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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
Fri Jul 05 2013
Journal Name
Hemoglobin
The Spectrum of β-Thalassemia Mutations in Baghdad, Central Iraq
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Publication Date
Wed Dec 15 2021
Journal Name
Al-academy
Employment of health materials in the internal administra-tive spaces
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 The internal administrative spaces of the interior designer formed an obsession for their development and for finding solutions and treatments to advance to enhance the state of adaptation for their employees by providing a healthy, appropriate and sound environment for work and production. . The first chapter focuses on laying theoretical foundations to show what health materials are used in the administrative spaces of the training directorates of the Ministry of Education in Baghdad. The second chapter dealt with the knowledge of health materials, their impact and effectiveness in the interior space, and the variables of their functional characteristics and their work in the interior spaces in a way that enhances the development of

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Publication Date
Sun Jun 03 2012
Journal Name
Baghdad Science Journal
Spectrofluorimetric method for the determination of glibenclamide in pharmaceutical formulations
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A sensitive spectrofluorimetric method for the determination of glibenclamide in its tablet formulations has been proposed. The method is based on the dissolving of glibenclamide in absolute ethanol and measuring the native fluorescence at 354 nm after excitation at 302 nm. Beers law is obeyed in the concentration of 1.4 to 10 µg.ml-1 of glibenclamide with a limit of detection (LD) of 0.067 µg.ml-1 and a standard deviation of 0.614. The range percent recoveries (N=3) is 94 - 103.

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Ellen Olenska’s Character in Edith Wharton’s The Age of Innocence
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Old New York was Wharton's term to describe this wealthy and elite class at the top of
the developing city's social hierarchy, a society which was utterly intent on maintaining its
own rigid stability. Even though, the roles of women in American society changed drastically
from 1820’s to 1860’s due to the civil war and such a progression was due in part to the
revolutionary thoughts. Women started taking their right to speak up openly and frankly and
become more like men. The role of many women had changed from being homemaker to
being able to provide for the family by either getting a job or start to be allowed to have a
voice. They had important roles not only in helping the family, but in sharing to rebuild th

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Publication Date
Sun Mar 06 2011
Journal Name
Baghdad Science Journal
The effect of Bacillus thuringiensis in Phthorimaea operculella (Zeller) (Lepetoptera:Gelechiidae)
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The following dilutions -710X46, -610X46, -510X46 of Bacillus thuringiensis were used for bioassay against the different larval instar of the potato tuber moth Phthorimaea operculella by the spraying method, the results showed that there was no significant influence in the percentage of egg hatching in comparison with the control. The sensitivity of larval stages was reduced with the increasing the age and exposure period. The study also showed that the larvae infected with B.t. stopped feeding, movement and a general paralysis causing the death of larva after (24-48) hours , and the larva color was changed from the natural waxy colour to brown finally to the black after death.

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Publication Date
Thu Feb 20 2025
Journal Name
Arab World English Journal For Translation And Literary Studies
The Impact of Culture in Translating English Idioms into Arabic
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This study sought to understand how critical cultural awareness was in translating English idioms into Arabic, particularly in political news where clarity and precision are paramount. The challenges that arise from the linguistic and cultural disparities between the two languages include differences in metaphor, image, and cultural reference. The study demonstrates, through the lens of Skopos Theory, how efficient translation relies on the function and intent of the text taking precedence over word-for-word equivalence and cultural context. Overall, the study establishes the need to transform idioms so that they better align with what is appropriate given the expectations of the audience. The results highlight the importance of inn

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Publication Date
Mon Jan 01 2024
Journal Name
Aip Conference Proceedings
Assessment of water quality in the shatt Al-Hillah river
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Publication Date
Wed Mar 01 2017
Journal Name
Neural Computing And Applications
The potential of nonparametric model in foundation bearing capacity prediction
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Publication Date
Sat Jan 11 2020
Journal Name
Dirasat, Human And Social Sciences
The translation of sexual puns in Shakespeare’s Hamlet into Arabic
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Publication Date
Mon Jul 01 2024
Journal Name
Journal Of Sustainable Studies
The Concept of Everlasting Childhood in John Barrie's Peter Pan
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The story of Peter Pan is considered one of the immortal tales that has been read and watched over many generations, and many of the events of the story have been changed over time to suit the time in which it will be read, and this is what will be discussed in this paper in addition to identifying the writer‟s life and the extent influence on Peter Pan. Time in the story of Peter Pan is particularly important because the story changes its events during that time in proportion to the era in which it is in, as there have been many changes in all events and characters to suit the reader. Through this paper, the researcher will come up with the life of the author and how his life affected Peter Pan‟s story, then a small summary of the stor

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