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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
Wed May 10 2017
Journal Name
Journal Of The College Of Languages (jcl)
РОЛЬ СРЕДСТВ НАГЛЯДНОСТИ В ПРОЦЕССЕ ОБУЧЕНИЯ РУССКОМУ ЯЗЫКУ КАК ИНОСТРАННОМУ В ИРАСКОЙ АУДИТОРИИ The Role of the Use of Visual Aids in the Process Of Learning Russian Language in Lraq as a Foreign Language
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В статье рассматриваются понятие наглядности и ее классификация, эффективное применение принципа наглядности, возможность и преимущество использования наглядности и современные инструменты ее реализации в ираке.

 

Вследствие глобальных изменений во всем мире изменилась и роль иностранного языка в системе образования. Современный человек, шагающий в ногу со временем, не мыслит себя без зна

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Engineering
Effect of Seismic Loading on Variation of Pore Water Pressure During Pile Pull-Out Tests in Sandy Soils
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Experimental model was done for pile model of L / D = 25 installed into a laminar shear box contains different saturation soil densities (loose and dense sand) to evaluate the variation of pore water pressure before and after apply seismic loading. Two pore water pressure transducers placed at position near the middle and bottom of pile model to evaluate the pore water pressure during pullout tests. Seismic loading applied by uniaxial shaking table device, while the pullout tests were conducted through pullout device. The results of changing pore water pressure showed that the variation of pore water pressure near the bottom of pile is more than variation near the middle of pile in all tests. The variation of pore water

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Publication Date
Sun Dec 17 2017
Journal Name
Al-khwarizmi Engineering Journal
Experimental Study Using the Passive Solar Chimney for Evaporative Cooling With PCM and CFM as a Thermal Energy Storage
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      In this work, a test room was built in Baghdad city, with (2*1.5*1.5) m3  in dimensions, while the solar chimneys (SC) were designed with aspect ratio (ar) bigger than 12. Test room was supplied by many solar collectors; vertical single side of air pass with ar equals 25, and tilted 45o double side of air passes with ar equals 50 for each pass, both collectors consist of flat thermal energy storage box collector (TESB) that covered by transparent clear acrylic sheet, third type of collector is array of evacuated tubular collectors with thermosyphon in 45o instelled  in the bottom of TESB of vertical SC. The TESB was

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Publication Date
Fri Jan 23 2026
Journal Name
Sciences Journal Of Physical Education
Cognitive bias and its relationship to the performance of the two skills of standing on (hands and the human wheel) on the floor movement carpet device in the artistic gymnastics for women
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Publication Date
Mon Apr 02 2012
Journal Name
Eastern Mediterranean Health Journal
Knowledge, attitude and practice regarding breast cancer and breast self-examination among a sample of the educated population in Iraq
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This cross-sectional, questionnaire-based study evaluated the knowledge, attitude and practice towards breast cancer and breast self-examination [‎BSE]‎ among 387 [‎302 females and 85 males]‎ educated Iraqis affiliated to 2 Iraqi universities. The participants were categorized into 3 occupations: student [‎71.3%]‎, teaching staff [‎10.3%]‎ and administrative staff [‎18.3%]‎. About half of the participants had a low knowledge score [‎< 50%]‎; only 14.3% were graded as [‎Good]‎ and above. Almost 75% of the participants believed that the best way to control breast cancer was through early detection and other possible preventive measures. Most participants [‎90.9%]‎ had heard of BSE, the main source of informatio

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Publication Date
Sun Oct 02 2016
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Driver and Posner Models in correcting Alternative Perceptions in Educational Psychology Material for the Students at the Institute of Fine Arts
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To achieve the goals, the researcher followed the design of equal and   independent groups of partial control and post-test . The research has chosen the Institute of Fine Arts in the area Almansour area as deliberate sample where three sections of students have been chosen and the   number of students is (69) students. The researcher conducted equivalence in the variables (age, and IQ , and the overall rate for grade III). in diagnostic phase,  (21) concepts of alternative    image out of (46) concepts have been identified in addition to the goals of formulation of acquisition concepts according to the three processes (definition, discrimination and application). Achievement test has been

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Publication Date
Sun Jan 01 2023
Journal Name
The Egyptian Journal Of Hospital Medicine
The Effect of a Program Using Auxiliary Tools to Improve The Long Passing Skill of Football Juniors
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Publication Date
Sat Jun 01 2024
Journal Name
Materials And Structures
Exploring the efficacy of sawdust ash as a mineral filler substitute for the production of asphalt mixtures
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Many waste materials can be repurposed effectively within asphalt concrete to enhance the performance and sustainability of pavement. One of these waste materials is sawdust ash (SDA). This study explores the beneficial use of SDA as a substitute for limestone dust (LD) mineral filler in asphalt concrete. The replacement rate was 0%, 15%, 30%, 45%, and 60% by weight of total mineral filler. Scanning electron microscopy (SEM) was employed to assess the surface morphology of Sawdust (SD), SDA, and LD. In addition, a series of tests, including Marshall stability and flow, indirect tensile strength,moisture susceptibility, and repeated uniaxial loading tests, were conducted to examine the performance characteristics of asphalt mixtures of diffe

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Building a mathematical model of the transportation problem under the dynamics of demand restrictions with practical application
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Abstract\

In this research we built a mathematical model of the transportation problem  for data of General Company for Grain Under the environment of variable demand ,and situations of incapableness to determining the supply required quantities as a result of economic and commercial reasons, also restrict flow of grain amounts was specified to a known level by the decision makers to ensure that the stock of reserves for emergency situations that face the company from decrease, or non-arrival of the amount of grain to silos , also it took the capabilities of the tanker into consideration and the grain have been restricted to avoid shortages and lack of processing capability, Function has been adopted

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Publication Date
Wed Sep 15 2021
Journal Name
Al-academy
The effect of differentiated education strategy on the achievement of the students of the Institute of Fine Arts in the subject of aesthetics: وفاء شكر حسن
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Current research targeted: Recognizing the impact of the differentiated education strategy on the achievement of the students of the Institute of Fine Arts / Diyala, for the academic year (2018-2019).
The researcher used the experimental approach designed by two groups (control - experimental) and with a post-test to achieve the goal of the research, and the research sample was chosen from students of the fourth stage for the academic year (2018-2019).
The sample was distributed randomly into two groups, the first experimental consisting of (30) students who studied using the differentiated education strategy, and the second control group consisting of (30) students who studied using the traditional method.
The researcher pre

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