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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 Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Research and Development Programs Effectiveness in the Central Library of Baghdad University
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Research and Development Programs Effectiveness in the Central Library of Baghdad University

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Publication Date
Mon Sep 09 2024
Journal Name
مجلة قسم الدراسات اللغوية و الترجمية التابعة لبيت الحكمة
- Structural and semantic features of predicative adverbs IN THE RUSSIAN SYNTAX SYSTEM
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Publication Date
Sun Feb 15 2026
Journal Name
Al–bahith Al–a'alami
THE ROLE OF WESTERN LEGISLATIONS AND LAWS IN PROTECTING CHILDREN FROM ADVERTISEMENT
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This study aims to identify the most important legislatures and legal frameworks pertaining to advertisement for children. It focuses on the western approach, which is characterized by the variety of its perspectives in presenting issues and in identifying problems. However, if studies show that there is a certain awareness about the advertisement impact on children, it is obvious that most of legislatures reject the laws restricting the broadcast advertising spots intended for children under 12 years of age, with the exception of the Swedish and the Canadian province of Quebec experiences, which opted for total ban on advertising spots broadcast messages targeting children.

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
The idea of divinity for al-Kindi and its roots in Greece
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Perceptions of deity have practical effects in a person’s life, especially in his attitudes toward natural things since nature was created, in which man has treated it as something sacred. The Greek philosophers before Plato and Aristotle did not find in them the idea of divinity clear. Rather, they all searched for the first substance or the first cause of existence, and then gave it all the attributes of God from eternity and eternity, and considered it a first reason without which the universe would not have existed. knowledg

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Publication Date
Sun Jun 30 2013
Journal Name
College Of Islamic Sciences
The Hadith Lesson Retreated in Colleges of Sharia Sciences (Reasons and Proposals).
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This research deals with shedding light on the issue of the poor understanding of students of Islamic sciences colleges for the subject of modern sciences; their causes and treatment, and it started with an introduction and an introductory research; The general weakness of the level of students of colleges of Islamic sciences in this article, and I detailed these reasons that relate to: the curriculum, the teaching staff, and students, and then concluded it with proposals and recommendations that would address this weakness.

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Financial markets liquidity and their impact in the return of common stocks
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    The research aimed to study the financial markets liquidity and returns of common stocks , Take the research  the theoretical concepts  associated with each of the liquidity of financial markets and returns of common stocks , As well as the use of mathematical methods in the practical side to measure market liquidity and Stocks  Return, the community of research in listed companies in Iraqi stock exchange that have been trading on its stock and number 85 joint-stock company, The research was based to one premise, there is a statistically significant effect for the liquidity of the Iraqi stock exchange on returns  of common stocks  to traded companies in which , Using th

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
The prevalence and antimicrobial sensitivity of Esbl Escherichia Coli. in clinical isolates
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Background: The antimicrobial resistance is one of the most serious and expanding health problems world -wide in the last decades. The esbl escherichia coli. (extended – spectrum beta-lactamase e.coli) represents an important aspect of it .Objectives: To get an overview on the esbl e.coli prevalence profile in general. Also to assess the antibiotic sensitivity of esbl e. coli trying to specify the most effective antibiotics in combating this micro-organism.Methods: this study tries to focus on this problem in Iraq which through a prospective study approach by taking 35 clinical samples from various sources (urine, blood, abscess, eye ,vagina ,stool and others),and after confirming the presence of e.coli, the presence of esbl e.coli and

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Publication Date
Thu Sep 15 2022
Journal Name
Al-academy
Color works in highlighting the functional and aesthetic aspects of interior designs
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Color is one of the most important elements involved and contributing mainly to designs and visual works, whether they are fixed or mobile, for internal spaces through what color gives it the possibilities on the physical and intellectual level, if the process is linked to the functional performance or the aesthetic value, which is thus included within the system of processors and basic works in Designing the interior spaces and highlighting the functional and aesthetic aspects of them through the executed designs that are linked to certain techniques and mechanisms. Therefore, they are processed according to the references and pressure structures or the creation and modern dealing with materials and designs to implement operations in hi

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Publication Date
Mon Aug 01 2022
Journal Name
Journal Of Engineering
The Behavior of Bond Strength between Rebar and Concrete in Rubberized Concrete : -
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Through an experimental program of eighteen specimens presented in this paper, the bond strength between reinforcing bar and rubberized concrete was produced by adding waste tire rubber instead of natural aggregate. The fine and coarse aggregate was replaced in 0%, 25%, and 50% with the small pieces of a waste tire. Natural aggregate replacement ratio, rebar size, embedded rebar length, the rebar yield stress of rebar, cover, and concrete compressive strength were studied in this investigation. Ultimate bond stress, bond stress-slip response, and failure modes were presented. The experimental results reported that a reduction of 19% in bond strength was noticed in 50% replaced rubberized concrete compared with convention

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
SiCi_xNxthin films preparation by TEA-Co2 Laser induced Vapor-phase reaction and study of the nature of chemical bonds and some their electrical and optical properties
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A pulsed (TEA-0O2) laser was used to dissociate molecules of silane ethylene (C2I-14) and ammonia (NH3) gases, through collision assisted multiple photon dissociation (MPD) to deposit(SiC i_xNx) thin films, where the X-values are 0, 0.13 and 0.33, on glass substrate at T,----648 K. deposition rate of (0.416-0.833) nm/pulse and thickness of (500-1000)nm .Fourier transform infrared spectrometry (FT-IR) was used to study the nature of the chemical bonds that exist in the films. Results revealed that these films contain complex networks of the atomic (Si, C, and N), other a quantity of atomic hydrogen and chemical bonds such as (Si-N, C-N, C-14 and N-H).Absorbance and Transmittance spectra in the wavelength range (400-1100) nm were used to stud

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