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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 Sep 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Human Resource Management and its Impact on the Level of Job Performance: An Analytical Research in the Iraqi Ministry of Interior
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        The current research aims to highlight the role of human resource management with its practices (human resource planning, selection and placement, training and development, performance evaluation, compensation, and incentives) in raising the level of individuals' performance and its dimensions (task performance, contextual performance, unproductive work behavior, and adaptive performance) by explaining the research problem, which can be limited to the low level of performance of individuals, where the researchers use the descriptive analytical approach and the SPSS program in the practical aspect of the research community represented by the general manager and his assistant

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Publication Date
Tue Dec 01 2009
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
HUNTING BEHAVIOR OF THE ORIENTAL HORNET, VESPA ORIENTALIS L., AND DEFENSE BEHAVIOR OF THE HONEY BEE, Apis mellifera L., IN IRAQ
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When the guard honey bees, Apis mellifera L., form a clump at the hive entrance or on the flight board, the oriental hornet, Vespa orientails L., either creeps toward the clump or hovers over it in order to take a bee. Once the hornet creeps, only few bees facing the hornet become alert, rock their heads and antennae, open their wings, and take a posture of defense. The rest of the clump stays listless without any signal of concern. However, the clump stays dense and the defending bees do not detach themselves neither from the rest of the clump nor from each other. For this reason, it is very difficult for the hornet to grab a bee unless the latter makes a “mistake” by detaching herself from other adjacent bees. If the hornet grabs s

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Publication Date
Thu Sep 13 2018
Journal Name
Baghdad Science Journal
The Prognostic Value of some Epithelial-Mesenchymal Transition Markers and Metastasis-Related Markers in Human Transitional Cell Carcinoma of the Bladder
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Recent reports provided evidence that epithelial to mesenchymal transition (EMT) and some matrix metalloproteinases (MMPs) contribute to the invasion and metastasis of cancer cells. This study investigated the expression pattern of some EMT markers (E-cadherin and Vimentin) and some MMPs (MMP-2 and MMP-9) in transitional cell carcinoma (TCC). Fifty five paraffin embedded biopsies were included in this study. Expression pattern of E-cadherin and Vimentin was evaluated by immunohistochemistry while cytoplasmic mRNA expression of both MMP-2 and MMP-9 were determined by in situ hybridization. The expression of all markers were significantly increased with the increase of patient's age (? 50 years), and furthermore an increase in men expression

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Publication Date
Sun Jan 01 2017
Journal Name
Al–bahith Al–a'alami
Exposure Habits of Female College Students for women's Programs in the Satellite and its Relationship to the Promotion of Family Values
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The status of women in any society is one of the basic criteria for measuring the degree of progress that society and follow renaissance march side by sidewith men , and is no doubt that women are now of interest to the state , even if limited , which promotes public ideologies on the need for womens participation in economic infrastructure operations and social and the right to gain information and knowledge, entertainment and exercise its role in development through its president and actor in the family and raising the next generation configuration.

And affect the basic tributaries that draws them women information and ideas have a direct impact on the composition of cultural and cognitive entity woman comes satellite channels

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Publication Date
Sun Mar 01 2020
Journal Name
Annals Of Burns And Fire Disasters
ANALYSIS OF BLOOD CULTURE RESULTS OF BURN SEPTICAEMIA PATIENTS OVER A PERIOD OF NINE YEARS IN THE BAGHDAD BURN MEDICAL CENTRE
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Burn is one of the most devastating traumas that someone can encounter in their life. Burn wound sepsis is still the leading cause of death in burned patients. Appropriate knowledge of the causative pathogen in burn sepsis is important for successful patient management and for the reduction of the incidence of antibiotic resistance. A retrospective study was conducted between 2010 and 2018 at the Burn Specialty Hospital in Baghdad.Atotal of 320 blood culture samples were obtained from patients with sepsis orsuspected of having sepsis. Patient age ranged between 9 months to 70 years old, with a mean total burn surface area of 45.26%. The most common microorganisms isolated from those patients who had sepsis or suspicion of sepsis were Klebsi

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Scopus
Publication Date
Fri Feb 15 2019
Journal Name
Route Educational & Social Science Journal
The effect of the 4-H model on self-regulated learning and life skills for female chemistry students in the second intermediate year
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Publication Date
Tue Dec 15 2020
Journal Name
Al-academy
The aesthetics of the design idea and its communicative role in the graphic achievement: انتصار رسمي موسى-دينا محمد عناد -سحر علي سرحان
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The field of graphic design has witnessed a unique, unique form transformed in its construction and installation and superior to systems through its creation of foundational data for design ideas with functional aesthetics and utilitarianism and effective and moving formulation in light of modern trends and what globalization has brought about in terms of openness to the outside world and the processes of communication and communication with the international community through graphic design. Based on the above, this study marked (Aesthetics of the Design Idea and its Communication Role in the Graphic Outcome) comes to clarify the topic through three chapters, including the first chapter, which was devoted to the research methodology, th

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Publication Date
Mon Jun 15 2020
Journal Name
Al-academy
The political dimension in the speech of the director, author (Dawoud Abdel Sayed) Citizen film, informant and thief (amodel): احمد جبار عبد الكاظم
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The research addresses the questioning of political loads in a cinematic model from the films of the author (David Abdel Sayed), who has been busy throughout his films in criticizing political power, where he presented protests visions her body the artistic composition of cinematic means of expression through artistic treatments that facilitate the representations of modernity in contemporary cinematic trends, and by this Several contemporary cinematic criticism is an example of a thinker cinematographer who presents his critical thesis on power politics through the composition of the film (material - form - expression). The research consisted of four chapters. The first was a methodological framework that included the research problem o

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The Evaluation of Information Security Management System in the Iraqi Commission for Computers and Informatics according to the International Standard (ISO 27001: 2013)
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    The current research included (the evaluation of Information Security Management System on according to international standard (ISO / IEC 27001: 2013) in Iraqi Commission for Computers and Informatics), for the development of an administrative system for information security is considered a priority in the present day, and in the light of the organizations  dependence on computers and information technology in work and communication  with others. The international legitimacy (represented by the  International Organization for standardization (ISO)) remains the basis for matching and commitment and the importance of the application of information Security Management System accordi

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Publication Date
Mon Aug 01 2016
Journal Name
Iosr Journal Of Dental And Medical Sciences
Evaluating the Effect of Showing the Dental Injector to Children on Their Dental Behavior in Relation to the Vital Signs And Maternal Anxiety
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