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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
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The effectiveness of teaching the theory of TRIZ in expressive performance and the development of creative thinking among preparatory school students
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The current research aims to find out (the effectiveness of teaching TRIZ theory in the expressive performance and the development of creative thinking among preparatory school students)
To achieve this, the researcher adopted on an experimental design is located in women with partial seizure experimental designs field in order to achieve the goals of the research, has sample consisted of two divisions seminars Mentzmtin in junior high school Diyala for Boys, and divided the sample of (60) called on the two groups, the first pilot of ( 30) student, and the other officer and number (30), student, and studied researchers experimental group theory TRIZ, while he studied the officer in the traditional manner, the researcher conducted a pa

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Publication Date
Wed Jul 06 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Using of costs based on activity that focused on performance in Reduce Costs and their reflection to improve competitive advantage: An applied research in wasitTextile and Knitting factory
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The research aims mainly to the role of the statement style costs on the basis of activity based on performance (PFABC) to reduce production cost and improve the competitive advantage of economic units and industrial under the modern business environment dominated by a lot of developments and changes rapidly, which necessitates taking them and criticize them to ensure survival and continuity.  The research problem is the inability of traditional cost methods of providing useful information to the departments of units to take many administrative decisions, particularly decisions related to the product and calculating the costs of the quality of the sound and the availability of the need and the ability to replace methods capa

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Effectiveness Of the Poetic Text Between the Presence and Absence in Abu Firas al_Hamdani Romyate
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Abu Firas al- Hamdani is one of the most prominent abbasid poets Who characterized their poetry with high artistic quality especially in his Romyate which blended the quality of feelings of grief, sorrow, longing and nostalgia that makes sensitive self conflict that stems with time from one hand and with place on the other hand. Because we are dealing with a poet lived west spatial coercive which it has been hurt him within a time conflict swinging between despair and some times patience and hope other times between the present and his painful reality also between the past and the beautiful times.
This researcher is to stand on this Romyat by monitoring effectiveness of the poetic text based on conflict between the presenc

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The history of rational thought for the investment by human capital and the investing in it.
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The investment however "was its description and meaning, it remains a resident" in the composition of capital assets located in the forefront of the creation of productive assets, and this means that the investment in the productive sectors is a priority in achieving capital accumulation, on any other investment that takes place with the stages of advanced development of formation , not forgetting "to humans and investment humans as head of real money product, the source of the economic surplus and accumulation, and the source of producing values, and if human labor was the source of value, and the human was the source of work, therefore humanitarian work on different levels and skills presents capital", so the investment in huma

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Publication Date
Wed Mar 29 2023
Journal Name
Journal Of The College Of Education For Women
The Counselor Brent Scowcroft and his Role in Achieving the Requirements of the American National Security
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       Despite the multiplicity of institutions contributing to the decision-making process in the United States of America, they interact to crystallize positions regarding international and strategic situations. The formulation of the national security policy depends on a number of institutions that complement each other in order to achieve an advanced security situation. Thus, the decision reflects the process of interaction of the existing regulatory institutions. This is because the essence of the national security and achieving its requirements also stems from the existence of a coherent system of shared beliefs and principles in the American society. Besides, these elements are the bases for achieving

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Publication Date
Wed Jan 07 2026
Journal Name
Al–bahith Al–a'alami
The Boundary between Advertisement and Mass Media Overlapping Levels in the Press (The Case of Iraq)
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The advertisement is important in maximizing the resources of journalistic institutions. It helps them to perform their duties and also establishes their independence. However, this type of communication has often overlapped with other types of communication, including media and publicity.

Those in charge of the press bear responsibility in this regard, as some of them harness the advertisement for personal purposes; or detrimental to media content. Many communication authorities have drawn attention to the danger of confusing the concepts and levels of the three activities and have moved towards establishing rules to reduce overlap between them.

The aim of this research is to try to disengage the concept of advertising,

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Publication Date
Thu Dec 15 2022
Journal Name
Al-academy
Discourse the presence of animals in Mesopotamian sculptures "The lion and the bull as an example"
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Showing animal shapes is one of the primary topics since the discovery of cave drawings, with semantic discourses, as they appeared in the ancient civilization of Iraq, with their discourse and intellectual structure, and their reflections on their plastic achievements. The research deals with three topics: the first (an introduction to the concept of discourse), the second: (the historical roots of animal forms), and the third (the manifestation of animal forms and their discourse, in Mesopotamia). Mesopotamian fauna and its concepts? What are the?, Its importance was also represented in: the presence of animals and their semantic and conceptual discourse, especially the sculptures (the lion and the bull), with the aim of revealing the

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Publication Date
Sun Jan 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
Numbness of the Mind Paradigm in Haruki Murakami’s After the Quake and Iraq’s After the Quake
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Haruki Murakami (1949-present) is a contemporary Japanese writer whose works have been translated into fifty languages and won him plenty of Japanese and international awards. His short stories are well constructed in a weird realistic manner and are mixed with elements of surrealism. His novels and short stories fall under the genre of magical realism. One of the major revolving themes that Murakami wrote about was the haunting feeling of emptiness and disconnectedness in a world which seems to care much for materialism and self-interests.

    The paper explores two of Murakami’s short stories in his book After the Quake (2000) and the relevance of their themes and characters to Iraq after the q

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Conflict investigation methodology Between the news and the work of the people of the city
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Praise be to Allah, Lord of the Worlds and prayers to our master and our beloved Muhammad and to his God and companions.
The Sunnah of the prophet completed the prayer and delivery agreed to accept them as evidence of legislation, and the fundamentalists differed in accepting the news of Sundays in the pieces, and most likely if the hadeeth is proven, and completed the correct conditions there is no objection to accept it in branches and pieces. As for the work of the people of the city is one of the evidence adopted when the imam Malik, who is the Imam of the House of the Prophet's blessed immigration, and scientists differ greatly. If you offer a ruling and the ruling of the Hadith of the individual, and the rule of the work of the

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Publication Date
Tue Jun 01 2021
Journal Name
Political Sciences Journal
The European Union and the Extremist Right Phenomenon: Brexit as a Model
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The European Unit has never been affected by a serious phenomena as the phenomena of the advancing of the far right parties. Though these parties vary in their impact in their original countries, they agree on one important issue which is the deconstruction of the European unit and limiting its supernational powers. These increasing popular parties aim at more national independence in decision making away from the decisions taken by Brussels. Moreover, they criticize the financial and administrative corruption accompanied many of the rescuing procedures directed for example towards countries like Greece and Spain during the international economic crisis. This failure nourishes many of the negative feelings against the European unit which

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