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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 Mar 06 2011
Journal Name
Baghdad Science Journal
Histological Structure of the Integument in Mastacembelus mastacembelus (Solander)
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The histological structure of integument in Mastacembelus mastacembelus have been investigated from skin fragments cut from nine regions at body surface. The results revealed that the integument of the fish investigated comprises three principal layers- the epidermis, the dermis (corium) and the subcutis-All the three principal layers may further be divided into secondary layers according to the function performed by their cells. The epidermis may further divided into three layers- the outermost epithelial coverage, the middle layer and the basal layer (stratum germinatiuum)-The dermis consists of a relatively thin upper layer of loose vascular connective tissue called the stratum laxum and a thick lower compact layer- the stratum compactu

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Analysis the Impact of Corruption on Investment in Iraq
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There are different types of corruptions such as administrative, political, economic and financial corruption. The corruption forms also varied such as bribery, nepotism and extortion. All types and forms of corruption play significant role in the all economic variables generally and on investments in particular, and the corruption used to be an intermediate means in reducing the rate of economic growth.  The corruption contributes in reducing the domestic investments via pay bribery by investors to officials’ persons for supplemental contracts and tenders which finally leads to reduction in the investment efficiency. The corruption also contributes in rise of operational costs for the investment projects.  In additio

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Publication Date
Wed May 18 2016
Journal Name
Al-academy
Actor performance features in the types of theatrical silent
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Publication Date
Fri Apr 28 2017
Journal Name
جامعة بغداد- كلية اللغات- قسم اللغة العبرية
The morphological construction of kitchen terms in Hebrew language
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This research sheds light on the morphological construction of kitchen terms in Hebrew language, especially methods of derivation, by offering an extensive review of the most important methods of morphological derivation. The field of kitchen terms is a fertile and rich field, where we see daily production of new kitchen tools which require suitable names with specific meanings. Morphologically, the research interested in methods of morphological derivation. So as to know and identify the common and effective methods to derive the kitchen terms in Hebrew language, in addition to put a special glossary of these terms. The research found that most of the kitchen terms were derived according to the methods of derivation prevailing in Hebrew la

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Publication Date
Fri Dec 30 2022
Journal Name
Journal Of The College Of Education For Women
The Role of Egyptian Workers in World War II
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The Egyptian labor movement is the oldest trade union movement in the Arab region. Beside, the labor movement in any society is, in fact, only a reflection of the extent of awareness of that class in that society. Such a comparison is based on the degree of social growth the working class has reached. Moreover, the Egyptian working class was characterized by modernity in its inception compared to other social forces and classes. In addition, its development is linked to the level of industrial development of the country. The peasants and craftsmen were the mainstay of production in the Egyptian society over several centuries. The labor union movement also represents the human aspect of the labor force when it encounters and interacts wit

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Publication Date
Sat Oct 01 2022
Journal Name
Al-adab Journal
The Triumph of Morality in William Shakespeare’s King Lear
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MORALS ARE THE MAIN PILLARS IN HUMAN'S LIFE

Publication Date
Thu Feb 01 2024
Journal Name
Baghdad Science Journal
The Role of Testosterone Level in Women with Osteopenia
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There is substantial data supporting the importance of both endogenous and exogenous estrogen in maintaining reproductive health and preventing chronic disease, androgens in women's health are rarely discussed. This is one of the first researches to investigate correlates of blood testosterone concentrations in women with osteopenia, in anticipation of the growing interest in the role of androgens in women's health. A 65 volunteer women were enrolled in the current study, they were divided into two groups, 35 postmenopausal women with osteopenia were in the first group, and the second group contained 30 postmenopausal women without osteopenia as a control. Blood samples were collected from all participants and analyzed for testosterone l

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Publication Date
Wed Sep 30 2020
Journal Name
Industrial Engineering &amp; Management Systems
Economic Analysis of the Financial Literacy Effects in G20
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ABSTRACT this paper extends the literature on the elements and effect of financial literacy by investigating the elements of financial literacy and the impact of financial literacy on financial inclusion and savings. This research confirms the results of researches of other economies but exposes some dissimilarities as well. The principal factors of financial literacy are discovered to be government efficiency, educational level, income, economic performance and infrastructure. Both education levels and financial literacy are found to be meaningfully and positively linked to financial inclusion and savings in G20 economies

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Publication Date
Mon Jun 01 2015
Journal Name
Journal Of The College Of Languages (jcl)
The Place of Reading Comprehension in Second Language Acquisition
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The present study aims to show the importance of ESL reading ability in acquiring English as a second language. The study involves 92 college students (males and females) from the Department of English at Nizwa College of Applied Sciences, Sultanate of Oman. They represent two groups, the foundation year students and the first year English majors. A number of tests were used to measure students’ overall proficiency in English as well as their reading ability (i.e., the ability to contribute to the main idea of the text, scanning, skimming, to derive word meanings from context, to use a dictionary to find meanings, definitions, to identify prefixes, antonyms and synonyms). Students’ ability to read was correlated to their proficiency

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Henry Tudor administrates The Throne Of England In (1485AD)
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The Era of Henry VII is the king who established the Tudor as they ruled England for
(24) years .He made drasfic changes in British Economy and the state of the country was
stable and secure.
Thes economic achievement of make him Qualified to be called The founder of the
modern English History .
On the basis of that significance to study one of the development stages of one of the
developed societies presently, i.e. the English society, this thesis came under the title (The
Internal Policy in England 1509-1547) to examine the overall political, economic and social
positions England passed through. The thesis also indicated the intensive labor state suffered
by the English society with all its sections, especial

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