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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
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
The senses and their role in financial transactions
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This study aimed to clarify the legal provisions concerning the senses and their role in financial transactions, in the light of the definition of all the vocabulary presented by this study (senses - the definition of senses apparent: they are hearing - sight - smell - taste - touch) in the first section. The study deals with the second topic of the reference and writing denominator phrase and includes two requirements, the first requirement: the establishment of the denominator of the phrase, which has two branches: Section I: signal Akhras. Section II: Signal of the Spokesman.
 The second requirement is that writing takes the place of the phrase in financial transactions. The owners argue that the sale of the blind is correct a

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Publication Date
Tue Dec 06 2011
Journal Name
Journal Of Planner And Development
investment in the residential sector and its finacing
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Adopting a policy of attracting investments in all countries, whether developing or developed prevailed, especially after the global crisis, and this trend is imposed by considerations of political and development (urban, economic, and social) can be formulated as a rational policy to solve many problems related to patterns of urban growth, economic, social, and including the problem of housing. As the reality of the housing sector in Iraq will require the allocation of substantial resources to promote it by the research problem is the lack of financial resources and the inability of investments to meet the various requirements including the requirements of economic sectors, particularly in the field of housing, infrastructure an

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Publication Date
Sun Mar 12 2017
Journal Name
Al-academy
The aesthetic and communicative " dimensions in t.v photo"
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T.V photo in modern shows has emerged with special characteristics and signs that have developed in cope with the development of medium and technique. This leads to adding a variety of aesthetic dimensions which are capable of attracting audience because of its communicative elements that have an important role in increasing of T.V show Watching. As a result, the research is limited to methodological Framework as the problem. The problem of the research deals with emerging the aesthetic dimensions of T.V photo. The major question is (what are the aesthetic and communicative dimension of T.V Photo?). The research aims at finding out the aesthetic dimensions of T.V photo in modern artworks. The significance of the research on the presented

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Engineering
Modeling and Optimization the Influence of CO2-MAG Welding Parameters on the Weld Joint Shape Factors
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This paper represents an experimentalattempt to predict the influence of CO2-MAG welding variables on the shape factors of the weld joint geometry. Theinput variables were welding arc voltage, wire feeding speed and gas flow rate to investigate their effects on the shape factorsof the weld joint geometry in terms of weld joint dimensions (bead width, reinforcement height, and penetration). Design of experiment with response surface methodology technique was employed to buildmathematical models for shape factors in terms of the input welding variables. Thepredicted models were found quadratic type and statistically checked by ANOVA analysis for adequacy purpose. Also, numerical and graphical optimizations were carried out

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Publication Date
Sun Dec 09 2018
Journal Name
Baghdad Science Journal
Enhancement of the Tensile and the Compression Properties for Heat- Cured Acrylic Resin Denture Base Materials
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This work aims to investigate the tensile and compression strengths of heat- cured acrylic resin denture base material by adding styrene-butadiene (S- B) to polymethyl methacrylate (PMMA). The most well- known issue in prosthodontic practice is fracture of a denture base. All samples were a blend of (90%, 80%) PMMA and (10%, 20%) S- B powder melted in Oxolane (Tetra hydro furan). These samples were chopped down into specimens of dimensions 100x10x2.5mm to carry out the requirements of tensile tests. The compression strength test specimens were shaped into a cylinder with dimensions of 12.7mm in diameter and 20mm in length. The experimental results show a significant increase in both tensile and compression strengths when compared to cont

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
Effectiveness of Woman's Personality between the Public and Private Event the Novel Feminist Iraqi 2003 - 2013
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After we completed this book search we must extraction most important the findings.
Event of war a majar impact on same as all human being but signed and its impact in the
psyche of iraqi woman unparalleled result of the suffering that were produced by these wars
that contributed to the destabilization of Her life at all levels a woman has lost her father,
husband and son an brother as well as extreme poverty caused by the economic blockade
brought in to existence wars that exacerbated the suffering was the woman to work and
economic in order to provide a living for her and her family and pre – empt the dreams and
ambitions so he excelled writer Iraqi in portraying the succession of wars that ate every thing
and

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Publication Date
Wed Sep 01 2010
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Global Financial crisis and its impact on the performance of the Emerging Stock Exchange: الاردن نموذجا
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The research aims to explain the reality and the roots of the problem financial crisis and its impact on the performance of the Amman Stock Exchange, by testing three hypotheses, the first and the second relates to the performance of the Amman Stock Exchange and its sectors before and after the financial crisis. And the third examined the relationship between indirect foreign investment and the performance of Amman Stock Exchange.
     Hypothesis testing results of the first and second pointed to the existence of statistically significant differences for the performance of the stock market in general and in particular their performance for the period before and after the financial crisis. The third hypothesis resu

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
THE MEDIATING ROLE OF PRODUCT INNOVATION ON THE RELATIONSHIP BETWEEN MARKETING INFORMATION SYSTEM AND CUSTOMER ORIENTATION
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 Marketing information system (KMIS) is an essential factor of developing business’ performance and getting sustainable success. The main goal of the research is to measure effect of MIS on customer orientation and product innovation. Also, another goal is to analyze the mediation role of product innovation in relationship MIS and customer orientation. This study sought to analyze the marketing information system and measure its effect on the customer orientation and product innovation. The data of the study were collected using questionnaire. The data were analyzed using statistical tools and SPSS programming. The results of the study showed that the KMIS can positively and significantly effect product innovation. Also, t

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Publication Date
Tue Oct 11 2022
Journal Name
College Of Islamic Sciences
Directing Grammarians for Grammatical Dispute To Interpret and Explain the fourth part of the Holy Qur’an
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Abstract

 The miraculous of al-Quran has been surrounded by the attention of scholars, as it is the one that has astonished the rhetoricians with its eloquence. So , they paid attention to every part of it  and hugely they studied it with accuracy in respect to its Surah  ad Ayahs.   It is considered the most important source from which Arab scholars and early grammarians drew, given their unanimity that it is the highest degree of eloquence and the best record of the common literary language.

 

Among these sciences is the science of Grammar, and without Qur’an, this science would not have emerged, which later had control over every science of Arabic

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
The base does no harm And their impact on the employment contracts of Iraqi private universities
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One of the rules concerning the control of civil transactions is the rule of no harm and harm, which was enacted by our Holy Prophet Muhammad (peace be upon him and his family). Scholars singled it out by research and investigation, and classified by non-scientists independent messages, showing the status of al-Qaeda in terms of its perception, meaning, branches and results, and the importance of this rule in the payment of damage and compensation for it has been provided by the Iraqi legislator generous within the provisions of Iraqi law in all its branches of public and private, as applied The judiciary Iraq The provisions of this rule have been issued and numerous decisions have been made to compensate for the damage and to give to ev

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