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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 Nov 27 2021
Journal Name
Route Educational & Social Science Journal
A STYLISTIC ANALYSIS OF ADVERTISING DISCOURSE: A CASE STUDY OF FACEBOOK COMMERCIAL ADVERTISEMENT
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BN Rashid

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Publication Date
Thu Jan 24 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Accounting For Investments In Joint Projects Accounting to the International Accounting Standard: An applied Study at the General Company for food Stuff Trading
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   As a result of the entry of  multinationals companies in Iraq for investing in the joint projects through conducting agreements and contracts for work on important and strategic projects to get the necessary funds and various experiences which characterize the foreign participant sides that Iraq currently needs them and because of the non-applying the accounting processing stipulated in the unified accounting system in addition to the absence of a local accounting bases as well as the default of the participant contracts on indicating the accounting methods about those projects which are considered one of the bases that enables auditors in the public sector to depend on it, thus the research paper deals with studying an

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Publication Date
Sun Mar 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Trend of Antibiotics Usage in the Intensive Care Unit in the Medical City in Baghdad
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High frequencies of multidrug resistant organisms were observed worldwide in intensive care units which is a warning as to use the only few effective antimicrobials wisely to reduce selective pressure on sensitive strains.

The aim of the current study is to asses the compliance of the currently followed antibiotic prescribing pattern in the intensive care unit in an Iraqi hospital with the international guidelines.A cross-sectional study was done in the intensive care unit (ICU) of the Surgical Specialties Hospital, Medical City in Bagdad from the 30th of November 2011 to the 5th of May 2012.Patients were followed until they were discharged or died to see any change in condition, response to drugs, devices u

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
The Application of the Alternative Evaluation Strategy in Social Studies In General Education in KSA
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The study aims to reveal the degree of application of the alternative evaluation strategy in social studies in public education in the Kingdom of Saudi Arabia. It also aims to identify the opinions of experts on how to implement this. The study adopted the mixed methodology, which represented in the descriptive-analytical method, and qualitative methods through the grounded theory. The study used two tools namely: a questionnaire for assessments of social studies teachers and semi-structured interview questions. The results of the study showed a medium degree of appreciation for the application of alternative evaluation strategies by social studies teachers in general education with an average of (2.28). The results also showed that ther

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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
Measurement and Analysis of Oil Price Fluctuations and Trends of Government Spending on the Security and Health Sectors in Iraq for the Period (2006-2016)
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The objective of the study: To diagnose the reality of the relationship between the fluctuations in world oil prices and their reflection on the trends of government spending on the various economic sectors.

The research found: that public expenditures contribute to the increase of national consumption through the purchase of consumer goods by the state for the performance of the state's duties or the payment of wages to employees in the public sector and thus have a direct impact on national consumption

The results of the standard tests showed that there is no common integration between the oil price fluctuations and the government expenditure on the security sector through the A

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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Self-Esteem and its Relationship with the Age, Gender and academic Achievement among the students of the south Iraq Colleges of Nursing
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Abstract
Objectives: this study aims to: (1). Assess self-esteem level and academic achievement for students of nursing colleges in southern Iraq. (2). Determine the relationship between levels of self-esteem and academic achievement of the student in the first semester. (3). Identify differences of self-esteem with gender and different age groups.
Methodology: a sample of (426 students) was purposively selected then collected by using a questionnaire which consisted of: I- Sociodemographic characteristics for assessing some important aspects of students, II- Rosenberg's Self-Esteem Scale (RSES) III- Iraq Grading Scale for assessing student achievement. Finally statistical analysis (SPSS) for data processing.
Results: study resu

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
The impact of The Bransford and Stein Model on the Achievement of Fifth-Grade Literary Students for Geography and their Reflective Thinking
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The current research aims to identify the effect of the Bransford and Stein model on the achievement of fifth-grade literary students for geography and their reflective thinking. To achieve the objective of the research, the following two null hypotheses were formulated:

  • There is no statistically significant difference at the significance level (0.05) between the average scores of the experimental group students who studied geography using the Bransford and Stein model and the average scores of the control group students who studied the same subject in the usual way in the achievement test. 2- There is no statistically significant difference at the significance level (0.05) between the average scores of the experimental gr

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Publication Date
Wed Jul 22 2015
Journal Name
Plant Growth Regulation
Effect of photosynthetic photon flux density on growth, photosynthetic competence and antioxidant enzymes activity during ex vitro acclimatization of Dieffenbachia cultivars
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Publication Date
Tue Dec 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
A Comparative Study of Blood Levels of Manganese, Some Macroelements and Heavy Metals in Obese and Non-Obese Polycystic Ovary Syndrome Patients
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Polycystic ovary syndrome (PCOS) is a prevalent condition in women of reproductive age. It is characterized by androgen excess and chronic anovulation. Some trace elements, macroelements, and heavy metals have been linked to pathophysiological mechanisms of PCOS .

To study the alterations in the serum levels of the trace element manganese (Mn), some macroelements, magnesium(Mg) and calcium (Ca), and the heavy metals cadmium (Cd) and lead (Pb), in obese and non-obese PCOS patients; and the association of these alterations with some of the hormonal changes occurring in PCOS.

The study was carried out at Kamal Al-Samarrai Hospital (Center for Infertility treatment and in vitro Fertilization "IVF") Baghdad- Iraq. Eig

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Publication Date
Mon Feb 09 2026
Journal Name
Modern Sport
Precision tracking and visual animation and its relationship to the results of the competition with the Sabre Players.
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In order to get advanced results, we must stand at the pointsthat have been observed by the trainers that are of significance inthe sport of fencing and concern for capacity optical (traceoptical and precision visual animation), so we must learn some ofthese types of capacity, whichever is more influential in the gamefencing so that they add a new axis to the player to pick andchoose in order to achieve the desired goal and raise the level ofthe game.The study aimed to identify the relationship between the visualtracking and accuracy of visual animated face and the results ofcompetitions Sabre of the other.Used a much more descriptive approach to study relational on asample of players clubs Sabre and the way intentional, whoqualified to the

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