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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 Mar 08 2021
Journal Name
Baghdad Science Journal
Impact germination in the content of the chemical components of Homs and sensory qualities of Biskt plant it,
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This study was conducted to identify the impact of germination in the ratio Almaah of Chemical Constituents of Homs and in the organoleptic properties of the Biskt plant it and compare the results with the treatment control (seeds Almnepth) Adhrt results for a significant increase in the percentage of crude protein with the progress of the process of germination, reaching 24.5% in percentage of crude protein with the progress of the germination process Krbu hydrate college during the germination period, reaching 59.2% in the fourth day

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Publication Date
Sun Oct 06 2013
Journal Name
Journal Of Educational And Psychological Researches
Awareness of children 's rights from the perspective of parents and educators kindergarten in the city of Baghdad
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The subject of children's rights in the modern era of the priorities of educators , because the child in the community is the future , which is held by the hope which is the basis for society in the renaissance and progress so quickly communities to prove these rights through its various institutions and issued legislation and held numerous conferences and taking specialists the field of childhood Aatron aspects of this rights and Aasalunha including a benefit for children until tomorrow for the rights of children , psychological and social health and educational . Therefore, the current study focused on the awareness of parents and educators of children's rights as individuals most closely satisfying their needs and rights. The

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Publication Date
Thu Jun 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
A Review of the Electrical Submersible Pump Development Chronology
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The electric submersible pump, also known as ESP, is a highly effective artificial lift method widely used in the oil industry due to its ability to deliver higher production rates compared to other artificial lift methods. In principle, ESP is a multistage centrifugal pump that converts kinetic energy into dynamic hydraulic pressure necessary to lift fluids at a higher rate with lower bottomhole pressure, especially in oil wells under certain bottomhole condition fluid, and reservoir characteristics. However, several factors and challenges can complicate the completion and optimum development of ESP deployed wells, which need to be addressed to optimize its performance by maximizing efficiency and minimizing costs and uncertainties. To

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Crossref (9)
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Publication Date
Wed Jun 30 2004
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Factors Affecting the Operation of a Fire Tube Boiler
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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
Proposed mechanism to activate the role of the Federal board supreme Audit in the examination of the federal budget estimates of the state
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The aim of the research is to present and discuss the subject of the budgeting estimates and how to activate the role of the Federal board of supreme audit in examining these estimates through reference to Articles 6 and 10 of the Federal board of supreme Law, which did not restrict Federal board of supreme in Preventive control on examination process for planning which is prepared from the government units, as the result of a large amount  of government units Provisions and the weakness of estimates in most of its items, which rely on personal assessment and not based on scientific and logical basis of the estimate, which leads to the emergence of a deficit is not true in the general budget and this seems clear in most Iraq

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Publication Date
Tue Oct 11 2022
Journal Name
College Of Islamic Sciences
The Jurisprudence rule and its impact on Islamic legislation “Forcing does not nullify the rights of others” as a model .
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Research Summary :

         Praise be to God, Lord of the Worlds, and prayers and peace be upon the Master of the Messengers, his family and all his companions, then after:

     This is brief research that contained between its two covers one of the jurisprudence rules derived from Islamic Sharia that guarantees the right of others, in case of forcing to do the prohibited act, and it is a restriction of the rule: “Necessities allow prohibitions” and “Hardship brings facilitation” and support for the rule: “Necessities are valued.” It is an origin in alleviating the taxpayer definitely , and the study has briefly shown some of the jurisprudential appli

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Publication Date
Thu Mar 30 2006
Journal Name
College Of Islamic Sciences
The Islamic call for the unity of human society and the rejection of division
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الحمد الله أولا واخرا وبعد .. إن الواقع الذي عايشه الناس في ظل دولة المسلمين منذ إقامة دولة الإسلام بعد بعثة الرسول الكريم (صلى الله عليه وسلم ) في المدينة ولأكثر من أربعة عشر قرنا نرى إنه عاش في كنف هذه الدولة الكبيرة من بلاد الصين شرقا وإلى وسط أوربا وجنوب فرنسا غربا العشرات من الملل و الأديان والأجناس وممن لا يدينون بالإسلام وهم كما تحفظ لهم دولة الإسلام منهم وعيشهم الرغيد فهم يمارسون شعائرهم وطقوسهم الديني

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Publication Date
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
THE LANGUAGE OF MEDIA BETWEEN THE CLASSICAL LANGUAGE AND THE DIALECT
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The media: ((Providing people with the right news, audio information, and constant facts that help them form a correct opinion in an incident or a problem, this opinion gives an objective expression of the mentality of the audience, their trends and tendencies). The German scientist Autogroot defines it as "the objective expression of the mentality of the audience, their spirit, their tendencies, and their trends at the same time." Whereas for  "Aristotle", (Language) is a specific verbal system created as a result of an agreement between the members of the human group somewhere )). It is a symbol of thought, and  a difference between humans and animals. Pronunciation and thought for “Aristotle” are intertwined: without pro

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Crossref
Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
The New Middle East and the Implications of the Arab Spring
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الخلاصة لقد شكل المحافظون الجدد وهم بالأساس نخبة من المثقفين ومن السياسيين الأمريكيين كتلة ضغط كبيرة التأثير على الإدارة في عهد الجمهوريين. حمل هؤلاء المحافظون مشروعاً إيديولوجياً البسوه لسلطة الجمهوريين وهو يهدف إلى جعل أمريكا سيدة العالم من دون منازع خاصة بعد انهيار الاتحاد السوفييتي ونهاية الحرب الباردة. واكب هذا الحدث التاريخي الكثير من الأفكار ومنها (نهاية التاريخ)، وصراع الحضارات، وكذ

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Crossref
Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Crisis of the Greeks (the euro crisis) and the lessons learned
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After more than ten years of successful march of the European single currency and EU countries faced a crisis in one of its debt, which recently joined the monetary union is not Greece . Perhaps mpre than th effects of this crisis, the fact that its consequences were not confined to Greece alone , but expand it to include all EU countries in general and the countries of the European Monetary Union in particular.

Sine the debt crisis that emerged Greek and talk a lot a bout their effects on the global economy and the potential harm done th the situation of the global economy recovers from the global financial crisis (mortgage crisis), or delayed and also the fears of other crises to other member states suf

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