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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 Oct 01 2018
Journal Name
Journal Of Educational And Psychological Researches
Media concepts in social studies and national textbooks in public education in light of media education standards and the nature of Saudi society
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The study aimed to reveal the degree of inclusion of media concepts in the books of social and national studies in general education in light of the criteria of media education and the nature of the Saudi society. Additionally, to identify the estimations of the participants in the study of the importance of including media concepts in these books, and to build a matrix of the range and sequence of media concepts in the books of social and national studies in the grades of Saudi general education. The study followed the descriptive approach in both descriptive analysis of the textbooks and descriptive survey of the study participants who were (203) students in the schools of boys and girls in general education in Makkah. The study used t

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Responsibility of the external auditor to detect the activity result of the public construction companies in accordance with the going concern principle: دراسة تطبيقية في شركة الفاروق العامة للمقاولات الإنشائية
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The audit profession today gets an increasing interest by the financial , economic and legal contemporary societies , because of the importance of the technical & neutral auditor’s opinion to the financial reports beneficiaries in order to enable them making their investment decisions , but some of them whom suffered damage or loss when they made that decisions according to the mentioned financial statements which consolidated with auditor’s report , exposed the function to a responsibility and credibility crisis in addition to missing the trust especially at the latest years. They always ask why or what is the reason that cause the auditor didn’t giving us any warning signs about the economic mater for that companies.

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Publication Date
Sun Jan 01 2012
Journal Name
European Journal Of Experimental Biology
A comparative study on cytotoxicity and apoptotic activity of pyocyanin produced by wild type and mutant strains of Pseudomonas aeruginosa
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Nutrient agar medium with various concentrations of cefotaxime was used for isolation spontaneous mutants from wild type strain of P.aeruginosa PHA-1. Eighty-two mutants were successfully isolated with the viable count 52×107 , these mutants were confirmed as spontaneous not physiological adaption mutants by reculture on the same medium. Then, wild type PHA-1 and mutants were examined for production pyocyanin; a blue greenish pigment was clearly noticed on King A medium. Remarkably the mutant strain named S300-8 was distinguished in productivity in comparison with wild type strain PHA-1; the amount of pigment was 56.0667mg/l and 74.53mg/l respectively. In addition, pyocyanin produced by mutant strain S300-8 revealed a potent efficacy again

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Publication Date
Mon Dec 22 2025
Journal Name
Wasit Journal For Pure Science
Synthesis, Characterization and Study of Liquid Crystal Behavior of Linear-Shaped Mesogens Containing Cyano and Alkyl as a Terminal Groups
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A novel series of liquid crystalline compounds containing 2,4-thiazolidinedione units with varying terminal alkyl chain lengths was successfully synthesized and characterized. The chemical structures of the synthesized compounds were confirmed by FT-IR, ¹H-NMR, and mass spectrometry. The mesomorphic behavior was investigated using polarized optical microscopy (POM) and differential scanning calorimetry (DSC). Compounds [V]₄, [V]₅, and [V]₆ exhibited enantiotropic nematic phases, while compound [V]₈ displayed a smectic A (SmA) phase. No liquid crystalline behavior was observed for compound [V]₃. The liquid crystalline properties were found to depend on the terminal-to-lateral chain length ratio, molecular geometry, and the nature

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Proposed Introduction to Activate the Role of Accounting System for Political Parties in Iraq
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     Purpose - The study aimed at evaluating the accounting system of the Iraqi political parties, which is applied according to legislative texts, and then the ability to provide accounting information to evaluate the strategic performance and control of the party's operational and financial performance.
Findings- The research found that the unified accounting system applied to political parties does not provide relevance informations to judge the performance of the political party, the researcher a proposal for an accounting system that provides the necessary information to measure and monitor the performance of Iraqi political parties can be presented. The

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Crossref
Publication Date
Fri Sep 20 2019
Journal Name
Journal Of The College Of Education For Women
History of Local Reprimands in the Northwest Caucasus from Ancient Times to the 19th century
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Ubikh is one of the most important tribes of the Northwest Caucasus and has a long history. Naturally, rebukes are an integral part of the Caucasus region. Their people were able to confront the Russian invasion of their lands like the rest of the Caucasus tribes to defend their existence, freedom and the right to build their independent state, but they were not able to resist the great Russian military progress they achieved on all sides. For the territory that belonged to Persia and the Ottoman Empire and ended the resistance of the Meridian movement in the Northeast Caucasus, the Russians left only the weak resistance of the tribes of the Northwest Caucasus led by the rebuke after Russia managed to eliminate all resistance movements i

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Publication Date
Thu Apr 07 2022
Journal Name
Eurasian Journal Of History, Geography And Economics
The impact of monetary policy on monetary stability in Iraq for the period (2004-2018)
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Monetary policy is an important part of the economic policy to influence the monetary aspect of stabilization, for this reason the research will seek to clarify the extent of the impact of monetary policy in achieving monetary stability in Iraq during the chosen research period, because the Iraqi economy suffers from monetary instability due to political and security turmoil, Therefore, an effective and effective monetary policy is required in terms of reducing inflationary pressures to reach the required monetary stability, in order to create the appropriate monetary environment for the work of the economic and productive sectors. Thus, the research adopted a basic hypothesis that monetary policy in Iraq has a clear impact on achieving mon

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Publication Date
Fri Aug 20 2021
Journal Name
Iraqi Journal Of Laser
The Influence of No-Core Fiber Length on the Sensitivity in Fiber Optic Strain Sensor
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The influence of sensing element length of no-core fiber strain sensor has been studied and experimentally demonstrated, four different lengths of 125 μm diameter no-core fiber is fused between two standard single-mode fibers and bi-directionally strained, the highest obtained sensitivity was around 16.37 pm με -1 which was exhibited in the shortest no-core fiber segment, to the best of our knowledge this is the first study of the influence of no-core fiber strain sensors length on sensor sensitivity. The proposed sensor can be used in many opto-mechanical applications such as, structural health monitoring, aerospace vehicles and airplane components monitoring.

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Publication Date
Sun Jul 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of Barman model in acquiring the historical concepts among fourth-grade literary students
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The researcher attempts to examine Barman model in acquiring the historical concepts among fourth-grade students at literary classrooms. To this end, the researcher held the null hypothesis, there is no significant difference between the experimental groups who was taught based on Barman model and the control group that taught based on the traditional method in acquiring the historical concepts on the post-test. To testify the effectiveness of Barman model, the researcher administered a questionnaire included (60) items on bunch of female-students who were selected from al-khamaeal preparatory school in al-hurriyah district in Baghdad. The author utilized different statistical tools to analyze the collected data.    &

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Publication Date
Fri Jun 29 2018
Journal Name
Journal Of The College Of Education For Women
The Tasks of the Intermediate Schoolmasters in Reference to Time Administration according to Headmaster’s Viewpoint
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The aim of this research is to recognize the tasks undertaken by   the   headmasters   of   intermediate   schools   concerning   time- administration,   in   accordance   to   the   viewpoints   of   the headmasters   of   intermediate   schools   in   the   Administration   of Education   of   Al-Karkh   the   Third.   The   sample   of   this   research consists   of   (60)   headmasters   and &n

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