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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 Dec 31 2020
Journal Name
Political Sciences Journal
The Trade War Between the United States and China and Its Impact On the World Economy2017-2019
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The trade war, of course, leads to a sharp tension in international relations because the economy is the lifeblood of the states. In the world of trade and economy, countries began to lean towards cooperation. Economic relations after World War II were more liberal, trade barriers were removed and global trade became more flexible and smooth

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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
The Problem of Political Empowerment of Women with Disabilities in Light of Iraqi Legislation
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Democracy in any country is measured by the cultural, social and economic level reached by women in it in general and women with disabilities in particular, and the extent of their participation in political life and political decision-making. As a result of the patriarchal power that societies have known, including Iraq, history has witnessed multiple types and forms of discrimination against women, which differed from one country to another, this matter has pushed women and since the beginning of the last century the issue of women's rights has been raised at the global, regional and national levels, through holding international conferences and agreements In order to empower women in all social, economic and political fields.

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Re-distribution of income in favor of the poor - theoretical entrance of stagnation treatment
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Research deals the crises of the global recession of the facets of different and calls for the need to think out of the ordinary theory and find the arguments of the theory to accommodate the evolution of life, globalization and technological change and the standard of living of individuals and the size of the disparity in income distribution is not on the national level, but also at the global level as well, without paying attention to the potential resistance for thought the usual classical, Where the greater the returns of factors of production, the consumption will increase, and that the marginal propensity to consume may rise and the rise at rates greater with slices of low-income (the mouths of the poor) wi

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Gravimetric Estimation of Caffeine in Different Commercial Kinds of Tea Found in the Iraqi Market
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          Caffeine (1,3,7-trimethylxanthine), which is the most widely consumed stimulant in the world, had been isolated and estimated gravimetrically in fifteen  different commercial kinds of tea found in the Iraqi market.The kinds of tea were chosen according to their differences in the degree of fermentation and the method of processing i.e. black , gray and  green . The isolated caffeine was identified by melting point, sublimation, TLC, chemical tests, UV , IR , HPLC and CHNO analysis.                                 &nb

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Strategic audit in detection of financial corruption cases in Iraq - Proposed Framework
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This research focuses on detecting the financial corruption cases in Iraq in light of adoption the strategic audit, the paper deals with the problem of the proliferation corruption cases particularly financial in Iraq and dramatically in the presence of audit and control devices as well as inspection and integrity devices, which indicates the existence of deficiencies and weaknesses in those devices in the implementation of audit and control functions in order to detect the corruption cases in the economic units in Iraq.

Stems objective of this research through the provision of approach of strategic audit concepts and indicate the extent importance of adopting of strategic audit as a means to detect the f

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Publication Date
Mon Apr 15 2019
Journal Name
Journal Of Global Pharma Technology
The dual role of Gentamicin in gene expression of fibronectin binding proteins in Staphylococcus aureus
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Objectives: The current work aimed to reveal the impact of gentamicin on the fibronectin binding proteins (fnbp) gene expression and its relation to biofilm and agr type in Staphylococcus aureus. Materials and Methods: A total of 25 S. aureus isolates were enrolled in this study previously isolated from different specimens. Identification confirmation and methicillin resistance were achieved by amplification of 16SrRNA and mecA. Multiplex polymerase chain reaction (PCR) based assay was employed to evaluate the agr typing. The gene expression of fnbA and fnbB genes was tested by real-time PCR technique. Minimum inhibitory concentration was estimated by micro broth dilution methodology. Microtiter plate method was performed to determine the a

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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of Law And Political Sciences
CONDITIONS OF COMPULSORY SALE AND THE RIGHT TO BE COLLECTING
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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The Kinetic responses and foraging behavior of Drosophila melanogaster larvae
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Adaptive responses in larval behavior may be of two kinds: Taxis: This involves a change in direction relative to source of a stimulus. Kinesis: Kinesis has no directional component, but involves change in the rate of performance in response to a stimulus. Drosophila larvae exhibited flexible behavioral responses associated with food acquisition and selection for different environmental conditions. In this investigation, we are concerned explosively with kinetic responses to food viability. Third instar larvae were subjected to test for thirty minutes in each of the following conditions i) in distilled water, ii) in Ringer's solution, iii) in glucose solution and on live yeast suspension. In each case the larva was in a thin layer of solu

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Publication Date
Sat Apr 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Evaluating the Performance of Combined Equipment (RAU) and Field Tested
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Abstract<p>An experiment was carried out evaluate the performance of RAU combined equipment under three levels of practical speed, (V1) 4.06 km. h<sup>-1</sup>, (V2) 4.43 km. hr<sup>-1</sup> and (V3) 5.76 km. hr<sup>-1</sup>, and three levels of depth with 10,20and 30 cm. It is denoted by D1, D2, D3 respectively. A split plot design was used within the RCBD design with three replications. The experiment results showed that the first practical speed 4.06 km.hr<sup>-1</sup> achieved the lowest slippage percentage from 9.61%, lowest traction power 14.65hp, lowest soil penetration resistance to1.34 kg.cm<sup>-2</sup>, and the highest total operating </p> ... Show More
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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Causes and Effects of Earnings Management on Stock Prices
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This study uses the performance of the discretionary estimation models by using a sample of listed companies in the Netherlands and Germany. The actual accounting framework provides a wide opportunity for managers to influence data in financial reporting. The corporate reporting strategy, the way managers use their discretionary accounting, has a significant effect on the company's financial reporting. The authors contribute to the literature through enhancement to these models to accomplish better effects of identifying earnings management as well as to present evidence that is particular to the Dutch and German setting.

For this, we followed the methodology of Dechow, Sloan, and Sweeney (1995) and Chan

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