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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
Sun Dec 01 2024
Journal Name
كلية التربية للبنات
Strategic Maneuvering in Commercial Advertisement: A Pragmatic Study
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This study deals with strategic maneuvering in advertisement from a pragmatic point of view found in some commercial advertisements in order to investigate and analyze the pragmatic devices that are used in the strategic maneuvering and stages. The study attempts to shed light on the most fuzzy areas in advertisements that is probably how the language of advertisements employed by advertisers to affect consumers positively. The primary goal of strategic maneuvering is to discover how the pragmatic devices have persuasive techniques that are used to gain a competitive advantage and more sales. This study is a contribution to the field of research in the language used in advertising. In this research, the effectiveness of strategic man

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Publication Date
Tue Aug 01 2023
Journal Name
Journal Of Engineering
Risk Response in Construction Project: A Review Study
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Construction projects are characterized as projects with multi phases and activities, complex, unique, and have many different parties and stakeholders. Risks could appear at one or more of the construction project stages and may affect the achievement of project objectives. Therefore, one of the key elements in the planning phase of any project is the risk management process (RMP). This study attempts to understand the terminology of risk in general, risk management, and response to risk in particular. This study is mainly a review of thirty-eight studies that have been published between 1997 and 2020 that demonstrate the importance of the crucial phase of risk response from the risk management process and its impact on

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Publication Date
Mon Jul 25 2022
Journal Name
Studies In Pragmatics And Discourse Analysis
Negation in American Discourse: A Socio-Cognitive Study
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The present study cognitive aims to investigate the negation phenomenon in American political discourse under Critical Discourse Analysis (CDA) principles. The research sample includes two speeches given by Clinton and Trump in their election campaigns in 2016. Since the nature of the study follows the social-cognitive approach, the researcher adopted two models of analysis to achieve the study’s objectives: First, the theoretical framework of MST (developed by Fauconnier (1994), Fauconnier and Sweetser (1996) to examine meaning construction resulting from building different levels of negative mental spaces by two different genders the selected speeches. Second, pragmatic model to examine the role of gender from the functional per

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Publication Date
Sun Jun 15 2025
Journal Name
الذكوات البيض
Drugs in Iraq 1932-1968 (A Historical Study)
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The spread of drugs in Iraq during the period 1932-1968 was one of the most dangerous. phenomena affecting humans, as it leads to addiction, to the point where people cannot live without it, it also leads to the destruction of the user's nerves and body, and the inability to maintain balance, or even perform daily tasks. There are different types of drugs, and the side effects vary from one type to another However in all cases, drugs remain the scourge of the world, They are a toxic substance that attacks the nerves and tries to destroy them' The importance of the subject lies in the fact that it is anew and unstudied topic, and it studies a phenomenon that affects humanity in general and Iraq in Particular through it light can be shed on t

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Visions in the poetry of Yahiya Ibn Hakam AL- Chazali: Visions in the poetry of Yahiya Ibn Hakam AL- Chazali
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Conclusion and results
1. The research concluded through considering the rhetorical visions,
appropriate relationships between utterances with a language derived
from the reality of the social, religious, and, cultural life.
2. The poet compound between realism and the documentation of the
poetic structure, its depth, and the conjugation of its symbolic
metaphors, and also between its phonetic music and the right artistic
nature and the inanimate rules to take in consideration what Dr. Ahmad
Haikal concluded that the tried to com up with something better than
that of the previous generation, but he is still following their orbit, and
their trend method of poem building.
3. The realistic images visionary r

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Publication Date
Sun Sep 01 2019
Journal Name
Yazyk I Kul'tura
Cognitive-communicative approach in the system of teaching Russian language for foreign students (in the condition of no language environment)
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Publication Date
Sun Jun 01 2025
Journal Name
Journal Of Physics: Conference Series
Determination of Radioactivity Levels in Some Rice Samples available in the Iraqi Markets Using the system of High-purity Germanium
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Abstract<p>This study aimed to determine the radioactivity and radiation hazard indicators of rice samples potentially for human consumption. Gamma spectroscopy was used to calculate the specific activity of natural and artificial radionuclides (<sup>238</sup>U, <sup>232</sup>Th, <sup>40</sup>K, and <sup>137</sup>Cs) in local and imported rice samples collected from local markets in Baghdad Governorate, Iraq, in addition to various radiological hazard indices. The radionuclide concentrations in the samples varied from 2.123 ± 1.457 Bq/kg to 13.032 ± 3.610 Bq/kg for <sup>238</sup>U, 2.906 ± 1.705 Bq/kg to 17.290 ± 4.158 Bq/kg for <sup>232</sup></p> ... Show More
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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Defining the Feature of Cold Wave (Al-Marba'aniyah) in Iraq: Defining the Feature of Cold Wave (Al-Marba'aniyah) in Iraq
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Abstract:
Al-Marba'aniyah, which is a long cold wave, was defined by ancient
Iraqis. It represents the coldest days in Iraq. In this research paper, a new
scale was put to define it. It shows that the period between the minimum
temperature degree recoded in December and the minimum temperature
degree recorded in January is considered to be the period of Al-Marba'aniyah.
The research concluded that Al-Marba'aniyah is unsteady and it changes in
the days of its occurrence. It was also concluded that the dates of the
beginning and the end of Al-Marba'aniyah are unsteady, too. Moreover, it was
found out that each of the Siberian high, European high, and finally the
subtropical high are the responsible systems for

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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Educational And Psychological Researches
Voluntary Work for Women in the Light of Islamic Education: Voluntary Work for Women in the Light of Islamic Education
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The research aims to identify the most important areas of voluntary work available to women in society, stand on the most important controls that push women to work in voluntary areas in society. The research also seeks to stand on the most prominent obstacles to the voluntary work of women in society. The research contained four main chapters: Chapter I: Definition of research, Chapter 2: Objectives, areas, controls and effects of volunteer work, Chapter 3: Voluntary Work of Women in the Celestial Religions, and lastly, Chapter 4: Theories, Constraints, and Recommendations for Voluntary Work for Women.The researcher suggested several recommendations: 1-establishing a unit responsible for planning,

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Publication Date
Tue Sep 05 2023
Journal Name
Pakistan Heart Journal
The Effect of Using Adhesive Tapes (Kenzo Tape) in Rehabilitating the Shoulder Muscles of Throwing Players in Paralympic Athletics Events
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AHHAN Al, AMAA Fatlawi, HAAN Al-Fatlawi…, Pakistan Heart Journal, 2023

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