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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
Thu Jul 09 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
Strength Training and its Effect in Some Biochemical Variables in the High Jumping of Advanced Players
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Fri Jun 28 2024
Journal Name
Qualitative Research In Education
His job role is in theatrical sports performance in the Iraqi Ministry of Youth and Sports
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The research aimed to identify the level of job security, the level of sports institutional performance, and the relationship, contribution and impact of job security to sports institutional performance from the point of view of workers in the Iraqi Ministry of Youth and Sports. The descriptive approach was adopted in the manner of correlational relationships on a sample of (400) individuals who were randomly selected by (33.333%) of the employees working in the institutions at the headquarters of the Ministry of Youth and Sports, amounting to a total of (2293) individuals for the sports season (2022-2023), and they are naturally distributed among (13) main institutions in the formations of the headquarters of this ministry, and after adopt

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
American hegemony over the Persian Gulf oil After the 1991 Gulf War and the Gulf War III in 2003
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Since the end of World War II, the United States of America began to look at the Gulf States and Iraq due to the possession of huge quantities of oil, after taking the American oil depletion in order to tighten control over the oil of these countries, has pursued various means, political and military, in the framework of its strategy So that it could achieve this control, which focused on control of production and prices, for the conviction that those who control oil impose control over the political decision of the countries of the world.

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Publication Date
Sat Aug 01 2015
Journal Name
Journal Of Engineering
Values and technology in architecture - the impact and vulnerability
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Technology is an important factor for achieving architecture as an impact and vulnerability. It represents one of the significant elements in creating the intellectual framework, as well as having its own intellectual breakdown, while values constitute the most important and obviously factor of the community's intellectual. Research aims was determined accordingly by: investigating the role and impact of values and their relationship to technology in architecture.

In this context, the research investigated values and technology in architecture, through discussing their aspects and dimensions in architecture. In the context of values, the research discussed their concept and the related ones to have a concrete def

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Analytical Chemistry
A Spectrophotometric Method for Tetracycline Determination in its Bulk Powder and Pharmaceutical Formulations Using Flow Injection and Batch Procedures: a Comparative Study
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A reliable and environmental analytical method was developed for the direct determination of tetracycline using flow injection analysis (FIA) and batch procedures with spectrophotometric detection. The developed method is based on the reaction between a chromogenic reagent (vanadium (III) solution) and tetracycline at room temperature and in a neutral medium, resulting in the formation of an intense brown product that shows maximum absorption at 395 nm. The analytical conditions were improved by the application of experimental design. The proposed method was successfully used to analyze samples of commercial medications and verified throughout the concentration ranges of 25–250 and 3–25 µg/mL for both FIA and batch procedures, respecti

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Wed Dec 29 2021
Journal Name
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Impact of Electronic Games on the Increase of School Dropout among Students in the Basic Stage in Jordan from their teachers’ Perspective
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The study aims to identify the impact of electronic games on increasing the dropout rate among students in the basic stage in Jordan from their teachers’ point of view. The study adopted a descriptive survey method. Its community consisted of all fe(male) teachers of the basic stage in public and private schools, (First Amman, Irbid, and special education in Zarqa and Amman). The electronic questionnaire was used as a tool for the study. The results have shown that the effect of electronic games on increasing the dropout rate among students in the basic stage in Jordan was high. Besides, there are statistically significant differences due to the gender variable for males. There are statistically significant differences due to the varia

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Publication Date
Sat Dec 01 2018
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Political Sciences Journal
A study in Tunisian - Iraqi Relations and its role in determining strategies for dealing with conflict and peace situations
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If the State attaches great importance to its foreign relations and intends to strengthen them in order to ensure the achievement of the highest national goals and interests. External relations between countries are one of the most prominent features of foreign policy, which depends on a combination of internal and external factors, the modern relations between Tunisia and Tunisia, which goes back to the pre-independence of Tunisia, when Iraq was a supporter of Tunisia's independence from France in the 1940s, Although these relations did not cause any disturbance by the two countries, but they remained weak relations did not develop in all areas except the sports and cultural field, which we will determine the reasons and the pos

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Publication Date
Fri Mar 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Role of using the Relative Strength Index in Making Speculation Decision in Stock: Applied Research in the Iraq Stock Exchange
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 The relative strength index (RSI) is one of the best known technical analysis indicators; it provides the speculators by prior signals about the future stock’s prices, and because the speculations in shares of companies which listed in the Iraq Stock Exchange have a high degree of risk, like risk of shares prices felling, so the speculators became committed to use some methods to reduce these risks, and one of these methods is the technical analysis by using the relative strength index (RSI) which enable the speculators of choosing the right time for buy and sell the stocks and the right time to enter or leave the market by using the historical rice data. And from here the problem of the research formulated as “Is the using of

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Crossref
Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The tax planning and its effect on the investment: On sample of Iraqi Contribution Company
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The importance of the current study  lies in the  importance of the  Tax policy that  being considered one of the most important tools working on fulfilling  the  social,  financial  and economic  goals  and improving  the investment environment  in the country  to become  having the ability to  activate the  national economy. The current study  has  referred  that  (  Has  the  tax planning  practiced by  the Iraqi  contribution  companies  led to increase  the  far-term tax  outcome through  getting  benefit of   the monetary  funds  and expansion in&nbs

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Publication Date
Fri Jan 29 2016
Journal Name
Al- Mustansiriyah J. Sci.
The Approximate Solution of Newell Whitehead Segel and Fisher Equations Using The Adomian Decomposition Method
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In the present work, we use the Adomian Decomposition method to find the approximate solution for some cases of the Newell whitehead segel nonlinear differential equation which was solved previously with exact solution by the Homotopy perturbation and the Iteration methods, then we compared the results.

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