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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
Thu Mar 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The relationship between the gap of knowledge and the strategic performance gap
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Address the intellectual controversy nature of the gap of knowledge and the strategic performance gap. The researcher start off from this intellectual controversy to seek to test the nature of the relationship and impact between them across a sample of (61) academics in the colleges of business and economics at the universities in Baghdad ,as the more specialized in the fields of knowledge and the strategic performance, The researcher is attain to the existence of relationship and impact of knowledge gap in strategic performance gap, the research included four axes first went to the methodology and second to theoretical frame and the third to view and analyze the results and test hypotheses while the fourth was devoted to the con

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The aesthetic of the Quranic voice and its relation to the meaning
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The Qur'an is an inexhaustible source for researchers, and all of them find a rich material for its research, and no wonder in it is the book of the greatest Arabic. Quranic research has been an attempt to extract the secret in the miracle of the Koran, and not the Quranic miracle is limited to the word and its meaning, but that the miracle extends to include every sound in motion or silent; the sound performance of the Quranic text increases the meaning of beauty and earns the word heartbeat, Souls; and this may be due to the beauty of voice in the performance and harmony between sounds and words, and harmony between the exits and descriptions, or the tides of the tides,
Based on the above and to show the miraculous aspects of the Qu

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Publication Date
Sun Dec 31 2023
Journal Name
College Of Islamic Sciences
The relationship between the rule of mental improvement and ugliness and the objectives of Sharia And its impact on rulings
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The research addresses a fundamental Islamic jurisprudential Purposeful issue, which is (Sharia), and to indicate the impact of this on Islamic jurisprudence, deriving rulings and extracting purposes, and to repel the illusion that this issue is only doctrinal, and clarifying the aspects of similarities and links between them by explaining the origin of deriving the purposes of Islamic Law (Sharia) through the meanings and wisdom learned from the texts and the explanation of the rulings. The rulings of Islamic Law (Sharia) have urged bringing benefits and repelling harms, and that the path to do so is reason and its production. I began the research by defining the purposes of Islamic Law (Sharia), then defining the rule of rational right

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Publication Date
Tue Jan 21 2025
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
A comparison between the hierarchical clustering methods for postgraduate students in Iraqi universities for the year 2019-2020 using the cophenetic and delta correlation coefficients
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The educational sector is one of the important sectors in the world, and it is considered one of the means of community development. In addition, it is one of the means of making the country’s renaissance and devel-opment because it represents the factory of thinking minds that make change. There is no doubt that this sector is the same as any other sector. The deficit in the studied scientific planning has been prolonged, which led to its deterioration, and the problems of education remain diverse and inherited from previous time periods, where the hierarchical cluster analysis was used on postgraduate students in universities in Iraq, except for Kurdistan region, and the number of universities that were included in the study was

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Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Dyslipidemia among patients with type 2 diabetes mellitus visiting Specialized Center for Diabetes and Endocrinology
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Background:The most common pattern of dyslipidemia in diabetic patients is increased triglyceride (TG) and decreased HDL cholesterol level, The concentration of LDL cholesterol in diabetic patients is usually not significantly different from non diabetic individuals, Diabetic patients may have elevated levels of non-HDL cholesterol [ LDL+VLDL]. However type 2 diabetic patients typically have apreponderance of smaller ,denser LDL particles which possibly increases atherogenicity even if the absolute concentration of LDL cholesterol is not significantly increased. The Third Adult Treatment Panel of the National Cholesterol Education Program (NCEP III) and the American Heart Association (AHA ) have designate diabetes as a coronary heart dis

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of monetary policy in the aggregate indicator of banking stability in Iraq: An applied research in the Central Bank of Iraq for the period (2010 - 2017)
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The research sought to demonstrate the effectiveness of monetary policy in banking stability by measuring the impact of monetary policy in the composite index of banking stability in Iraq for the period 2010/2017, as the stability of the financial system is one of the main objectives that the Central Bank is keen to achieve along with other objectives to ensure the performance Effective for all economic units, this is what prompted the central banks to give more attention in ensuring the safety, durability and stability of their financial systems, and the increasing interest by the Central Bank of Iraq in the subject of financial stability stems from its responsibility in ensuring a sound and stable financial system. Maintain it and mini

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Suggested Plan for Developing the Sources of Energy in Enviroment In Light Of Sustinable Development and the Affective Of Geographic Arabic Teacher
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It is known that energy subiect has ocuppied a lot of scientests minds about
how to treat the traditional energy and the renewing energy . we know that
most traditional energy coal , oil , Natural gas, neuclear fuel , are limited
guantiy and alsow subjected to be ended .Statics studies refer to reserve
of oil in world will exhausted btween ( 2075- 2100) and alsow cosl too .
While neuclear fuerl which the world seek today through explod the uranium
atom ( 233) the therum atom (239) and neuclear mxied through ruemlear
mixing , These energy have effect on environment and humanity speciaty if
they are used in militery purposes .
For all theses scientests srarch for resources of renewing enery through
researches

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Publication Date
Thu Jun 22 2017
Journal Name
Research Journal Of Pharmaceutical, Biological And Chemical Sciences
Testing the Efficiency of Probiotic in Reducing the Growth of Aspergillus flavas in Corn Stored and its Effect on Performance of Broiler
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This study has been done for testing the effectiveness and efficiency of probiotic in its ability to inhibit Aspergillus flavus , which secretes the aflatoxin B1 and compare it with materials that were approved to be effective in the inhibition of the growth of fungi and break down and reduction of mycotoxin. these are the filax substance and ozone gas. A laboratory experiment has been conducted to determine the isolates out of the fungus producing the aflatoxin B1.the isolate producing aflatoxin B1 has grown on the yellow corn seed. the probiotic was added along with the filax and they have been exposed to ozone gas and then they were stored from 30 days. A bio test was con conducted to knw the effects of biological toxin on the broiler me

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of Educational And Psychological Researches
A training program for chemistry teachers based on the knowledge economy and its impact on the productive thinking of their students
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       The current research aims to build a training program for chemistry teachers based on the knowledge economy and its impact on the productive thinking of their students. To achieve the objectives of the research, the following hypothesis was formulated:

   There is no statistically significant difference at (0.05) level of significance between the average grades of the students participating in the training program according to the knowledge economy and the average grades of the students who did not participate in the training program in the test of productive thinking. The study sample consisted of (288) second intermediate grade students divided into (152) for the control group

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Publication Date
Wed Feb 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
A comparison between the logistic regression model and Linear Discriminant analysis using Principal Component unemployment data for the province of Baghdad
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     The objective of the study is to demonstrate the predictive ability is better between the logistic regression model and Linear Discriminant function using the original data first and then the Home vehicles to reduce the dimensions of the variables for data and socio-economic survey of the family to the province of Baghdad in 2012 and included a sample of 615 observation with 13 variable, 12 of them is an explanatory variable and the depended variable is number of workers and the unemployed.

     Was conducted to compare the two methods above and it became clear by comparing the  logistic regression model best of a Linear Discriminant  function written

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