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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
Tue Aug 15 2023
Journal Name
Journal Of Economics And Administrative Sciences
Inclusive leadership in the General Secretariat for the Council of Ministers - An analytical research
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The current research aims to evaluate the level of inclusive leadership within the General Secretariat for the Council of Ministers, and its role in achieving integration in work through the need to improve relationships between different administrative levels, facilitate participation, expression of opinions, and belonging to the organization. In order to achieve the research objective, the descriptive analytical statistical method was chosen using the SPSS V.25 programs, with various statistical methods and measures, including mean, standard deviation, variance coefficient, relative importance, and simple regression, through a questionnaire tool for data collection. The research community included the leadership in the sample of resear

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Publication Date
Wed Jun 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of the Strategic Leadership in Strategic Learning Exploratory Research at Anbar University
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        This study aims to know the extent of the impact of Strategic Leadership as an independent variable in Strategic Learning as a dependent variable to help the senior leadership in Anbar University to take the right decisions to develop Strategic Learning programs in light of the circumstances of the Covid-19 and the sudden decisions adopted by the university to switch to E-learning and to blend. The survey was conducted by distributing a questionnaire that was adopted as a primary tool in data collection from the study sample represented by the university's senior leaders, An intentional random sample of (105) was selected from our community of (127), the data were analyzed by (SPSS) Depe

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Publication Date
Sat Apr 01 2017
Journal Name
Al–bahith Al–a'alami
Stereotypical Frames if the Image of Women in the Iraqi TV Drama after 2003
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This study aims to deliver the woman’s image and to unveil on how to be introduced in the TV series. The research is based on the survey method-using content analysis tool. The research sample represented in the TV series produced by the IMN, which were displayed in 2014 and used the pattern of Margaret Gallagher to analyze the content of the series in accordance with the frame analysis theory.
The study came up with declination of the woman’s representation compared with man in Iraqi TV drama, also the study finds that the series introduced the woman according to the personal, social, political, and economic frames in a standardizing method. It focuses on the characteristics always attributed to it as showing her obedient of the

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Publication Date
Fri Nov 29 2024
Journal Name
The Iraqi Geological Journal
Unveiling the Mysteries of Fractured Basement Oil Residues in the Upper Benue Trough, Nigeria
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This study offers additional evidence for the occurrence of oil residues within fractures of the basement rocks in the Upper Benue Trough, Nigeria. The data suggests that the observed oil residues were originally generated as light oils, which were later biodegraded into heavy oils. These Upper Benue Trough's oil stains are a valuable tool for hydrocarbon exploration in the region as they indicate the existence of a petroleum system in the basin. We find a strong similarity to the proportions of C27, C28, and C29 regular steranes of oils found in the sandstones and shales of the Bima Formation in the Upper Benue Trough when we plot the relative quantities of these steranes of the investigated basement rock oil types on a ternary gra

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Publication Date
Sat Jun 01 2024
Journal Name
Journal Of Scientific Development For Studies And Research
The Role of E-Learning in teaching the Arabic language to non- native speakers
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After the information revolution that occurred in the Western world, and the developments in all fields, especially in the field of education and e-learning, from an integrated system based on the effective employment of information and communication technology in the teaching and learning processes through an environment rich in computer and Internet applications, the community and the learner were able to access information sources and learning at any time and place, in a way that achieves mutual interaction between the elements of the system and the surrounding environment. After the occurrence of the phenomenon of Covid 19, it led to a major interruption in all educational systems that had never happened before, and the disrupt

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Publication Date
Thu Oct 01 2009
Journal Name
Journal Of The College Of Languages (jcl)
Computer-assisted Programme for the Teaching of the English Syllable in RP Allophonic Pronunciation
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Native speakers of English from different parts of the world have different accents,but the differences of accents are mainly the result of differences in the sound of  vowels  and consonants . The actual use of all these sounds in combination leads the speaker to produce a number of segments which only appear on the production level and realized on the perceptual  one . RP pronunciation represents the teachable variety in all Iraqi universities because it is the most acceptable and understandable accent all over the world and not only in South East London ..The structure of the English syllable in RP  pronunciation is influenced by the appearance of certain allophones especially aspiration and glottalization which ch

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Publication Date
Thu Jul 01 2021
Journal Name
Key Engineering Materials
Observational Evidences of Double Cropping Impacts on the Climate in the Northern China Plains
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Abstract<p>The impacts of harvested cropland in the double cropping region (DCR) of the northern China plains (NCP) on the regional climate are examined using surface meteorological data and the satellite-derived normalized difference vegetation index (NDVI) and land surface temperature (LST). The NDVI data are used to distinguish the DCR from the single cropping region (SCR) in the NCP. Notable increases in LST in the period May–June are found in the area identified as the DCR on the basis of the NDVI data. The difference between the mean daily maximum temperature averaged over the DCR and SCR stations peaks at 1.27°C in June. The specific humidity in the DCR is significantly smaller than in</p> ... Show More
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Publication Date
Sun Dec 15 2019
Journal Name
Al-academy
The Dominating Sign of the Space Structure in TV Drama: صادق كاظم عبد علي
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  The space constitutes a cornerstone of the creativity process since the emergence of arts and literature. Gaston Bachelard has a significant role in highlighting the importance of the place in his book entitled (Poetics of Space). Since then, the space, especially in the TV drama, is no longer a mere background indicating the location or the date of the event. Space inside these series has become an inseparable part of the artistic or dramatic fabric, that the visual scene started to formulate alongside the movement of the individuals in their language or accents that are specified inside the space as an incubator for the décor, clothes, makeup, accessories and lights in addition to the sound and musical effects. The lens angles

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Publication Date
Wed Jan 01 2020
Journal Name
Biochemical And Cellular Archives
Embryonic Development of the Inner Ear in the Quail Bird Coturnix Cotarnix (Linnaeus, 1758)
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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Health Problems for the Elderly at the Nursing Home in Baghdad city
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Objective: Assessment of health problems and identify demographical information to elderly. Methodology:
it is a descriptive study, data were collected by the researchers depended on the direct interview with the
elderly by using the study instrument (questionnaire) as well as review the records of the geriatric.
Results: The majority of study sample (66%) were males and (24.3%) were within age group (70-74) years,
(44.7%) were widows, and (41.7%) did not read and write. This study applied the international classification
of diseases(short-table) in (11) items, which stated that most of the elderly were complaining from
health problems: debility of hearing (80.65%), eczema or allergies (69.35%), debility of vision (66.9

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