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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 Sep 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Analysis of the relationship between inflation and the tax revenue in Iraq for the period 1990-2010
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The Iraqi economy has suffered for a long period of inflation because of the Iraq war and the resolutions and the sanctions that were imposed on Iraq, this phenomenon overshadowed at various aspects of the economy including the tax revenue that the State seeks to optimize the total income for the budget, the research covers the years 1990-2010, these years have been divided according to the country's economic variables.

The research  adopted on econometrics analysis that is based on the information and data available on topics and has been using statistical methods to test functions are formulated.

Research concluded that rates of inflation and GDP impact is limited to direct taxation and indirect in current prices a

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Publication Date
Sun Jul 01 2018
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
THE IMPORTANCE OF GEODIVERSITY ON THE ANIMAL DIVERSITY IN HUWAIZA MARSH AND THE ADJACENT AREAS, SOUTHEASTERN IRAQ
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    Geodiversity is the variety within abiotic natural elements that include: rocks, minerals, landforms, soil types, and water resources. Recently ecologists and naturalists recognized that there is close relationship between geodiversity and ecosystems. Huwaiza marsh is located south eastern Iraq within Lower Mesopotamian plain. The main rock bed units which crop out north east of the studied area comprises many types of rocks: conglomerate, sandstone, mudstone, siltstone and claystone belong to Bai Hassan, Mukdadiya and Injana Formations. The general elevation of the area ranges around 5 meters (a. s. l.) near the marsh and increase northeast to more than 100 meters (a. s. l.) and the Land forms are: cuesta, oxbow lakes

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Publication Date
Tue Dec 06 2011
Journal Name
Journal Of Planner And Development
The strategies of sustainable urban management in the Islamic city according to binary ( the city and power)
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Urban planning task and the control of constructional planning and urban management for cities considers the main tasks that the government takes care off. The paper discusses the concept of power from historical view of ancient Islamic cities to discover the strategies of urban management that the Islamic city adopt and to employ it in contemporary cities ,the more problems that modern cities suffer from which appears through poorness of urban context ,belongs to the loss of balance exists between the different faces of power that takes the tasks of urban management .therefore enhancement of urban environment is being through re-back that balance in administrative structures that make the cities go ahead . So the attention has b

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
Analysis of the symbolic images in the work of Mexican theater of: "all cats are brown," the writer Carlos Fuentes and "Palinuro on the stairs," the writer Fernando del Paso
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 This article briefly analyzing contemporary works appeared in theater writer from Latin America, which comes within the theme of "power." Latin American Literature, such as two-way extremely clear: the vanguard of social and attention, have arrived at certain moments to some extent be regarded as a two-way rival. That desire to participate in the revolution of expression and artistic significance, has appeared evident in the literature of Latin America in the late nineteenth century and ended in the third decade of the twentieth century. The writers that stage would prefer not to serve the objectives of the revolution of Arts own but the objectives of social and political revolution that stimulate the world. These acts were issued

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Publication Date
Wed Jan 21 2026
Journal Name
Nasaq
The Effectiveness of The Proposed Teaching strategy According to The Common Knowledge Construction Model in The Achievement of Students of The Second intermediate grade in Mathematics
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Publication Date
Wed Jan 21 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Nutritional Status among a Group of Preschool Children in Relation to Concentration of Selected Elements in Saliva and Caries Severity (A Comparative Study)
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Background: Nutritional status during childhood is very important for individual development and growth. Nutrition has local and systemic effect on the oral health by affecting dental health and salivary composition. This study was aimed to determine effect of iron, sodium and potassium ions in saliva on the nutritional status and to determine the effect of nutritional status on caries severity among preschool children. Material and Methods: The sample consists of 90 children aged 4 and 5 years of both genders, selected from 6 kindergartens in Al-Resafa aspect of Baghdad province. Children classified according to their nutritional status into three groups (normalweight, underweight and overweight). Nutritional status was determined by usi

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Publication Date
Sat Sep 03 2022
Journal Name
International Journal Of Health Sciences
Using Elisa and nested PCR for detection of the toxoplasmosis in milk and the influence of infection and some factors on milk composition in the Iraqi local and Shami goats
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This study concluded detection of Toxoplasma gondii in milk, immunologically by using Elisa and nested PCR)nPCR (based on B1 gene, also to investigate the effect of toxoplasmosis, parity, breed and flock on some milk composition in the Iraqi local and Shami goats in the middle of Iraq. A total of 80 milk samples of the lactating goats were collected. Results of this study showed the prevalence of Toxoplasmosis was 21.25% and 28.75% by Elisa and nPCR respectively without significant differences. The sensitivity of Elisa was a low (30.43%) whereas the specificity was a high (82.45%). The degree of agreement estimated by Kappa coefficient revealed a slight agreement (0.14) between two methods. The results indicated that goats infected

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Publication Date
Sun May 02 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The extent of adopting the dimensions of the Blue Ocean Strategy and its impact in the market share: بحث استطلاعي في شركة الحمراء للتأمين
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With the increase in competition between insurance companies in addition to the increasing numbers in the number of insurance companies, whose number decreased to (32) private companies until the end of the year (2020). The blue ocean at the level and its effects on increasing the market share. Therefore, the two researchers tested the hypothesis and the research concluded that there is a relationship A .Also the researcher put some recommendations the most prominent is that the invention is considered one of the successful strategies an d the company has to encourage the employees according to inventive thoughts

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Publication Date
Mon Dec 30 2019
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
A Comparative Study of Pressure Losses and Hole Cleaning Efficiency of Water and Polymer solutions in Horizontal Wells
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The main objective of this study is to experimentally investigate the effect of the CMC polymeric drag reducer on the pressure drop occurred along the annulus of the wellbore in drilling operation and investigate the optimum polymer concentration that give the minimum pressure drop. A flow loop was designed for this purpose consist from 14 m long with transparent test section and differential pressure transmitter that allows to sense and measure the pressure losses along the test section. The results from the experimental work show that increasing in polymer concentration help to reduce the pressure drop in annulus and the optimum polymer concentration with the maximum drag reducing is 0.8 kg/m3. Also increasing in flow rate a

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Educational And Psychological Researches
Anxiety of death among pregnant women in the light of some Demographic variables Governorates Bethlehem and Tulkarm as a model
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This study aims to identify the anxiety pregnant women have of dying, in the light of some Demographic variables in Bethlehem (age, residence, and the mother's job). The descriptive method was used in this study. To achieve the study purposes, the researchers developed a questionnaire as a tool of study, which consisted of (19) paragraphs ,after been verified of its validity & stability.

The researchers distributed questionnaires, and then analyzed them. Results illustrated that the levels of anxiety pregnant women in Bethlehem had of dying was average,  with a mean total score of (3.11),  and with a standard deviation that had the total score of (0.476). Results also illustrated statistical differences in the pregn

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