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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
Test wisdom of Postgraduate Students at the University of Samarra and its relation to the Engagement of learning and psychological tension
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The aim of the present research is to identify the test wisdom and the engagement with learning and psychological tension among postgraduate students at the University of Samarra according to the variables of the department, gender, age, and whether students are employee or non-employee. The study also attempts to identify the relationship between the test wisdom and the engagement with learning and psychological tension. The research sample consisted of (75) postgraduate students randomly selected from college of Education. The researcher applied the test–wisdom of (Mellman & Ebel) and the scale of engagement with learning preparation by (Al-zaabi 2013). In addition, the researcher used the list of the psychological stress of (Abu

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Survey theopinions professional and academics on building the strategy of internal audit function and the possibility of keeping abreast of developments
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The research problem is clearly deficient suffered by the internal audit function in all institutions of Iraq, as a result of the lack of sponsor organizations for this profession and there is no law or local legislation determine its powers and its responsibilities and scope of work As well as the lack of interest of senior management in economic units that function, as it focuses its work on the scope of financial and accounting matters only So required to rebuild this function in line with the current developments as well as the lack of a framework that defines the strategy of this function, and it came the idea of research to find out how to create a regulatory method for re-strategic construction of the internal audit function depen

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Publication Date
Mon Aug 05 2024
Journal Name
European Endodontic Journal
Assessment of Treatment Quality Risk Factors Influencing the Radiographic Detection of Apical Periodontitis in Root-Filled Teeth: A Retrospective CBCT Analysis
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Publication Date
Tue Sep 01 2015
Journal Name
Journal Of Engineering
Effect of Recirculation Ratio on the Uniformity Flow in a High Area Ratio of Outlets Pipe at Different Entrance flow rates
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The uniform flow distrbiution in the multi-outlets pipe highly depends on the several parameters act togather. Therefor, there is no general method to achieve this goal. The  goal of this study is to investigate the proposed approach that can provide significant relief of the maldistribution. The method is based on re-circulating portion of flow from the end of the header to reduce pressure at this region . The physical model consists of main manifold with uniform longitudinal section having diameter of 152.4 mm (6 in), five laterals with diameter of 76.2 mm (3 in), and spacing of 300 mm. At first, The experiment is carried out with conventional manifold, which is a closed-end. Then, small amount of water is allowed

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Publication Date
Sun Mar 01 2015
Journal Name
Baghdad Science Journal
Study of the Toxic effect of new Cadmium ( II) complex [ CdL2]. 1/2H2O on GPT and ALP activity in some organs of female mice comparable with anitumor drug Cyclophosphamide (CP)
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Cadmium has been known to be harmful to human healthy , manily Via contaminated drinking water , food supplies , tobacco and industrial pollutant . The aim of this study was to determine the toxicity of new Cadmium (II) complex ( Bis[ 5- ( P- nitrophenyl ) – ? 4 – Phenyl- 1,2,4- triazole -3- dithiocarbamatohydrazide] cadmium (II) Hydra ( 0.5) and compare it with anticancer drug cyclophosphamide ( CP) in female albino mice . This complex causes to several alterations in Enzymatic activity of Glutamate Pyruvate Transaminase (GPT) and Alkaline Phosphatase (ALP ) in three organs after the treatment of mice with different doses of a new cadmium (II) complex ( 0.09 / 0.25ml , 0.18/ 0.5ml and 0.25mg /0.7 ml /30 gm of mous

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Publication Date
Fri Jan 01 2016
Journal Name
Aip Conference Proceedings
Analysis of performance measures with single channel fuzzy queues under two class by using ranking method
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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Tax Planning Policy Directions for The Development of The Tax Outcome in Iraq for The Years (1990- 2010): An Applied Research at The General Board of Taxes
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The importance of research is to be considered by highlighting the tax policy in Iraq which extended for successive measurement of the amount of tax receipts for respective periods, the research problem represents security, economic and political issues that Iraq suffered which were very difficult since Nineties of the last century until now that led to a lake of clarity in tax policy trends, volatility in it and finally reflected on the tax revenues increase or decrease. One of the main recommendations of the research is: (The necessity to develop a deliberate strategy for tax policy in Iraq which should take into account financial, economic, and social goals in appropriate way).

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Publication Date
Mon Mar 01 2021
Journal Name
Journal Of Physics: Conference Series
The Bifurcation Analysis and Persistence of the Food Chain Ecological Model with Toxicant
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Abstract<p>In this work, the occurrence conditions of both local Bifurcation and persistence were studied, Saddle-node bifurcation appears near fourth point, near the first point, the second point and the third point a transcritical bifurcation occurred but no pitchfork bifurcation happened near any of the four equilibrium points. In addition to study conditions for Hopf-bifurcation near positive stable point that is the fourth point. Besides discuss persistence occurrence as globally property of the food chain of three species include prey, first predator and top predator with impact of toxin in all species and harvesting effect on the predator’s only. Numerical results for the set of hypothe</p> ... Show More
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Publication Date
Sun Sep 24 2023
Journal Name
Arab World English Journal
The Correlation between EFL Learners’ Academic Intelligence and the Level of Productive Skills
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Communicating effectively by gaining productive skills in a classroom setting is one of the critical goals of learning the English language. The current study was conducted to explore the correlation of EFL learners’ level of academic intelligence with their productive skills. The study tries to find an answer to what is the correlation between EFL learners’ academic intelligence and level of production skills. The study population represents EFL students at the departments of English language of the Iraqi Colleges of Education for the academic year (2022-2023). The sample includes 310 EFL students selected from the 3rd year of the Department of English of the College of Education, Ibn-Rushd for Human Sciences/University of Bagh

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Publication Date
Wed Jan 01 2020
Journal Name
The International Journal Of Literary Humanities
Lilith’s Dark Legacy: Daphne du Maurier’s "Rebecca" and the Myth of the Genesis
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