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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 2015
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the competitiveness for commercial banks in Iraq for a period of 2004 – 2012
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This study was conducted on a sample of commercial banks in Iraq, chosen according number of considerations for twenty banks, contained two public banks and eighteen private banks.                                                                                             &

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Publication Date
Wed Mar 29 2023
Journal Name
Journal Of The College Of Education For Women
The Omani Sultanate of Zanzibar between Unity and Separation for the Period between (1223-1275 AH/ 1806-1861 A)
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Sultan Said bin Sultan bin Ahmed bin Said Al-Busaidi (1223-1273 AH / 1806-1856 AD) was able to rule Oman and Zanzibar in a unified Arab-African state during his reign. However, it was separated for several reasons. Thus, the study aims to clarify the efforts made by Sultan Said for annexing Zanzibar to Oman, establishing the Arab-African Sultanate, and shedding light on the role played by Britain in dividing the Arab-African Sultanate and separating Zanzibar from the Omani rule in (1275 AH-1861 AD). The study has adopted the historical descriptive analytical approach. The study has reached several conclusions, such as: The economic motivators  were the most important factors that pushed Sultan Said to move his capital from Muscat to

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Article The problem of nuclear proliferation and its impact on the formula of strategic balance in the Middle East after the events of September 11, 2001
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The issue of nuclear proliferation is one of the most vital issues as it reflects a form of dealing in the field of international relations. Therefore, the Middle East region has taken great interest in reducing the levels of nuclear armament and acquiring nuclear power within the strategic framework of the international and regional powers. The establishment of a nuclear-weapon-free zone in the Middle East region is currently one of the most important international and regional arrangements for controlling the levels of nuclear proliferation and attempting to build a state of stability and balance. In the Middle East and the world. The importance of the research comes from the fact that it deals with an important and vital issue

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Publication Date
Sat Dec 17 2022
Journal Name
Iraqi Journal Of Laser
PDF Study the Effect of Gold Film Thickness on the Sensitivity of the U Shape Fiber Sensor by the Occurrence of LSPR Phenomenon: Saffana Z. Maseer*, Bushra R. Mahdi
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Abstract: In this paper, a U-shaped probe with a curvature diameter of half a centimeter was implemented using plastic optical fibers. A layer of the outer shell of the fibers was removed by polishing to a D-section. The sensor was tested by immersing it in a sodium chloride solution with variable refractive index depending on solution concentrations ranging from 1.333 to 1.363. In this design, the sensor experienced a decrease in its intensity as the concentration of the solution increased. The next step The sensor was coated with a thin layer of gold with a thickness of 20 nm, and the sensor was tested with the same solutions which resulted in a shift in wavelengths where the shift in wavelength was 5.37 nm and sensiti

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Publication Date
Mon Dec 31 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
DETERMINATION OF THE CHEMICAL COMPOSITION OF THE COWS, SHEEPS AND CHICKENS BONES AND THE POSSIBILITY OF USING THEIR FAT ECONOMICALLY.: DETERMINATION OF THE CHEMICAL COMPOSITION OF THE COWS, SHEEPS AND CHICKENS BONES AND THE POSSIBILITY OF USING THEIR FAT ECONOMICALLY.
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This study includes applying chemical tests on cow, sheep and chicken bones including both hallow and flat. The results of chemical tests on bones mentioned the moisture percentage which was between 4.95-7.32 %, and it was noticed the difference in protein percentage among different kinds of bones, The highest protien percentage was 39.62 % in hallow chicken bones and the lowest was in hallow sheep bones 20.31%, at the same time, the highest Ash percentage was in hallow sheep bones48.11% , whereas the highest percentage of fat was in hallow cow bones 30%. The chemical and physical tests were conducted for extracted fat from hallow and flat bones for cows, sheeps and chicken. It was found that peroxide values (PV), and free fatty acids (F

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Publication Date
Wed Sep 18 2019
Journal Name
Journal Of The College Of Education For Women
The Linguistic Term and the Problems of the Arabic Reception
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        The linguistic researcher reads a systematic crisis, idiomatic problems within the linguistic term coming to the Arab culture. Where most of them return back to problems of receiving these sciences which are represented by phenomena like the multiplicity linguistic term, disturbance translated idiomatic concept and its duality.

Aims of the research :

1-Initializing new textbooks to form linguistic project and Arabic linguistic theory.

2-Determination adjusted knowledge, concepts of Arabian heritage linguistics subject

3-Observation  the causes of disturbance crisis of linguistic term and its relation to

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Publication Date
Fri Jun 20 1930
Journal Name
College Of Islamic Sciences
Prison and imprisonment   And their impact on the strengthening of power In the Qur'anic perspective
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Prison and imprisonment  
And their impact on the strengthening of power
In the Qur'anic perspective

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Publication Date
Wed Mar 15 2023
Journal Name
Al-academy
The Developed Materials and Techniques and Its Role in Exposing the Aesthetic Of Art Work
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This study is targeting the new developed materials and techniques and how they were affected by the scientific and technological developments that contributed to revelated new and varied developed materials and techniques. And from the artist’s formulation by using the materials and techniques and through its embodiment and sensor the values, artistic and aesthetic standards by breaking from the familiar in aesthetic contemporary way.
The studies on questioning what’s the role of The New Developed Materials and Techniques in exposing the aesthetic of the art work?

This study is to show the aesthetic of the art work through the new developed materials and techniques. Which was based on descriptive analyzing method and hig

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
The treatment of the output of Marquez novels in the international cinema … Love in the time of cholera: منهل باسم سعيد الطاهر
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Gabriel Garcia Marquez, the Nobel laureate of literature in 1982, is one of the most famous Latin American writers who have been distinguished by the magic of realism. We can say the months in the world and he is almost the most controversial for many reasons and for these reasons he did not accept that his novels turn into movies Marquez agreed to turn one of his most important and most beautiful novels, "Love in the Time of Cholera," which he wrote in 1985 and agreed to convert to a film in 2006 after the novel was bought by the author for $ 3 million. Mike Noel to bring out

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Publication Date
Thu Aug 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the sustainability of the public debt in light of the volatile oil revenues in Iraq for the period (2005-2015)
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Abstract

This study deals with the fluctuations of oil revenues and its effect on the public debt. This can be studied through the indicators of debt sustainability, the financial, and economic indicators which express the risk of debt. The study focuses on clarification of the public debt path and its management both domestic and foreign. The sustainability of debt takes an important role according the macroeconomic variables. This study stresses the relationship between the rental economy in Iraq and the risk of the public debt, it is very important to work high oil prices, and on investigating during high work to establish a fund to support the budget deficit. This will reduce future risks arising from the use of publi

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