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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 Sep 17 2019
Journal Name
Journal Of The College Of Education For Women
A New Logic of Victory in Suzanne Collins’ The Hunger Games With Reference to Elements of Intertextuality in William Golding’s Lord of the Flies
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Suzanne Collins’ novel  The Hunger Games suggests a new logic of victory and set a distinguished focus on the unique personality of her heroin which brings to the mind the permanent correlation between all moral values. The Hunger Games World seems to be much more like one big bowl as it links the past, present, and the future. An Intertextual reference is interwoven in the present research as it brings Golding’s Lord of the Flies to the surface, and it highlights certain similarities between the two texts. In which Ralph, Piggy and Simon in Golding’s Lord of the Flies are the incarnations of stable moral values and hope of surviving ethics and rules in a chaotic and turmoil world. The event

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Publication Date
Mon Feb 18 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Insurance Awareness in marketing Insurance Services: An Explorative Research views of a Sample of Employees in the National Company for Insurance
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This research aims at shedding light on the concept of insurance awareness and clarifying its role on marketing insurance services of a sample of (100) employees in the National Company for Insurance. Questionnaire is used as a main instrument for collecting data and information from the sample. Their answers were analyzed by using arithmetic means, standard deviation, centesimal weight, and the correlation coefficient ( , F, t) tests .The research reached several conclusions of which:1.The sample member's response to insurance awareness and marketing insurance services factors was in the medium level.2.There was a positive relationship of a moral sign between insurance awareness and marketing insurance services, that correlation coeffic

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Publication Date
Wed Jan 05 2022
Journal Name
Journal Of Positive School Psychology
Influence Of Variance In Rest Interval For The Explosive Power Training For The Arms And Legs In The Light Of Some Biochemical Indicators For The Cellular Equilibrium Of The Volleyballers
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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Importance of obligation to the rules of professional conduct and its impact on tax revenues: An applied research in a sample of companies registered at the Department of the Public Authority for corporate taxes
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The researcher  tried to show the importance of obligation with the rules of professional conduct set by the Association of Accountants and Auditors of Iraqis when expressing an opinion the financial statements submitted tax administration and enhance the confidence of these lists, and adopted in the tax settling accounts process and its impact on tax revenues, and touched a researcher at the theoretical side of the search to the problem of research and of my Is there a trace of non- not to obligation by the rules of professional conduct in Iraq affect the tax revenue with the rules of professional conduct in tax revenue for companies research sample, the research aims to study the rules of professional conduct set by the Associatio

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Publication Date
Thu Dec 31 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
THE PROBLEM OF RANDOMSLAUGHTER IN BAGHDAD AND THE POSSIBILITY OF APPLYING MOBILE SLAGHTERHOUSEES TO REDUCE THEM: THE PROBLEM OF RANDOMSLAUGHTER IN BAGHDAD AND THE POSSIBILITY OF APPLYING MOBILE SLAGHTERHOUSEES TO REDUCE THEM
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One of the most important elements of achieving food security is livestock, which is an essential element in the agricultural sector, and is one of the state support sectors. Animal production (sheep) ranked an important position in this sector due to the economic advantages that are available when rearing. Moreover, the success and development of sheep breeding depend on several factors, including financial return and achieving profitability. The study aims to identify the phenomenon size of random slaughter as a problem, which spread in Baghdad and its causes and the factors that influencing its development. As well as, the possibility of applying the idea of a​​mobile slaughterhouse to reduce this phenomen

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Publication Date
Wed Aug 17 2022
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees21gr
Study the effective addition of coumarin dye on the optical properties of poly (methyl meth acrylate)
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The effect of adding different volume of coumarin dye (5, 15, 25 and 35) ml on optical properties of Poly (Methyl Meth Acrylate) was studied. Films of pure PMMA and PMMA with different volume of coumarin dye (5, 15, 25 and 35) ml were prepared using the casting technique. Transmission and absorption of the films were measured by using UV-VIS spectrometer technique type (100 Conc), in order to assess the type of transmission which was found an indirect transition. An optical energy gap of pure PMMA is (4.95e v) and after adding coumarin with volume (25, 35) ml, the energy gap for PMMA decrease by (0.05) compere to pure PMMA films and addition energy gap appear equal to (4.1 e v). It was found that the absorption coefficient, extinction coeff

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Study of the properties of Ru-isotopes using the proton-neutron interacting boson model (IBM-2)
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The proton-neutron interacting boson model (IBM-2) has been used to make a schematic study of the Ruthenium ( ) isotopes of mass region around with and . For each isotope of the values of the IBM-2 Hamiltonian parameters, which yield an acceptable results for excitation energies in comparison with those of experimental data, have been determined. Fixed values of the effective charges ( ) and of the proton and neutron g factors ( and ) have been chosen for all isotopes under study. The calculated electric quadrupole moments of state, transitions, the magnetic dipole moments transitions and mixing ratios are in reasonable agreement with the experimental data.

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Publication Date
Wed Mar 15 2023
Journal Name
Iran. J. Ichthyol
Histological study of lingual papillae on the tongue of the adult Iraqi domestic cat, Felis catus
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The results of this study showed that the tongue of the adult Iraqi domestic cat is divided into three regions of apex, body and root. The dorsal surface of all regions possesses five types of lingual papillae, two mechanical which are filiform and cylindrical papillae, while the other three types are taste papillae which are foliate, fungiform and circumvallate papillae, while these papillae are absent on its ventral surface. The histological examination of all tongue areas revealed that it consisted of three tunica, the tunica mucosa and the tunica submucosa (the lamina propria) and the tunica muscularis. The tunica mucosa consisted of the epithelial lining, which is a stratified squamous epithelial tissue covering the lingual papillae, a

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Publication Date
Thu Dec 01 2022
Journal Name
Iraqi Journal Of Physics
Study the Effect of Dielectric Barrier Discharge (DBD) Plasma on the Decomposition of Volatile Organic Compounds
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Recently, research has focused on non-thermal plasma (NTP) technologies as a way to remove volatile organic compounds from the air stream, due to its distinctive qualities, which include a quick reaction at room temperature. In this work, the properties of the plasma generated by the dielectric barrier discharge (DBD) system and by a glass insulator were studied. Plasma was generated at different voltages (3, 4, 6, 7, 8 kV ) with a fixed distance between the electrodes of 5 mm, and a constant argon gas flow rate of (2.5) I/min. DBD plasma emission spectra were recorded for each voltage. The Boltzmann plot method was used to calculate the electron temperature in the plasma ( ), and the Stark expansion method was used to calculate the elec

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Publication Date
Sat Mar 26 2022
Journal Name
Nasaq Journal
An analytical study of the science textbook of the intermediate 1st grade according to life skills
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The aim of this study is to develop the science textbook for the 1st intermediate grade by analyzing it according to life skills. Its core areas were mental skills, environmental skills, and health skills. The analysis tool was used after verifying its validity and stability in analyzing the science textbook for the 1st intermediate grade, and the results of the study resulted in the inclusion of mental skills on a high percentage of repetitions, while we find that this percentage is low in the inclusion of environmental and health skills. The study recommended the importance of achieving balance and justice in including skills in the science textbook for the 1st intermediate grade, by emphasizing the environmental and health skills by incr

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