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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 Mar 15 2021
Journal Name
Al-academy
Aesthetics of the Artistic Construction in Educational TV Programs " progrm Hello Hi! A Model": محمد عبد الرضا حسين
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  The TV has the ability to combine sound and picture, which makes it of a direct impact on the recipient as it is a rich communicative tool with various artistic forms that display through this small screen programs and films, so that the TV has become superior over many other means of communication.
This research is concerned with the technical and artistic ability in the production of programs owned by the TV as a means of attraction of educated children aged between 5-12 years old, which makes it an educational supplement for the school that helps them in providing knowledge, acquiring skills and being informed about the different sciences through educational programs. It is known that the child at this stage enjoys when wa

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Publication Date
Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
The use of eggplant peel powder in the treatment of hyperlipidemia caused by antibiotics administration in male local rabbits
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Publication Date
Wed Oct 11 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Deductive Group Pattern in Developing the Creative Thinking of Second Intermediate Grade Pupils in History Discipline
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The present study aims to identify the effectiveness of deductive group patterns in developing the creative thinking of second-intermediate-grade pupils in history discipline. The current null hypothesis has been investigated: There are no statistically significant differences at (0.05) between the scores mean of the experimental group pupils who were taught according to the deductive group pattern and the scores mean of the control group pupils who were taught according to traditional method in creative thinking testing. the study sample was divided into two groups: an experimental group of (30) female students and a control group of (31) female students. The two groups are equalized based on the variables of age, the scores of the firs

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of The College Of Education For Women
The measurement of Ibn Abi al-Rabee (688 AH) in his book (Abstract in the regulation of Arabic laws)
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The book of the summary in the control of the laws of Arabic is one of the most important books of Andalusian grammar, the resonance of which is clearly evident among the mother of the language books in the seventh century AH because of the character of the educational style easy and simplified service for anyone who wants the Nile Arabic grammar, that end through what is pursued in his book (Summary) on according to visual standards, as was Ibn Abi Al-Rabeea of first- type, and illustrated in which he addressed the analogies, and he followed the modalities expressed and its consequences relating to each attachment in which a (illness and reasoning factor) And what he said in the framework of each service for the study material in his ha

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Us-china Public Administration
Victims of Terrorism between Compensation and Loss of Rights: A Comparative Study between Iraqi Law and French Law
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The problem of the damage caused by terrorist acts has raised many difficulties in many countries, including Iraq, which requires the existence of a law that sets out sufficient rules for compensating the victims of terrorist acts, in order to compensate them for the harm they have not suffered. It may be difficult or impossible for them to identify causing damage, and therefore unable to obtain compensation by applying the traditional rules of liability that require proof of fault and identify the culprit. The security funds come as an appropriate alternative that pays compensation in such cases for victims to reparation for the damage they suffered. Therefore, this problem remains one of the most problems that Iraq suffers from it, which

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Publication Date
Fri Apr 01 2016
Journal Name
Al–bahith Al–a'alami
Indicators of Mental image among Students of the University of Baghdad about Iraqi Political Parties-(a research based on a master thesis)
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Media studies have focused mostly on the issue of the mental image because the image that is formed in the mind has become not only a photo of a human being and having kept for himself. This image has an outside influence which may sometimes up to the formation of the fate of others and it sometimes includes individuals and groups together.
This study comes in the context of identifying the image of Iraqi political parties among Iraqi university students and the nature of the view that students have in their minds about these parties.
Chapter one includes the problem of the research, the importance of the study, the goals and method used. Chapter two is divided into two sections: section one deals with the concept of the mental i

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Publication Date
Wed Dec 01 2010
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Technical methodology balanced performance as a strategic framework for the economic units operating in the Iraqi industrial sector environment
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facing economic units operating in the environment sector of the Iraqi

industrial many pressures in its seeking to measure and evaluate its performance because of variables, today's corporate environment, as the case which makes looking for a methodology can be adopted to evaluate its performance with a more holistic, rather than being limited to traditional measures that are no longer enough to keep pace with rapid changes in today's corporate environment, which requires that measures of performance are derived from the strategy of unity and commensurate with the specificity of the environment in Iraq. Try searching discussion Ttormwhrat and performance measurement systems to suit the business strategies and directions of change

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Publication Date
Tue Jan 01 2019
Journal Name
Mustansiriyah Journal Of Sports Science
The use of training methods in accordance with special exercises to develop flexibility and perform the skills of shooting from above the chest (abduction) to wrestlers ages (14-15)"
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Evolution has become a feature of this era because of the speed that makes it open multiple horizons and many to identify everything that is new in different areas and also characterized by the competitive position of emotional attitudes changing depending on the positions of winning and defeat, and the use of training methods are the most important pillars of the game of wrestling, The methods contribute to raising the level of the wrestler and refining his physical and skill potential. The problem of the research is that the shooting exercises from above the chest are very important in Roman wrestling and can be terminated by the player. Through very personal interviews for coaches and concluded that there is a weakness in the level of fl

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Publication Date
Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
STUDY OF SOME BIOLOGICAL ASPECTS OF MICE INFECTED WITH HYDATID CYST OF Echinococcus granulosus PARASITE AND THE THERAPEUTIC CAPACITY OF ETHANOLIC EXTRACT OF Cladophora glomerate ALGAE
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Publication Date
Tue Aug 02 2022
Journal Name
Muthanna Journal For Admisrative And Economic Sciences
MEASURING AND ANALYSING THE CAUSAL RELATIONSHIP BETWEEN AGRICULTURAL TERMS OF TRADE AND SOME AGRICULTURAL VARIABLES IN IRAQ FOR THE PERIOD 1990-2019
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The research aims to investigate the existence of a direct causal relationship between selected agricultural variables: agricultural output (as a representative of growth in the agricultural sector), agricultural terms of trade as a completely new variable in agricultural studies in recent years, agricultural labour which is an important part in the total workforce for Iraq, and finally, agricultural investment because of its importance and vital role in the production process, creating job opportunities, and then raising the level of employment, then it's role to achieving agricultural growth and development. For this purpose, the researchers used the Toda-Yamamoto causality methodology for a time series covering from 1990 to 2019. The res

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