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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 Dec 10 2017
Journal Name
Al-academy
The Dynamics of the artistic form in the Iraqi theater
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The research is aimed at dynamics the dynamics of the artistic form within the theater and the dynamics of this movement in the development of the form and the multiplicity of meaning. This research came to address a problem of great importance in the creation of the image and the form of theatrical presentation. The evolution and transformation within the display system requires a dynamic structure that enables the form of growth and growth. The aim of the research was to identify the dynamics of form in the Iraqi theater. The researcher then identified two terms: form and motor.
In the theoretical framework, it was divided into two sections: the first (the dynamics of the artistic form) and the second (the dynamics of the act of dir

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Publication Date
Fri Mar 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the internal audit in the performance enhancing
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  After the internal audit as a tool of internal control in any organization, and helps in the evaluation of all internal control activities, as a tool to ensure compliance with the plans and policies to achieve the goals of the institution as much as possible of the efficiency, effectiveness, and should have the Internal Audit full independence and is linked to senior management, and aims to get the credibility and accuracy of information and data, and keep abreast of modern developments.

  The practical side includes the preparation of the questionnaire, which included a set of questions that fit the hypothesis of the research, was Tozeiha the research sample consisting of employees of the Internal Audit Department an

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Publication Date
Tue Jun 14 2022
Journal Name
Al-academy
The aesthetics of the symbol in the Iraqi theater scene
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Theatrical performances began with the Greeks when the theatrical scenes and skeletal figures were encoded, where the large wall of the Alskina, which contains three doors, the middle of them with a high height, and the two sides took the natural size, where the middle door indicated a symbolism of the god or demigods, as we find the condensation of the symbol in the architecture of the theater, and the symbol was taken In the theatrical scene, the development semantically and aesthetically, and interpreting and interpreting the current day, where the laser light formed the symbolism of the contemporary virtual scene, and in order to identify the aesthetics of the symbol in the theatrical scene, the current research was evaluated into fo

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Publication Date
Tue Aug 20 2019
Journal Name
Political Sciences Journal
The authority of the president in the successive regimes in Iraq in the time - span 1920-2003
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Abstract The success of the system of government in any country needs to have a handle on the amount of power efficiency , capacity , capability and wisdom, Iraq has gone through since its inception through several stages of time, namely: The first stage: which ran from August 23, 1921 until July 14, 1958 and was ruling monarchy (rule of the royal family) and punishing power of political elites both of them and works access to power without taking into consideration the laws and principles of the Constitution, and as a result of the inability of civilian powers and political parties access to power to grant that army officers regulatory and disciplinary specifications as well as possessing arms and overthrow the rule of the minority coup

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Publication Date
Wed Feb 14 2018
Journal Name
International Journal Of Science And Research (ijsr)
Effect of the Active Thinking Model in the Achievement of Students of the Fifth Grade Applied Science of Physics and Their Pivotal Thinking
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The aim of the current research is to identify the effect of the active thinking model in the achievement of students of the fifth grade applied science of physics, and their pivotal thinking by verifying the two zero hypotheses, where there is no significant difference at the level of significance (0.05) between the average scores of the experimental group who studied physics using the active thinking model and the average scores of the control group students who studied the same material in the usual way in the achievement test, as well as in the pivotal thinking test. The research sample consisted of (77) students of the applied fifth grade students in two divisions (a) and (b), randomly selected (a) to be the experimental group, and (b)

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Publication Date
Fri Nov 03 2023
Journal Name
Lecture Notes In Electrical Engineering
A Survey Study and Comparison of Drones Communication Systems
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Publication Date
Thu Jun 01 2023
Journal Name
Journal Of Composite Materials
Fabrication and characterization of bioactive composite: A pilot study
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The increasing requirement and use of dental implant treatments has rendered dental implantology indispensable in dentistry. The aim of this study is to determine the optimum concentration of calcium silicate to be incorporated into a polyetherketoneketone (PEKK) matrix used as an implant material to enhance the bioactivity and mechanical properties of the composite compared with unmodified PEKK. In this study, different weight percentage (wt%) of micro-calcium silicate (m-CS) is incorporated into PEKK with ethanol as a binder. Subsequently, the mixture is dried in a forced convection oven at 120°C and poured into customized molds to fabricate a bioactive composite via compression molding (310°C, 15 MPa, and 20 min holding time

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Publication Date
Mon May 17 2021
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
The Relative Contribution of the Flexibility for the Hip Joint, the Angle of the Knees, and the Muscular Strength for Arms of Performance of the Front and Back Rolling Skills, Opening on the Floor Movement Mat
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In order to improve the students’ performance level in some of the skills that are implemented on the mat device of ground movements, including the front and rear rolling, it is necessary to study the most important indicators that have a clear impact on the performance of those rolls. Among the objectives of the research: To identify the percentage of the contribution of flexibility of the hip joint, the angle of the knees and the muscular strength of the arms in the performance of the front and rear rolling skills, an opening of the research sample. The researchers used the descriptive method in the survey method for its suitability to the nature of the work, and the research community was represented by students of the third st

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Publication Date
Sat Jun 04 2022
Journal Name
Al–bahith Al–a'alami
Agitation Negative Social Behaviours in the Talk Shows of the (NRT) Satellite Channel: Research extracted from a master's thesis
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This research asks what are negative social behaviours in the Kurdistan Region of Iraq (KRI) raised by the talk shows on the (NRT) channel? Furthermore, it aims to identify the most significant themes addressed by talk shows on the (NRT) channel regarding negative social behaviours in the KRI by using the content analysis approach through non-random purposive sampling to understand the dialogue contents that dealt with this subject. This study has reached a set of results: through its talk shows, the (NRT) channel attempts to create a media vision about the spread of negative social behaviours in the KRI and stand up to the dangers associated with these behaviours. At the same time, those programs tried to marginalize the behaviours that

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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
Implications of Financial Reporting Governance in rationalizing investors decisions In financial markets in light of An International Financial Reporting Standards (IFRS)/ An analytical study of a selected sample of the joint stock companies in Iraq
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The financial crises that occurred in South East Asia and America, and the discovery of the financial and administrative corruption that affected these companies, which led to the crisis. Since then, organizations and institutions interested in accounting have begun new ways to further rationalize the management of these companies. Hence the concept of governance, which means good governance. Al-Susiya confirmed its adoption of the financial reporting standards and adopted internal and external auditing for the purpose of increasing the reliability and credibility of the financial and reports that increase the confidence of investors in making their investment decisions in the financial markets The study dealt with the contributi

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