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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 Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Deposit insurance system and its role in financial security for the period (2010-2018) Study the experiences of Selected countries with reference to Iraq
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Founding a System to secure deposits and protecting the depositors is considered one of the important and exchanged subjects out there in the banking system/field in Iraq at the current time, and the reason behind the exchange and spread of this subject is due to the financial crisis of which the banking sector is suffering from and the stumbling of many banks, those factors have had led to the insecurity of the depositors and their mistrust towards banks, thus, it is necessary to create a system to secure deposits in which depositors would be compensated for the losses caused by the banks' failures. in addition, it could be a countermeasure system which maintains the banking stability, protects the rights of depositors and gains

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
THE ROLE OF SOCIAL ENTREPRENEURSHIP IN IMPROVING THE QUALITY OF LIFE OF THE CUSTOMER Field research at the Iraqi Ministry of Labor and Social Affairs
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Abstract:
      This research emerged due to the needs of Iraqi social sector for diagnosing the problems ,finding the appropriate solutions,and exploiting the social opportunities to solve these problems .The research problem focused on raising the following question: "Were Iraqi Managers in the Ministry of Labor and Social Affairs able to use their qualifications as social entrepreneurs in the ministry to improve the quality of life of the disadvantaged groups?", In light of that, the importance and objectives of the study were determined, and this research derives its importance from trying to address social problems by measuring the degree of meeting the subjective and objective needs of the custo

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
The Physical Performance Of The Actor Within The Shows Of Anas Abdul Samad ( the play silence as the cry as a model): حليم هاتف جاسم
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The body has the ability to effect the audience in the the theatrical show , since he or she is transmitter , sender , seen and viewer of the humanitarian discourse as well the the images and connotations of the theatrical show, it is a tool of communication that substitutes for millions of spoken words, the modern schools of direction focused on the body language of the actor and gave it prominence in depicting facts by different connotations. The researcher studies the physical performance of the actor throughout focusing on the connotational dimensions of the body within the theatrical show , as well as the positioning of performative body within the modern schools of direction depending on the theatrical show (Rebuke ) of the Iraqi d

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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the external audit in improving the performance of the services provided: Applied research in the municipal directorate in ALMuthanna
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The subject of improving the performance of services provided by government institutions of the important topics at the present time because of their direct contact at the service of citizens and the increased importance of these units as a result of the diversity of activities performed by the so governments of the countries and their people made sure to pay attention to the good use of those allocated to those sectors of resources and spending in the service prescribed and manage the highest level of efficiency and effectiveness and monitor the proper management of the money used in those sectors and evaluate their performance through the Supreme Audit Institutions so that they can play their role oversight and contribute to th

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Publication Date
Thu Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the indicators of the educational process and scientific levelUsing the analysis of variance of ordered data in repeated measurements
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In this research want to make analysis for some indicators and it's classifications that related with the teaching process and the            scientific level for graduate studies in the university by using analysis of variance for ranked data for repeated measurements instead of the ordinary analysis of variance . We reach many conclusions  for the                         

important classifications for each indicator that has affected on   the teaching process.         &nb

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Publication Date
Mon Dec 30 2024
Journal Name
Iraqi Journal Of Science
The Impact of Fear and Anti-Predator Behavior on the Dynamics of Stage-Structure Prey–Predator Model With a Harvesting
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In this paper, an ecological model with stage-structure in prey population, fear, anti-predator and harvesting are suggested. Lotka-Volterra and Holling type II functional responses have been assumed to describe the feeding processes . The local and global stability of steady points of this model are established. Finally, the global dynamics are studied numerically to investigate the influence of the parameters on the solutions of the system, especially the effect of fear and anti-predation.

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Publication Date
Thu Mar 30 2006
Journal Name
College Of Islamic Sciences
The Messenger’s approach to preaching (the Meccan stage in light of the Qur’an and Sunnah)
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First: People’s need for advocacy:

Calling for a legal necessity for all people, regardless of their races, colours, tongues, and culture, to explain the truth, spread fear, bring benefits, ward off evil, regulate a person’s relationship with his Lord, and his relationship with creatures, so that he knows his money and what he owes.

All of creation is in dire need of the call to God’s religion with insight due to their inability to reach out to goodness, righteousness, guidance, and success on their own. Man is limited in thinking in this universe, limited in his resolve, unable to know what will improve his affairs in the two worlds. His need for religion is one of the necessities of his life, and one of the comple

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Publication Date
Thu Jan 01 2026
Journal Name
Journal Wlkalam
Earthquakes in the Holy Qur’an and the Hadith of the Noble Prophet, an intellectual approach
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Earthquakes in the Holy Qur’an and the Hadith of the Noble Prophet, an intellectual approach

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Publication Date
Tue Jun 14 2016
Journal Name
Al-academy
Expressive and aesthetic role of the scenes in the initiation speech the picture (Cinema Togravea)
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Construction is the opening of the important pillars of the construction of the film as a whole for this, we find that the first of any narrative of my film begin at the borders of this construction is the window that we look through the contents tale and puzzle narrative is of significance that degrade traveler when reservoirs expression later in reasoning and find justifications ills that came by those initiation, this initiation may be the window that lead us to the core, understanding the story through signals received to the recipient to sail because of the paths of pickling what is which is encoded, but this initiation may serve as keys that understanding the be puppies and signals that beset and surrounded to what He holds inevita

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Publication Date
Tue Sep 27 2022
Journal Name
Al–bahith Al–a'alami
THE MOST IMPORTANT PHENOMENA OF THE ARABIC LANGUAGE IN THE MEDIA BETWEEN (warning and development)
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Summary of the research : Our research tagged (Arabic language in the media between warning and development) attempts to follow the most prominent phenomena that accompanied the evolution of the use of Arabic language in the media with the development of these means and spread technically globally, and how divided researchers and linguists and intellectuals Arabs into two teams, each demanding what contradicts the other, in the matter The use of the Arabic language in the media, and the arguments of each team in the need to deal with the media as one of the pillars of the nation culturally, historically and civilized, in order to enhance its position and maintain unity, continued the research highlighted the positions of hard-lin

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