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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
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
A Factorial Study for separation anxiety in students, of Baghdad City
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A Factorial Study for separation anxiety in students, of Baghdad City

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Publication Date
Mon Feb 10 2025
Journal Name
International Linguistics Research
A Semiotic Study of Reduplicative Words in Selected American Slang Expressions
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This study explores the semiotic aspects of American slang, specifically focusing on the phenomenon of reduplicative expressions in informal speech. Despite the extensive research on American slang, limited attention has been given to the cultural and mythical meanings embedded within reduplicative expressions. To address this gap, the study investigates how these expressions convey denotative, connotative, and mythical meanings within casual American discourse. The objectives of the study include: 1. To what extent does Barthes’ semiotic model hold potential for application in this study? 2. How are reduplicative slang expressions widely used in everyday American life? 3. To what extent do qualitative and quantitative methods hav

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Publication Date
Wed Sep 28 2022
Journal Name
Journal Of The College Of Education For Women
A Cognitive Linguistic Study of Battered Woman in Selected Iraqi Caricatures
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The present paper is a qualitative descriptive study. It aims to examine the macro-cultural schemata addressing the concept of violence against women in Iraq from a cognitive linguistic point of view. To meet this objective, a number of Iraqi social caricatures have been selected from two popular and active Iraqi caricaturists, Odeh Al-Fahdawi and Nasser Ibrahim. The selection and the analysis of data have been achieved following the validity and reliability procedures and the ethical considerations. To meet this objective, Sharifian’s Model (2011) of Cultural Schemata has been adopted in data analysis. The study has concluded that the macro-cultural schemata regarding the concept of violence in the selected panels reveals that violenc

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Publication Date
Sun Sep 07 2008
Journal Name
Baghdad Science Journal
A Study of some biochemical parameters in patients with &#61538;- thalassemia
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Serum levels of iron,copper,ceruloplasmin and transferrine were estimated in three groups of patients with ?- thalassemia: 24 patients have splenectomy thalassemia major, 29 patients have non splenectomy thalassemia major and 19 patients have thalassemia intermedia , data were compared to normal and pathological controls (anemia and minor). There were significant increase in trace element levels in all studied groups of pateints as compared to normal and pathological controls. Also there were a significant increase in ceruloplasmin levels,While the result revealed that there were a significant decrease in transferrine levels in all groups of patients studied as compared to normal and pathological controls. The result also indicate that the

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Publication Date
Thu Jun 27 2019
Journal Name
Journal Of The College Of Education For Women
The Formula of the Name (Faael) in Plural According to the Dictionary Use
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The grammar structure transforms from its fundamental field to another field that takes new dimensions, and is used in another way in speech that differs from the first one, because the formula basis of the name(Faael) in speech is a (distorted characteristic), and the distorted characteristic indicates the stability and the necessity of the characterized. as this characteristic has changed from its use as a distorted characteristic which was established by the elders. to a use that differs from the first and cannot be overlooked to achieve a new purpose, to be used as plural

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Publication Date
Thu Mar 21 2019
Journal Name
Biochemical & Cellular Archives
EVALUATION OF THE POTASSIUM AVAILABILITY IN THE SALINE SOILS USING THE THERMODYNAMIC CRITERION
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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Research In Social Sciences &amp; Humanities
The ROLE OF THE CLEANER PRODUCTION STRATEGY IN ENHANCING THE MAIN SUCCESS FACTORS
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The business environment is witnessing tremendous developments in the field of production and technology, which requires the development of production methods to go in line with these developments and the increasing competition, which has gone beyond the economic aspects to extend to the environmental aspects, as economic units tended to adopt a cleaner production strategy and through what they achieve by producing environmentally friendly products and achieving economic efficiency. Reducing costs, providing a safe and clean environment for workers, and reducing waste from production operations.

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Publication Date
Thu Mar 19 2015
Journal Name
Al-academy
The role of the music in developing the national identity: أحمد جهاد البدر
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Music has a significant role in shaping the artistical, musical and national identity of individuals. The resources of the cultural identity can be divers according to the multiplicity of the social component. In Iraq, there is a unique ethnical and sacred diversity, which is rather than playing a positive role in shaping the cultural and national identity, on contrast, it is establishing to create many local identities in the same society. Each identity reflects the culture of individual ethnic or religious group, which makes people make their own decisions according to their background rather than according to the benefit of the country.Music as an important cultural source has a social function in forming an artistical identity with n

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Publication Date
Wed May 18 2016
Journal Name
Al-academy
The Variation of The Designing in decorative the Calligraphic authorization: حسـين علي يونــس
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Formed a decoration element Tzeigna important holidays linear, since regulating mechanism of vocabulary and formative elements Btnoatha through activation design with space linear in order to add value expressionistic, and achieve career goals and aesthetic, has promised these diversities and one of the finest artistic achievements that excelled the designer patterned through expertise and skill in the output of the design artwork beautiful image to fit with the importance degree in the field of calligraphy and set the rules, and was questionably basic research problem is the following:
What are the variations in the design of linear motifs Vacations?
In order to solve these problems and to reach the desired outcomes research ai

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Publication Date
Mon Oct 01 2018
Journal Name
European Journal Of Dentistry
The anti-inflammatory effect of the platelet-rich plasma in the periodontal pocket
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ABSTRACT<p> Objective: Chronic periodontitis (CP) is a common inflammatory disease that causes destruction to the supporting tissues of the teeth. Many treatment modalities tried to stop the disease progression. Platelet-rich plasma (PRP) is one of the regenerative methods that used in adjunct to conventional periodontal treatment. The aim of this study was to evaluate the anti-inflammatory effect of PRP by monitoring the lymphocyte count before and after its application to the periodontal pocket. Materials and Methods: Twenty patients, with CP and a pocket depth equal to or deeper than 4 mm, subjected to scaling, root planing, and PRP injection into the pocket. The lymphocyte count measured before an</p> ... Show More
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