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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
Wed Jun 20 2018
Journal Name
Al-academy
Calendar curriculum material history of civilization in the design department
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The curriculum is considered one of the most important corners for the educational process, it participates in achieving the educational equilibrium between its elements.

The curriculum of (History of the Art) in the college of Art Education / dept. of plastic art education and ceramic as the other curriculums and due to the subject of history of the art develop the knowledge, taste and experiment for art studier also this subject has a direct relation with practical educational activities like colors and growth the knowledge of the student in field of contents and symbols and evidences of meaning in old , medium and contemporary arts, due to the fact that this curriculum has been applied since long time more than four years, and

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
The effectiveness of artificial intelligence in contemporary digital graphic design
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In our world, technological development has become inherent in all walks of life and is characterized by its speed in performance and uses. This development required the emergence of new technologies that represent a future revolution for a fourth industrial revolution in various fields, which contributed to finding many alternatives and innovative technical solutions that shortened time and space in terms of making Machines are smarter, more accurate, and faster in accomplishing the tasks intended for them, and we find the emergence of what is called artificial intelligence (artificial intelligence), which is the technology of the future, which is one of the most important outputs of the fourth industrial revolution, and artificial inte

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Publication Date
Thu Nov 01 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of the anatomical knowledge in undergraduate Nursing collage students
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Abstract Objective: The aim of this study is to evaluate the level of the anatomical knowledge of undergraduate students in Nursing collage/Baghdad university.Methodology:The sample was collected by symmetrical probability. Research sample includes (197)students represent four classes which is distributed as following: fifty students represent first class, fifty students represent the second class, forty nine students represent the third class,&fourty eight students represent the fourth class. Results:The study concludes that the anatomical knowledge level for collage students is intermediate .The m

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Publication Date
Sun Jan 01 2006
Journal Name
Journal Of The College Of Languages (jcl)
The Analysis of Errors Made by Iraqi Students in Writing
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Writing plays an effective role in developing one's thinking and
enhancing Learning. It is, in fact, a means of widening one's own views about
the world for the numerous uses that it can serve (Samuel, 1988:28).
In regard to the unquestionable significance of writing in the teaching –
Learning process, the traditional approach seems to be far from being able to
put such significance into practice. Traditionalists give priority to formulating
students' ideas before using prescribed rhetorical framework and then
submitting the written product for grading. Emphasis is, therefore, limited to the
prewriting stage where a certain topic is explored, and the role of the teacher is
confined to assigning the topic and

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Publication Date
Wed Mar 30 2022
Journal Name
College Of Islamic Sciences
The impact of Jurisprudence Rules in Addressing Contemporary security Challenges
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The impact of Jurisprudence Rules in Addressing Contemporary security Challenges

Islamic jurisprudence is related to various fields of knowledge, as it is a science of great value, great in impact, and among the most prominent features of jurisprudence comes the jurisprudence rules. It regulates the principles of the doctrine for the jurist. Therefore, the main this research focuses on (the impact of jurisprudence rules in addressing contemporary security challenges). It is the relationship between jurisprudence rules and achieving security. Its fruit would be a statement of the distinguished impact of jurisprudence rules on the stability of the country, and its leading role in maintaining, strengthening, and pre

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Publication Date
Wed Feb 01 2012
Journal Name
Engineering And Technology Journal
Determinants of E-Learning Implementation Success In The Iraqi MoHE
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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
Exploring the actual implementation of e-wallet application in Malaysia
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E-wallet, also referred to as digital wallet, is a software application designed to replace physical wallets, with the primary purpose of facilitating online transactions when users wish to make virtual payments. Nowadays, E-wallets are not limited to mobile applications, but they have also been extended to wearable devices, such as smartwatches, enabling users to make payments via their watches. This research study focuses on three main E-wallet service providers in Malaysia, namely TouchNGo E-wallet, Boost, and Grab pay, as they are the top three E-wallets in the country. The aim of this paper is to explore the real-world implementation of E-wallets among mobile phone users in Malaysia, employing the Technology Adoption Model as the th

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Publication Date
Sat Mar 01 2014
Journal Name
Computers &amp; Mathematics With Applications
Simultaneous determination of time-dependent coefficients in the heat equation
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Publication Date
Mon Mar 01 2021
Journal Name
Journal Of Applied Spectroscopy
SPECTROPHOTOMETRIC METHOD FOR THE DETERMINATION OF METOCLOPRAMIDE IN PHARMACEUTICAL FORMS
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A UV-Vis spectrophotometry method was developed for the determination of metoclopramide hydrochloride in pure and several pharmaceutical preparations, such as Permosan tablets, Meclodin syrups, and Plasil ampoules. The method is based on the diazotization reaction of metoclopramide hydrochloride with sodium nitrate and hydrochloric acid to yield the diazonium salt, which is then reacted with 3,5-dimethyl phenol in the presence of sodium hydroxide to form a yellow azo dye. Calibration curves were linear in the range from 0.3 to 6.5 µg/mL, with a correlation coefficient of 0.9993. The limits of detection and quantification were determined and found to be 0.18 and 0.61 µg/mL, respectively. Accuracy and precision were also determined b

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Publication Date
Wed Jun 30 2021
Journal Name
The Journal Of Contemporary Issues In Business And Government
The Role of Servant Leadership in Developing Management Information Systems
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The research aims to test the impact of servant leadership in management information systems, as well as to identify the level of servant leadership practice and management information systems in the Directorate of Communications and Information Systems in the Iraqi Ministry of Interior, in terms of the importance of the research variables to the directorate and the sample community, as the research adopted the exploratory analytical descriptive approach In his achievement, through a survey of the opinions of an intended quota sample of (266) individuals, By adopting the questionnaire as a main tool for data collection that includes (44) items divided into the two research variables, As well as conducting open interviews to identify the pro

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