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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
Fri Mar 28 2025
Journal Name
Journal Of Physical Education
Special exercises using tools and their effect on teaching the skill of a front shoulder circle on the rings apparatus in artistic gymnastics for students
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Sports skills in some individual games require physical and motor qualities to facilitate the process of skill performance and also require the instructor or trainer to use more than one strategy, method and way to bring the performance to the level of mastery and avoid injury. The aim of the research is to know the effect of using special exercises using tools and their effect on teaching the skill of a front shoulder circle. The research hypothesis is that using special exercises with tools has a positive effect on teaching the skill of a front shoulder circle on the rings apparatus. Research method: - The researchers used the experimental method by designing two equal groups, the control and the experimental, to suit the research

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Publication Date
Sun Jan 01 2017
Journal Name
International Journal Of Latest Trends In Engineering And Technology
Study the effect of number of nozzle on optical and structural properties of sno2 films grown by (apcvd)
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Publication Date
Wed May 28 2025
Journal Name
Retos
The effect of exercises in the third intensity zone of the strength characteristic of speed for the legs on some physiological and biochemical indicators for handball players
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Objective: preparing exercises for the third intensity zone for strength and speed for the legs, and identifying their effect on some physiological and biochemical indicators for (the level of lactic acid concentration, the concentration of sodium bicarbonate, the concentration level of (potassium K+) and (sodium Na+) in the blood, and the number of breathing times (RF) Research methodology: the experimental research method was adopted by designing the experimental and control groups on a sample of Army Sports Club players amounting to (16) players, deliberately selected (100%) from their community using a comprehensive enumeration method, and then divided into two groups of equal number, After determining the tests for physiologica

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Publication Date
Wed Nov 30 2016
Journal Name
International Business Management
ESTIMATE OF THE MULTIPLIER EFFECT OF THE MONETARY AND FISCAL POLICY ON NON-OIL GROSS DOMESTIC PRODUCT IN THE IRAQI ECONOMY FOR THE PERIOD OF 1990-2014
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The monetary policy is a vital method used in implementing monetary stability through: the management of income and adjustment of the price (monetary targets) in order to promote stability and growth of real output (non-cash goals); the tool of interest rate and direct investment guides or movement towards the desired destination; and supervisory instruments of monetary policy in both quantitative and qualitative. The latter is very important as a standard compass to investigate the purposes of the movement monetary policy in the economy. The public and businesses were given monetary policy signals by those tools. In fiscal policy, there are specific techniques to follow to do the spending and collection of revenue. This is done in order to

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Publication Date
Thu Dec 28 2023
Journal Name
Journal Of Physical Education
Proactive leadership and its relationship to managing the organizational error of the Iraqi Handball Federation from the point of view of the clubs participating in the Iraqi Elite League for the season 2023-2024
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This research seeks to study the role of proactive leadership as an essential element that helps all federations that lead the wheel of sports, including the Iraqi Handball Federation, so that it builds a correct environment that helps manage the organizational errors that the Handball Federation may fall into, and this in turn helps in early detection of errors and obstacles that may occur. It is likely that the Federation will fall into the process of managing and organizing the Iraqi Handball League, in addition to increasing the clubs’ ability to assist the Iraqi Handball Federation by being proactive so as not to make mistakes. The research community included the administrative bodies of the clubs participating in the Iraqi E

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Publication Date
Fri Sep 29 2023
Journal Name
Cumhuriyet Dental Journal
Root Resorption in the Permanent Teeth. A Review
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The loss of dental hard tissue as a result of odontoclastic activity is known as root resorption. It is unwanted and pathological in permanent teeth. Root resorption may happen within the root canal called internal root resorption or on the outer surface of the root called external root resorption. Regardless of where it occurs, root resorption is irreparable, can cause pain for the patient, necessitates treatment, and in some circumstances, resulting in the early loss of the affected tooth. It might be challenging to precisely diagnose and treat root resorption. There is limited information within literatures on root resorption therefore this review aims to understand the radiological and clinical characteristics of r

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Publication Date
Wed Sep 15 2021
Journal Name
Al-adab Journal
The Iraqi countryside in a novel (Exceeded border)
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The novel was generally distinguished from other literary arts in its connection with the living reality as an imaginative practice that relies on political, economic, social, intellectual and cultural references and as a crucial tool in reading cultural references and dive deep into reality. As every novelist has a vision to embody this reality. As every novelist has a vision to embody this reality. The novel of ("Exceeded border by Hammed Al-Kafa’i) is a considered a fertile field for presenting social issues in their apparent structure and revealing the cultural patterns behind them which lies in its deep structure. The novel here moves its characters in its imaginary world in a way that it becomes more capable of adaptation and crysta

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Publication Date
Wed Mar 18 2020
Journal Name
Baghdad Science Journal
A Comparative Study of Heavy Metals and Trace Elements Concentration in Milk Samples Consumed in Iraq
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The measurements of major and trace elements in different brands of milk powder selected from the Iraqis market via the X-ray fluorescence (XRF) Technique have been studied in the present work. The result of the measurements reveals the high concentrations of sodium, phosphorus, sulfur, chlorine, potassium, calcium and magnesium. Furthermore, low concentrations of aluminum, silicon, iron, bromine, molybdenum, iodine, barium, titanium, manganese, cobalt, chrome, nickel, copper, zinc and lead were detected. Neutron activation analysis (NAA) and Kjeldahl technique were also employed to determine the concentrations of nitrogen. It was found that the nitrogen concentration was in the range of (1.96 - 3.23) % which is within the permissible li

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Publication Date
Mon Nov 21 2022
Journal Name
College Of Islamic Sciences
Sources of audio images in the poetry of the Islamic
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      الحمدُ للهِ رب العالمين ، والصلاة والسلام على نبيه الأمين محمد r وعلى آله الطيبين الطاهرين ، وأصحابه الغر الميامين:

             تعد الصورة السمعية مفهوما بيانيا نجده في البلاغة العربية واضحاً مؤثرا، مؤديا دورا جوهريا في إيصال الفكرة التي يروم الأديب إيصالها إلى المتلقي   ولا تبدو السمعية واضحة إلاّ إذا نظر إليها في حالة أدبيه تهز كيان الشاعر &nbsp

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Publication Date
Fri Jun 30 2023
Journal Name
Anbar Journal Of Agricultural Sciences
THE EFFICIENCY OF MICROBIOLOGY IN THE PROCESS OF PESTICIDE BIODEGRADATION
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This study aims at recognizing Pesticides and how the process of pesticides biodegradation by microbiology took place, and the effect of environmental condition on this process. And how the research uncovered the efficiency of microbiology in the biodegradation process of pesticides, as the perfect temperature for the biodegradation process is 40 °C and humidity effect on pesticides efficiency, when high humidity reduces pesticide efficiency and the perfect acidity to increase bacteria efficiency is 7, for the incubation period, it was found during the previous studies that the best incubation period is 5-7 days, in this period the bacteria imprint on pesticides and increase biodegradation of it.

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