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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 Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
The War Importance of Basra in the Islamic Conquests in the Rightly Guided Caliphs Period
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There are many reasons made Basra a good defense, first of all was the
establishment of the famous Arab tribes, like Bakir bn. Wail and Tamim. Besides there were
A lot the armed forces. In addition to that the strategic place of Basra. All these reasons
played a good part when the war broke out.
The Arabic tribes played a good part in the war to engaged Persians, and prevent
them from sending any helps to their armies against the Kufain who were fighting Persians in
the North of Iraq. While the Basrain army aiming to Conquer the south of Iraq.
Basra become the first strategic place for the Islamic movement of the conquers.
Latter on Kufa and Bahrain were the second and third.
The Muslims guranted the pupils of

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Publication Date
Mon May 27 2019
Journal Name
Al-academy
Improvisation Effectiveness in the Performance of the Actor in the Theatrical Show: مصطفى عباس خلف
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Improvisation is that spontaneous automatic achievement which is formed by a new cognition that is not based on something prior to it or a previous cognition. It is instantaneous. Whereas in art, improvisation also inters in all types of applied and performance arts as a foundation for launching and initiating it in music, painting, cinema, television and theater. In order to study the improvisation of the actor, the researcher put forward a theoretical study that included two sections. The first section is (the improvisation concept) and the second section is (improvisation in the show). The researcher, in the research procedures, took an intentional sample that was represented by the theatrical show (Rehearsal in Hell Play) and after t

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Publication Date
Fri Dec 01 2023
Journal Name
Political Sciences Journal
¬The Role of the European Union in Conflicts Resolution in the Eastern Neighborhood: Selected Models
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The launch of the EU’s Eastern Partnership in 2009 intended to signal a new, elevated level of EU engagement with its Eastern neighborhood. Yet there remain several long-simmering and potentially destabilizing conflicts in the region, with which EU engagement thus far has been sporadic at best. The Union’s use of its Common Security and Defense Policy (CSDP) in the region and to help solve these disputes has been particularly ad hoc and inconsistent, wracked by inter-institutional incoherence and undermined by Member States’ inability to agree on a broad strategic vision for engagement with the area.

The three CSDP missions deployed to the region thus far have all suffered from this incoherence to various extents. In particu

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Publication Date
Wed Mar 30 2016
Journal Name
College Of Islamic Sciences
The conversations of reason and thinking as stated in the Sunnah and its impact on human behavior
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The Sunnah of the Prophet has a great impact in building human behavior, and the formation of Islamic thought, has worked to spread science in all of Egypt, as it carried to the people of the eternal prophecy of the love of science, it was a source of knowledge and civilization. It is a generous source, a rich source of the Islamic nation, always tender, and renewed benefit, which is not only a source of legislation and language but is a source of guidance for thought and guidance of behavior, and the Hadith The importance is obvious In the integration of Islam, and show aspects of human integration in the personality of Mustafa , and the Muslims are interested in talking - collected and codification -, and made the effort of the cent

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of The Mechanical Behavior Of Materials.
Calibration and analysis of the potable water network in the Al-Yarmouk region employing WaterGEMS and GIS
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Abstract<p>Water supply and distribution networks play an important role in our daily activities. They make a substantial contribution to public health by providing potable water for public consumption and non-potable applications such as firefighters and other purposes such as irrigation. This study used ArcMap 10.8 and WaterGEMS CONNECT Edition update 1 version to create a hydraulic network model to simulate the pipes’ network. Detailed network information, including pipe lengths, layouts, and diameters, was given by the Baghdad Water Department. The TUF-2000H Handheld digital ultrasonic flow meter has been used to measure the water flows in the network’s source nodes. In eight junctions, </p> ... Show More
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Publication Date
Sat Sep 12 2020
Journal Name
Al-kindy College Medical Journal
Antenatal, Intrapartum, and Postnatal Maternal health Care during COVID-19 Pandemic
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There is limited data and evidence about the effects of COVID-19 on Maternal health, especially when new information is emerging daily, through pregnancy, child birth and post natal period, women are vulnerable to have the infection, this article, aimed to show the suitable measures that should be applied for women at reproductive age who are suspected /confirmed with COVID -19 infection,

During pregnancy it is advisable to continue the antenatal care schedule, although reducing face to face visit is recommended (unless the pregnant condition required that ),and prioritize ANC at health facilities for high-risk pregnancy and during second half of pregnancy with adequate infection prevention control  measures.

Regardi

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Publication Date
Thu Oct 25 2018
Journal Name
Al-kindy College Medical Journal
Prevalence and risk factors for hepatitis C virus in Beta thalassemic patients attending blood diseases center in Ibn- AL -Baladi Hospital, Baghdad
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Background: Thalassemias are a group of heterogeneous genetic disorders, in which the rate of production of hemoglobin is partially or completely suppressed due to reduced rate of synthesis of α or β- chain

Objectives: to estimate the prevalence of Hepatitis C infection among B thalassemia patients attending Ibn-AL-Baladi center of blood diseases in AL-Sader city, in AL-Resafa Quarter of Baghdad and to determine the possible risk factors.

Type of the study: Cross- sectional study.

Methods: A cross sectional study conducted on B Thalassemia patients attending the blood diseases center in Ibn-AL-Baladi hospital during the period from 1st

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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of the Active Reading Strategy on the Achievement of the Second Year Middle School Students in Biology
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Abstract

The aim of the current research is to identify the effect of the effective reading strategy on the achievement of second-middle students in biology, as well as the imaginative thinking skills of students. The researcher adopted the experimental design with partial control to achieve the goal of the research. The current research community identified the second-middle students in the government schools of the Baghdad Education Directorate / Rusafa I for the academic year (2021-2022 AD). The Safina Intermediate School for Girls was chosen to be the research sample in the form of intentionally, two classes were randomly selected from a total of four classes, one of them is experimental and the other is con

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Publication Date
Sun May 02 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of economic development efforts in the structural imbalances of the Iraqi economy for the period (2007-2018)
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Sustainable development is launched through the interaction between the economy and natural resources and preserving them from exhaustion as well as the efficient management of natural and social resources and includes a diversified economic condition and thus is the focus of attention to the development of economic structures, which is intended to improve the level of human well-being by increasing its share in the necessary goods and services and their relationship With economic growth, which is the most important driver of economic transformation, because it reflects the ability of society and increasing its productive capabilities and investing in the optimal way Although the Iraqi economy is considered one of the diversified

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Publication Date
Sat Aug 13 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of e-marketing on the quality of the insurance service: Applied research in the National Insurance Company
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This research aims to introduce the importance of electronic marketing and the extent of its impact on the quality of the insurance service in general, and the national insurance company in particular, and the advantages it can achieve, an increase in its competitiveness, as well as contributing to increasing the efficiency of the performance of the insurance company.

The research relied on the questionnaire form as a main tool for obtaining data and information by the 70 questionnaire questionnaires required for the field side of the research, as they were distributed and retrieved in full, and all of them are suitable for analysis. The sample .The questionnaire was designed with three axes, the first wa

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