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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
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of the practice of professional doubt on the quality of the auditor's performance in Iraq: بحث استطلاعي
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              Due to the increasing interest in the quality of auditing by writers, researchers and regulators of the auditing profession. The matter necessitated a statement of the extent to which the auditor practices professional skepticism, because of its significant impact in discovering errors and material misrepresentations contained in the financial statements in order to give the financial community confidence in them and the success of the audit process. The research aims to clarify the concept and importance of the practice of professional skepticism and its effect on the quality of the auditor's performance in Iraq. To achieve the research objectives, the two re

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Publication Date
Wed Jun 14 2023
Journal Name
Al-academy
The effectiveness of the harvesting strategy in the collection of environmental art by the Institute of Fine Arts students
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 The current research aims to: (know the effectiveness of the harvesting strategy in the achievement of the students of the Institute of Fine Arts in environmental art.
- In order to know this effectiveness, the researcher put a main zero hypothesis and derived six sub-hypotheses from it. the usual way; As the research community reached (120) male and female students of the Fine Arts Institutes for the morning study in Baghdad. As for the research sample, it was chosen by the simple random method, and the number was (75) male and female students for the year 2021-2022 AD. The researcher applied a pre-knowledge test for the four groups of research to find out the level of previous experiences of students in the subject of environmen

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Publication Date
Mon Mar 01 2010
Journal Name
Journal Of Economics And Administrative Sciences
The economic feasibility of substituting different residues replaces part of the barley In the fattening of the Arabian lambs
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This experiment was carried out at the Grdarash field belongs to the Agricultural researches directorate/general Agriculture directorate-Erbil in September (2007)، 27 Arabic lambs aged (5-6 months) With average initial weight (39.178 Kg/lamb) were used. Lambs were divided in to (3) groups (9 lambs/group). Control group was fed on (85% barely، 10% bran and 5% straw)، and second and third groups were fed on various by-product in replacement with barely in loss and block shape respectively.

The total gain of three groups were (392708.32، 634826.52 & 445613.72 ID resp

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Publication Date
Sun Nov 16 2025
Journal Name
Lecture Notes In Networks And Systems
The Extent to Which Public Relations Departments in Government Institutions Use Artificial Intelligence Applications in Their Communication Activities: A Field Study
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Abstract This study explores the extent to which public relations (PR) departments within Traqj governmental institutions are integrating artificial intelligence (AI) applications into their communication activities. The research adresses the growing importanc of AI in enhancing administrative efficieney, communication transparency, and stakeholder engagement. Adopting a descriptive research design, the study relied on an electtonic questionnaire distributed to PR profesionals across various ministries and government bodies, collecting 100 valid responses. The indings reveal that while younger PR practitioners are actively embracing AI, older employees show limited engagement. Most participants acquired AI-related skills through self- learn

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Publication Date
Fri Aug 24 2018
Journal Name
Indian Journal Of Physics
Study of the nuclear deformation of some even–even isotopes using Hartree–Fock–Bogoliubov method (effect of the collective motion)
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In the present research, the nuclear deformation of the Ne, Mg, Si, S, Ar, and Kr even–even isotopes has been investigated within the framework of Hartree–Fock–Bogoliubov method and SLy4 Skyrme parameterization. In particular, the deform shapes of the effect of nucleons collective motion by coupling between the single-particle motion and the potential surface have been studied. Furthermore, binding energy, the single-particle nuclear density distributions, the corresponding nuclear radii, and quadrupole deformation parameter have been also calculated and compared with the available experimental data. From the outcome of our investigation, it is possible to conclude that the deforming effects cannot be neglected in a characterization o

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Publication Date
Wed Dec 01 2021
Journal Name
Gene Reports
The molecular study for evaluation the antibiotic resistance of Escherichia coli and Klebsiella pneumoniae bacteria isolated from urinary tract infection patients
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Urinary tract infection is a bacterial infection that often affects the bladder and thus the urinary system. E. coli is one of the leading uropathogenic bacteria that cause urinary tract infections. Uropathogenic E. coli is highly effective and successful in causing urinary tract infections through biofilm formation and urothelial cell invasion mechanisms. Other organisms that cause urinary tract infections include members of the Enterobacteriaceae family, streptococci and staphylococci species and perch. In addition, K.penumoniae is another important gram-negative bacterium that causes urinary tract infections. With the PCR technique, unseen bacterial species can be detected using standard clinical microbiology methods. In this study, the

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Publication Date
Wed Sep 01 2021
Journal Name
Iraqi Journal Of Physics
Study the Effect of Graphene on the Contact Angle, Water Absorption and Thermal Stability ( TGA ,DSC) for Blend (Epoxy & Repcoat ZR)
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In this study, polymeric coating was developed by incorporating nano graphene in the polymer blend with applications to oil storage tanks. The oil storage tanks samples were brought from the oil Pipeline Company / Doura refinery in Baghdad. The coating polymer was formed with a blend (epoxy resin and repcoat ZR). The proportion of mixing the mixture was 3:1:1 epoxy resin 21.06 gm: repcoat ZR 10.53 gm: hardener 10.53 gm. The blend/graphene was prepared using in stui-polymerization method with different weight percentage 1, 3, 5, and 7 wt % added to blend. The resulting solution was put in a glass tube on a magnetic stirrer for one hour at a temperature of 40 °C. The result of contact angle and wate

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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
The designed housing projects as an alternative for the informal building and their impact in addressing the heterogeneity of the urban escape in the built residential areas
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The phenomenon of informal building Spread recently in Iraqi residential areas, in general, and in Baghdad, in particular, due to the urgent housing need, on the one hand, and lack of commitment to building controls, on the other hand, to highlight the phenomenon of uncommitted building to controls and housing governing legislation in Iraq, leading to heterogeneity in both building densities and plot areas, and disorder in the urban fabric and urban escape of those areas. Research problem identified as the absence of a clear vision about the General aspects of the phenomenon of informal building in residential street scene, and the role of designed housing projects as a substitute for informal building in built residential areas. The des

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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
Social Support and Its Relationship to Psychological Rigidity in a Sample of Breast Cancer Patients In the Ramallah and Al-Bireh Governorate
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This study aims to identify the impact of social support on breast cancer patients’ psychological rigidity using a sample in Ramallah and al-Bireh. A descriptive correlative approach was adopted to fulfill the goals of the study and a questionnaire consisted of two criteria: social support and psychological rigidity, which was adopted as a tool for data collection for the study. In order to achieve the goals of the study, the researcher selected a convenient sample that consisted of 123 female breast cancer patients in Ramallah and al-Bireh. This sample represented 50% of the original patient population. The study showed that the average estimated percentage of social support and psychological rigidity for women with breast cancer, in

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effects of Different Concentrations of Melatonin on the Time-course of Nitrite–induced Oxidation of Hemoglobin: In vitro Study
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         Melatonin is a potent scavenger of reactive oxygen species or free radicals like superoxide and hydroxyl radicals. The oxidation of hemoglobin to methemoglobin (meth-Hb) by oxidizing compounds has been widely studied. The present work was designed to evaluate the ability of different concentrations of melatonin to inhibit nitrite–induced oxidation of hemoglobin. Blood samples were obtained from apparently healthy individuals from which erythrocyte hemolysate was prepared. Different concentrations of melatonin (10-9-1.0 mg/ml) were incubated for 10 min with the hemolysate, then to the resultant mixture 1 ml of sodium nitrite (final concentration 0.6 mM) was added, and the

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