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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 Sep 30 2017
Journal Name
College Of Islamic Sciences
Women and Symbol In the stories of Mowaffaq Khadr
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The world of Muwaffaq Khidr Al-Qasasi has a clear and realistic orientation. This trend is in full harmony with his philosophy and vision of life and things. Through self-awareness is nothing but an expression of an imbalance in the interaction between self and reality, and it remains lacking in credibility.

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Publication Date
Sun Dec 10 2017
Journal Name
Al-academy
Form and function in the design of intellectual toys
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Playing is the only common language among children in every place and time, to the fact that what distinguishes the children is their quest to play and fun way innate, not acquired, which is expressed with the child really is one of the rights. And play a key entrance to the growth of the child mentally, intellectually and cognitively and not for the child emotionally and socially just. In the play the child begins to identify and classify objects and learn concepts and circulate among themselves on a linguistic basis. Activity here and play a major role in leading the linguistic development of the child in the composition has the communication skills.

The Games (especially intellectual ones) Whatever the cause of the development

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Morphological Participation in the Forms of (Faul) and (Fael)
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This research examines the phenomenon of the Arabic language repeated in the Qur'an and poetry, as some morphological formulas are valid in their uses and indications in more than one way. search).

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Publication Date
Fri Dec 15 2023
Journal Name
Al-academy
The dialectic of form and meaning in postmodern art
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Some have considered the dialectic in form and meaning from different points of view, and dismantled them from each other, and this view is correct if we adopt according to the logic of Aristotle when it comes to dialectic, the dialectic of form and meaning has different aspects and does not share a single line in terms of conceptual meaning, the form is the appearance What the recipient sees with the help of cognitive tools, the content or content is the mental meaning, which in turn depends on his own tools, and to this extent this view is correct, and the intellectual content or meaning of the artwork or the human message that the artist wants to convey to the viewer.
The research included four chapters. The first chapter included

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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of The College Of Education For Women
Jews and their role in the heritage of Baghdadi
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The research sheds light on an important religious sect that played a fundamental role in the structure of the Iraqi society in general and the Baghdadi society in particular, in which the Jews in general and the Jewish women in particular played an active role in the culture and heritage of Baghdadi society. The educational, cultural and artistic activity of Jewish literacy is a model for study.

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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Negotiating policies for the granting of investment loans: A CASE STUDY ON IRAQI MIDDLE EAST BANK FOR INVESTMENT& COMMERCIAL GULF BANK
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The negotiation phase is gaining great importance in investment loans due to the magnitude of the amounts awarded and the need to obtain adequate lending guarantees and the development of better conditions, and this requires that negotiating policy with fixed principles that balance between meeting the demands of customers and maintain market share and achieve profits and avoid defaults and losses the bank, and so I have touched Find the concept of investment loans and procedures for granting and the concept of the negotiation process for the granting of loans. The practical side to ensure the preparation of examination form consists of questions commensurate with the methodology developed by the researchers, were directed to the officia

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
A Comparative Study of Various Intelligent Algorithms Based Nonlinear PID Neural Trajectory Tracking Controller for the Differential Wheeled Mobile Robot Model
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This paper presents a comparative study of two learning algorithms for the nonlinear PID neural trajectory tracking controller for mobile robot in order to follow a pre-defined path. As simple and fast tuning technique, genetic and particle swarm optimization algorithms are used to tune the nonlinear PID neural controller's parameters to find the best velocities control actions of the right wheel and left wheel for the real mobile robot. Polywog wavelet activation function is used in the structure of the nonlinear PID neural controller. Simulation results (Matlab) and experimental work (LabVIEW) show that the proposed nonlinear PID controller with PSO
learning algorithm is more effective and robust than genetic learning algorithm; thi

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Publication Date
Fri Jul 10 2020
Journal Name
Int. J. Agricult. Stat. Sci
STUDY EVALUATION AND ANALYSIS OF THE PROPERTIES OF SOME PERFORMANCE STANDARDS FOR AGRICULTURAL TRACTOR AND SORGHUM BICOLOR (L.) MOENCH YIELD
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A field experiment was conducted in an agricultural field in Al-Hindia district, Karbala governorate in a silty clay soil during the year 2020. The research included a study of two factors, the first is the depth of plowing at two levels, namely 13 and 20 cm, which represented the main blocks. The second is the tire inflation pressure at two levels, namely (70 and 140 kPa), which represented the secondary blocks. Slippage percentage, field efficiency, leaf area, and 300 grain weight were studied. The experiment was carried out using a split-plot system under a Randomized complete block design, at three replications. The tillage depth of 13 cm exceeds/transcend by giving it the least slippage of (11.01%), the highest field efficiency of (50.

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Publication Date
Thu Dec 31 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The dimensions of organizational confidence and its relationship to achieving the strategic position of banks: is an applied research on a sample of private Iraqi banks
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The research aims to show the dimensions of organizational trust represented by (administrative policies opportunities for innovation and self innovation and self- realization,availability of information,prevailing organizational values) and its reiationship to achieving the strategic position of banks represented by formation of expectations,buiiding networks,learning operations As the research was applied in each of the banks (middle east)Iraqi investment,Al-Ahly Iraqi, Business Bay, Al- Mansour investment bank),the qusestionnaire was adopted as a tool to collect data and information from the sample number (138)who are in the site (department director, division ,M.division director ,division officer, unit officer)the statistica

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Publication Date
Fri Jan 01 2016
Journal Name
Iraqi Journal Of Science
The Engineering Properties and Geochemical Relationship For The Volcaniclastic Rocks Of The Muqdadiya Formation In Hemrin Area, NE. IRAQ
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Volcaniclastic rocks of Al Muqdadiya Formation (Pliocene) in Injana area, southern Hemrin anticline, NE of Iraq, were studied ( petrographically, physically, mineralogically and geochemically , as well as the engineering properties) to assess the suitability of volcaniclastic rocks to use them in industry as refractories. The results show that the physical and engineering properties change with the temperature change. The bulk density and the specific gravity increase by increasing temperature while the apparent porosity, water sorption and the linear shrinkage decrease. On the other hand the compressive strength increase by increasing temperature. The volcaniclastics have very low thermal conductivi

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