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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
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
Scientific Thinking Controls under the Light of Ibrahim Story in the Holy Qur’an
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This study aims at identifying thinking, its aspects, controls, thinker’s characteristics, and the attempts that followed by Ibrahim’s people. This was achieved under Ibrahim’s story, (peace and blessing be upon him), in the Holy Qur’an. The study used the descriptive method through induction and deduction. The study reached the following results: thinking is an organized reasonable human action, which includes all human life in the fields of science, knowledge, and calling for Allah. It depends on remembering what is already in the memory and it should be subjected by revelation and Islamic legislation. The study illustrated that the most important thinking controls are monotheism, piety, Islamic legislation, the Holy Qur’an,

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Publication Date
Tue Mar 19 2019
Journal Name
Political Sciences Journal
Rentierism effect on the democratic choice of the state In Iraq after 2003
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The linguistic meaning of the verse in the Arabic dictionaries applies very much to the reality of rent and its effect. This is true of economic growth as a continuous increase in real per capita income in addition to the same thing. Therefore, development does not necessarily achieve a comprehensive and structural increase of the various economic sectors. As the rent came in the sense of a terrible land open Maim any fertilized. And the camel is a ma'aya and a ra'i: that is, it goes in the pasture and returns itself. This is similar to the extraction of oil after it is ready for investment and earn its revenue as soon as it exists or is extracted by external parties. If the rent is first linked to agriculture, especially the fertile lan

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Publication Date
Sat Dec 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
Measuring the Level of Entrepreneurial Orientation: Analytical Research in the National Security Advisory
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The current research aims to measure the level of entrepreneurial orientation and its dimensions (creativity, independence, proactivity, risk tolerance, and achievement) in the National Security Chancellery, as its importance and role in guiding senior leaders of the chancellery to make strategic decisions with high quality in various Iraqi concerns, more specifically the security aspect. The data was collected from 94 individuals (the research sample) from the research community (120) individuals at different administrative levels and intentionally where the questionnaire was adopted as a main tool for data collection and the primary data was analyzed through descriptive and inferential statistical methods (arithmetic mean, standard dev

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Publication Date
Mon Feb 16 2026
Journal Name
Al Kut Journal Of Economics And Administrative Sciences
Use of the Bootstrap in the logistic regression model for Breast cancer disease
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The logistic regression model is one of the oldest and most common of the regression models, and it is known as one of the statistical methods used to describe and estimate the relationship between a dependent random variable and explanatory random variables. Several methods are used to estimate this model, including the bootstrap method, which is one of the estimation methods that depend on the principle of sampling with return, and is represented by a sample reshaping that includes (n) of the elements drawn by randomly returning from (N) from the original data, It is a computational method used to determine the measure of accuracy to estimate the statistics, and for this reason, this method was used to find more accurate estimates. The ma

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Publication Date
Sun Dec 10 2017
Journal Name
Al-academy
The Composition of design according to norm renovation in the interior design space
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The interior spaces represent a true reflection of the concepts and values ​​of humanity and requirements; were interested in current research ongoing changes that have occurred in those human values ​​and requirements over time, even pat each time warp its values ​​and its own requirements. Those changes, which receive Bdilalha the spaces linked by a renewal which guarantees the interior design of the spaces of sustainability and bio-coordinated. Launched search from an initial perception that those associated with the changes of the spaces through time that have not been subject to examination and supervision, they will constitute a continuing threat of losing the ties with the past under the pretext of modernization and mo

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Publication Date
Fri Aug 16 2019
Journal Name
Canadian Journal Of Physics
Influence of the variation in the Hubbard parameter (U) on activation energies of CeO2-catalysed reactions
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Accurate description of thermodynamic, structural, and electronic properties for bulk and surfaces of ceria (CeO2) necessitates the inclusion of the Hubbard parameter (U) in the density functional theory (DFT) calculations to precisely account for the strongly correlated 4f electrons. Such treatment is a daunting task when attempting to draw a potential energy surface for CeO2-catalyzed reaction. This is due to the inconsistent change in thermo-kinetics parameters of the reaction in reference to the variation in the U values. As an illustrative example, we investigate herein the discrepancy in activation and reaction energies for steps underlying the partial and full hydrogenation of acetylene over the CeO2(111) surface. Overall, we find th

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Publication Date
Fri Aug 28 2020
Journal Name
Iraqi Journal Of Science
The Local Bifurcation of an Eco-Epidemiological Model in the Presence of Stage- Structured with Refuge
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In this paper, we establish the conditions of the occurrence of the local bifurcations, such as saddle node, transcritical and pitchfork, of all equilibrium points of an eco-epidemiological model consisting of a prey-predator model with SI (susceptible-infected) epidemic diseases in prey population only and a refuge-stage structure in the predators. It is observed that there is a transcritical bifurcation near the axial and free predator equilibrium points, near disease-free equilibrium point is a saddle-node bifurcation and near positive (coexistence) equilibrium point is a saddle-node bifurcation, a transcritical bifurcation and a pitchfork bifurcation. Further investigations for Hopf bifurcation near coexistence equilibrium point

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Publication Date
Mon Aug 21 2023
Journal Name
Sport Tk-revista Euroamericana De Ciencias Del Deporte
Organizational affiliation in the absence of financial allocations for members of the Iraqi Olympic sports federations
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Publication Date
Sun Feb 24 2019
Journal Name
Iraqi Journal Of Physics
Comparison of three interpolation methods for the average monthly temperature in the south of Iraqi zone
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This study focuses on evaluating the suitability of three interpolation methods in terms of their accuracy at climate data for some provinces of south of Iraq. Two data sets of maximum and minimum temperature in February 2008 from nine meteorological stations located in the south of Iraq using three interpolation methods. ArcGIS is used to produce the spatially distributed temperature data by using IDW, ordinary kriging, and spline. Four statistical methods are applied to analyze the results obtained from three interpolation methods. These methods are RMSE, RMSE as a percentage of the mean, Model efficiency (E) and Bias, which showed that the ordinary krigingis the best for this data from other methods by the results that have b

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Publication Date
Mon Jan 11 2021
Journal Name
Journal Of Planner And Development
The effect of rural building types informing the type of traditional courtyard houses in Sulaimaneyah city.
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The types of traditional houses vary from region to region according to physical and non-physical circumstances, and Sulaymaniyah city is characterized by a type of traditional houses that differ significantly from those in most cities and regions neighboring are always different from the general pattern that is prevalent in the region and the Muslim world.

 

The aim of this research is to study the cause of this difference or distinction in the traditional houses in Sulaimaniyah city, by comparing the most common models in these houses and comparing them with the general models of village houses that originally existed in the region to relaize the convergence and contrast between them. The research was based on a co

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