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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
Thu Jun 29 2017
Journal Name
College Of Islamic Sciences
The illusion of al-Tabarsi in the kunya of Abi Jaafar in the interpretation of Majma' al-Bayan
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The persons who Allah Ioves them in the holly Quran

Objectivity Study0Dr 0muyad Turky Ali 

Allah men tioned in Auran the loving of benevolent and who Allah loves him gave him everything 0the loving of benevolent came fist and after that the loving of justice who remove injustice and after that loving purified and in noeent 0After that mentioning loving of Knighters ( fighters )The eharity with money and to clear up the justice and loving purified is a reason of accessing paradise 0 

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Strategic Intelligence in Organizational Success Analytical research in the colleges of the University of Fallujah
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The current research aims to verify the role of strategic intelligence as an explanatory variable in organizational success as a respondent variable in the colleges of the University of Fallujah, the research community. (Dean, Associate Dean, Section Head, Division Officer, Unit Officer), The researcher used the questionnaire as the main tool to collect data that included (50) items, in addition to using personal interviews and field observations as aids in data collection. The researcher relied on statistical programs (SPSS V.25; Excel V (16) In the treatment and analysis of data through the use of the most appropriate statistical methods (arithmetic mean, standard deviation, difference coefficient, determinatio

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Publication Date
Wed Jun 14 2023
Journal Name
Al-academy
Aesthetic employment of alliteration between the realistic and the fantasy in animated films
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When a person found himself in a life he did not understand، he tried to create in his imagination powers and gods that tried to protect him from his ignorance of that world، and when he was reassured internally through those fantasy creatures when he made them the greatest protector and the source of his existence and his being، he began to weave myths and myths until he created his reality that he did not have. Any hint، and when we go back to the mechanism of embodying those myths، myths and fantasias in which he lived، we will find that the first building blocks were written on the walls of the caves in which he lived during that period. And when his thought developed and thus his expressive means developed، he began to embody

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Publication Date
Tue Dec 15 2020
Journal Name
Aip Conference Proceedings
The water bodies in the Southern East of Iraq before and after 2018
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This study is concerned with the recent changes that occurred in the last three years (2017-2019) in the marshes region in southern Iraq as a result of the changes in the global climate, the study included all the water bodies in the five governorates that are located in the southern regions of Iraq (Wasit, Maysan, Dhi-Qar, Qadisiyah and Basrah), which represent the marshes lands in Iraq. Scenes of the Landsat 8 satellite are used to create a mosaic to cover the five governorates within a time window with the slightest difference between the date of the scene capture, not to exceed 8 days. The results of calculating the changes in water areas were obtained using the classifier support vector machine, where high accuracy ratios were recorded

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
THE MACROECONOMIC ENVIRANMENT OF THE FOOD INDUSTRY IN IRAQ AND ITS FUTURE PROSPECTS
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Food industries are variety to include number of agricultural products (plantbotential and animal) which can be manufactured locally, thus, Iraqi market is full by different types of food products from neighbor countries, because of un equivalence and inability of competence, in away to cover (90%) average of local request need under commercial  opening.

In Iraq although its importance, this industry suffers from difficulties, the most important one is the rising  in  products costs, shortage in agricultural products, experience, and qualification, besides, the challenges , by flooding market in food products and what are contained of higher competitive features from quality and prices side

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
Fairness in the ancestral quarrel at the meeting of subordinate and representative metaphors
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Having signed my eyes on the manuscript labeled (equity in the ancestral quarrel at the meeting of subordinate and representative metaphors) I was impressed by the process of achieving it; That manuscript came to light; to be seen by specialists in Arabic rhetoric and students of science, and supplement the library of rhetoric one of the sources ..

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
Simplicity and complexity in the visual layout of the designs Children magazine covers
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The magazine covers the subjects of (simplicity and complexity in the visual layout of the designs of magazine coverings of children) Chapter I The problem and importance of the goal and limits of research and addition to Terminology. In the second chapter the theoretical framework in which the first topic the role of simplicity and complexity in the design and the second section Visual design and design relations and the third research design in magazine covers and the third chapter includes the methodology of research and analysis and the results and conclusions and sources and the most important result of the research is (simplicity and complexity of design, Continuity and vitality and attract the attention of the receiver through the

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Publication Date
Mon Mar 15 2021
Journal Name
Al-academy
The effectiveness of media communication and its problems in the contemporary theatrical presentation
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Publication Date
Wed Dec 11 2019
Journal Name
Journal Of The College Of Education For Women
Turkish Policy Towards Africa in the Era of the Justice and Development Party
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Turkish policy towards Africa witnessed important developments over time that began before the Ottoman era and then developed during the Ottoman era when the Ottoman state played an important role in maintaining security by confronting Portuguese interventions in North Africa and sending military aid. Thus, the Ottoman state was able to develop its policy towards Africa for important considerations based mainly on the employment of the religious factor and the spread of Islam for the African acceptance of the Ottomans in the African territories and thus, achieve economic, strategic and political motives. Later, these relations declined in the Republican era due to the weak political and economic potential of Turkey on the one hand and th

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
Rashid Street and its impact in the political twenties of the last century
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Rasheed Street has had great importance by the nature of what was seen as being of vital events of a key facility in the Iraqi capital Baghdad since ancient times until now .
And such as cultural and historical memory-rich street for Iraq, pulsating nerve since the beginning of the last century thanks to the commercial and intellectual stature, as well as being a tourist landmark frequented alleys most of the tourists coming to Iraq , which counted for them a source of tourist attraction, given the religious diversity of fungal who excelled by the street, as we find in exchange for his Church of the Virgin Mary, the time which was built in the middle of the Caliphs Mosque towering minarets and promised that the oldest and largest of t

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