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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 Nov 01 2020
Journal Name
The Iraqi Journal For Information And Documentation Studies
Smart Libraries and Their Applications in The Arab World
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The main aim of conducting this research is to identify the applications of Smart libraries in the Arab world. The Researcher relied on the documentary and Survey approach to collect information and data through the Internet, and to get to know these libraries. Then the Research came in three sections dealing with the first topic: The general framework of the study. The second topic deals with: introducing Smart libraries and indicating their types and characteristics. The Third topic dealt with the requirements of Smart libraries'application by identifying the basic components of it (Smart building, Smart Librarian , Smart devices, systems and software, Smart information sources,and Smart beneficiaries), and dealt with Smart libraries appl

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Publication Date
Wed Jun 20 2018
Journal Name
Al-academy
Spatial transformations and visual construction in the contemporary theater
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The current research deals with the subject of spatial transformations and visual construction in contemporary theater. How the visual system works to create spatial diversity in the contemporary Iraqi theater performance and how visual construction contributes to a spatial development process capable of building a tourism system that creates an architectural architecture that leaves the topography of the scriptural architecture. And the production of various indications and patterns in the scene of theatrical presentation in order to produce the new foundational meaning by creating a new structure that leads to diversity and diversity in the visual system and the beginning of visual constructions and their applications. Knowledge and te

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Crossref
Publication Date
Mon Jun 03 2024
Journal Name
International Journal Of Social Trends
Digital Literacy and Its Importance in the Modern Workforce
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Digital literacy is crucial in the modern workforce, where technology plays an integral role in daily operations. This abstract explores the significance of digital literacy in enhancing productivity, efficiency, and competitiveness in the workplace. Digital literacy encompasses the ability to use and navigate digital tools and platforms effectively, including software, applications, and online communication tools. In today's digital age, employers increasingly value candidates with strong digital skills, as they are better equipped to adapt to rapidly evolving technologies. This abstract highlights the importance of digital literacy in empowering employees to perform tasks more efficiently, collaborate seamlessly, and innovate effecti

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Publication Date
Thu Feb 02 2023
Journal Name
Journal Of The College Of Basic Education
Context and conveying meaning in the Iraqi theatrical show
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يشكل السياق جانبا مهماً في فهم الخطاب والمقصود هنا العرض المسرحي، من خلال ما يمده السياق للمتلقي من مؤشرات، يتم الاعتماد عليها في استكمال المعنى الظاهر بالمعنى المستتر، فالسياق يعتمد في الاصل على المحيط المادي الاجتماعي الذي يتم فيه التواصل وفيه يتعرف المرسل والمتلقي أحدهما على الآخر وتتبلور الصورة التي يحملها الطرفان أحدهما عن الآخر، الى جانب كونه يمثل الاحداث التي سبق لهما أن عاشاها والتبادل القولي

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Publication Date
Thu Jun 30 2011
Journal Name
Al-khwarizmi Engineering Journal
The Effect of the Solution Heat Treatment on the Mechanical Properties of Aluminum-Copper Alloy (2024-T3) Using Rolling Process
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The effect of solution heat treatment on the mechanical properties of Aluminum-Copper alloy. (2024-T3) by the rolling process is investigated. The solution heat treatment was implemented by heating the sheets to 480 C° and quenching them by water; then forming by rolling for many passes. And then natural aging is done for one month. Mechanical properties (tensile strength and hardness) are evaluated and the results are compared with the metal without treatment during the rolling process. ANSYS analysis is used to show the stresses distribution in the sheet during the rolling process.  It has been seen that good mechanical properties are evident in the alloy without heat treatment due to the strain hardening and also the mechanical

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Publication Date
Thu Dec 01 2022
Journal Name
Al-kut University College Of Humanities
The values ​​of environmental sustainability among the student-teacher at the College of Education for Pure Sciences, Ibn al-Haytham
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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The Level of Academic Achievement and its Relationship with Some Characteristics of Female Students at College of Education for Girls in Baghdad University: The Level of Academic Achievement and its Relationship with Some Characteristics of Female Students at College of Education for Girls in Baghdad University
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Abstract

Personality is one of the most important elements that should be developed in university student. Thus, we have to develop the positive traits and neutralize the negative traits of students as well as we have to pay attention to the level of student achievement at the same time, the researcher designed a scale to measure the traits of study sample. The research come out with a number of recommendations and proposals, the most important of which Enhancing the positive characteristics of university students in order to reach them to the level of mature personality with mental health. Enhancing the positive role of the high level of achievement by motivating the stude

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of The College Of Education For Women
The Warning Messages of Jeanne DuPrau’sThe City of Ember to the World with Reference to Gil Kenan’s Film Adaptation: The Theory of Conspiracy
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The City of Ember is a very interesting novel that is although intended for young readers, have so many layers and messages that are misunderstood. In this research, both the novel and the film adaptation are studied with the intent to decode the warning messages that the novelist and the director tried to introduce to the audience. The research studies four vital messages; the first message is that history repeats itself for the novel has many allusions to the history of Jews and their painful holocaust and even goes back in history the days of Moses and the Exodus, the second message tackles the conspiracy theory that states nothing happens by accident and that everything is planned and connected hence comes the third message

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Effect of IFRS 16 on the quality of financial reporting For the Iraqi economic units Applied to the General Company of Iraqi Airways
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The rental activity receives "significant" interest from accounting organizations interested in issuing accounting standards worldwide, such as the Financial Accounting Standards Board (FASB), the International Accounting Standards Board (IASB). As leases represents an important source of finance for economic units as an alternative to financing assets through purchase or borrowing. Professional organizations have focused on addressing the situation of extra-budgetary funding through which the lessee hides many leases that are classified as financing without It shows in the budget, which gives an incorrect picture of the reality of the financial situation of economic unity, IASB has issued IFRS 16, which terminates off- Balance s

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Crossref
Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
The current research aims to identify the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham
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  • Identifying the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham.
  • Identifying the statistically significant differences in the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham according to the gender variable.
  • And the descriptive approach was used, due to its relevance to the nature of the research objective.

    To verify this, the visual culture skills test consisted of (22) items of the multiple choice type, where the (Koder Richardson 20) equation was applied to calculate the stability of the visual culture skills test. For the skill of writing

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