necessity, and what the researchers have tended to do is that the development that has acquired integrated pragmatics is only for the development of the subject of necessity, as it is one of the contents of the saying, and this is what made Decroux define it as the semantic element that Concerning the saying, as for Grace; He paid great attention to the conversational imperative, and understood the requirement by clues or suggestions, as it is an element known for its absence and presence in the linguistic structures included in the text when reading or when understanding. This study has paved the way for clarifying the concept of necessi

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
Perceiver And the imaginer in the texts of Yusuf Al _ sayegh
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This research deals with the perceived and the imagined in the texts of Yusef Al-Sayegh, considering language as the most important source in literature and theatrical criticism, and given the importance of the subject, the researcher monitored many philosophical and psychological opinions and theories related to (the perceived and the imagined), and they were discussed and their compatibility with the Iraqi theatrical t As for the second chapter, where (the theoretical framework), it included two topics, and the first topic was about the concept of the perceived and the imagined, and the second topic was about Youssef Al-Sayegh and the structure of the theatrical text.
In the third chapter, where (research procedures), the research

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Publication Date
Tue Dec 30 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The study of tempromandibular joint disorders and anti-cyclic citrullinated peptide antibodies in serum and saliva of patients with rheumatoid arthritis
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Background: Rheumatoid arthritis is an autoimmune disease that affects mainly the synovial membranes and articular structures and is characterized by chronic, systemic inflammation involving multiple joints.Being a synovial joint, the Temporomandibular Joint is subject to the same disorders affecting other synovial joints, including RA.Beside it was considered as a specific serological marker for diagnosing RA disease ,antibodies to cyclic citrullinated peptide have proven to be associated with joints destruction, though; it may play a potential role in the prediction of the disease severity. Materials and Methods: Sixty nine individuals (69) were enrolled in this study, forty nine (49) were patients diagnosed with Rheumatoid Arthritis, a

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
Evidence for monotheism in Islam and the Qur’an and the meaning of the names and attributes and their unification
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This topic is considered to be of a high degree of importance to every Muslim, and its importance is due to the fact that monotheism is:

Prove that God Almighty is the God who created everything and everything opposite to monotheism is polytheism, and it is taking other than God Almighty as a deity.

Therefore, we have to know the concept of God. If he is known, then he knows the concept of monotheism and the concept of polytheism

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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Physics: Conference Series
Determination of Radionuclides and Heavy Elements in the Rising Dust in the Small Side of Diwaniyah City due to the Movement of Wheels and Cars
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Abstract<p>This research aims to determine the concentration of radionuclides in dust samples on the public streets of the small side of Diwaniyah city in Iraq as a result of movements of wheels and cars using the gamma spectra and high purity germanium detector (HPGe) with resolution of (2.3 keV) for energy (1.332 MeV) of cobalt <sup>60</sup>Co. Dust samples were collected from the streets Diwaniyah city with (26) samples prepared for measurement. The results of the specific activity concentration of Uranium-238, Thorium-232, Potassium-40 and Cesium-137 were (14.66 ± 0.950, 26.29 ± 2.431, 219.04 ± 15.150 and 11.49 ± 0.876) Bq/kg respectively. The radiation parameters Ra<sub>e</sub></p> ... Show More
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Publication Date
Mon Mar 25 2019
Journal Name
Al-academy
The Aesthetic Discourse of the Pop Artists and its Representations in the Output of Students of the Department of Art Education: هند عبدالله عبد
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The emergence of artistic movements in Western countries was after the period of modernity. They have introduced a great dialectical problem at the level of thought and discourse, which necessitated a change in the course of the aesthetic discourse into new visions. Thus, the present research aims to identify the aesthetic discourse of pop artists' Art and its representations in the outputs of the students of the Department of Art Education. The theoretical framework included two sections: the first one, what is the aesthetic discourse and the second is the educational bases of the students' outputs. The procedures of the current research included the analytical descriptive approach. The research sample consisted of (4) outputs chosen ac

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Publication Date
Tue Sep 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
The impact of various staining substances and immersion time on the stainability of bonded sapphire brackets with three kinds of light cure orthodontic adhesives (An in-vitro study)
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Background: The need of the patient for a more reasonable esthetic orthodontic intervention has risen nowadays. Thus, orthodontists make use of esthetic orthodontic materials like brackets, ligature elastics, and arch wires. The esthetic brackets come as different forms of materials, such as ceramic brackets, which have their stainability remaining as the most important consideration for the patients and the orthodontists. This study aimed to compare the staining effects of various staining materials, including black tea, cigarette smoke and Pepsi, as well as the time effect on the color stability of sapphire ceramic brackets bonded with three kinds of light cure orthodontic adhesives: Transbond, Resilience and Enlight. Materials and Met

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Publication Date
Tue Jan 01 2019
Journal Name
International Journal Of Supply Chain Management
The effect of internal training and auditing of auditors on supply chain management: An empirical study in listed companies of Iraqi stock exchange for the period 2012-2015
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Publication Date
Wed Mar 16 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of a Training Program to Develop the Skill of Organizing Time for the Kindergarten Department Students
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The current research aims to identify the time-management skills based on the post-test of the experimental group as well as to examine the effect of a training program on developing the skills of managing time among the study sample. To achieve the research objectives, the researcher designed a scale of time management skill included (30) paragraphs. The research reached that the training program is significantly effective in managing and organizing time. There are statistically significant differences in pre-posttest between the experimental and control groups.

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