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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 Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
A comparison between Bayesian Method and Full Maximum Likelihood to estimate Poisson regression model hierarchy and its application to the maternal deaths in Baghdad
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Abstract:

 This research aims to compare Bayesian Method and Full Maximum Likelihood to estimate hierarchical Poisson regression model.

The comparison was done by  simulation  using different sample sizes (n = 30, 60, 120) and different Frequencies (r = 1000, 5000) for the experiments as was the adoption of the  Mean Square Error to compare the preference estimation methods and then choose the best way to appreciate model and concluded that hierarchical Poisson regression model that has been appreciated Full Maximum Likelihood Full Maximum Likelihood  with sample size  (n = 30) is the best to represent the maternal mortality data after it has been reliance value param

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Publication Date
Thu May 01 2025
Journal Name
Iraqi Journal Of Humanitarian, Social And Scientific Research
Portuguese Colonial Policy in Brazil in the Sixteenth and Seventeenth Centuries
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Over the course of two centuries, Portugal emerged as one of the most powerful European empires, with colonies stretching from Asia and Africa to Brazil. A significant factor in this expansion was the role of winds, which carried one of Cabral’s ships westward, landing unexpectedly on unknown shores—the Brazilian coasts. These territories later became some of Portugal’s richest and most important colonies. Therefore, the study begins in the 16th century and concludes at the end of the 17th century. The study was divided into four sections. The first section addressed Portugal's discovery 0022 of Brazil and its naming before it gained economic importance. The second section discussed the Portuguese occupation of Brazil in 1530 and its

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Publication Date
Tue Oct 06 2020
Journal Name
College Of Islamic Sciences
Distress Tolerance among the Employees in Media and Communication in Baghdad.
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Abstract: The aim of this study was to identify the Distress Tolerance among the Employees in  Media and Communication in Baghdad.and to identify the significance of the differences between sex ,scientific specialization ,age,and marital status. and the researcher used the Distrees  Tolerance measure for Simon &Gahar 2005.  The sample of the study consisted of(37)Employees.The Scale of Distrees Tolerance were used as the study tools after being checked for their Validity and Reliability. The research results indicated that employees have high scores on the scale of stress tolerance and that there are statistically significant differences between the age groups and between married and unmarried people a

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Publication Date
Sat May 16 2009
Journal Name
Journal Of Planner And Development
Information technology and replacement system in decision-making in the city
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IT has its impact on all aspects of life, including its planning and operations. Based on the assumption that the plan can adapt any technique as an analytical tool within broader dimensions to include society in general and meet the requirements of that society. They have neutral values, meaning and usefulness rather than being adopted as abstract goals or objectives so that the planner or the decision-maker can benefit greatly from them. This information technology is summarized in three main axes: First: Geographic Information Systems. Second: computer modeling. Third: visual simulation and the Internet. The problem of research is that the decision-making environment of the plan is surrounded by uncertain information-planning conditio

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Analyzing the content of the two science books (the two chemistry units) for the intermediate stage according to environmental problems
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    The main goal of the current research is to know -Environmental problems included in the content of the two science books (chemistry units) for intermediate stage

A list of environmental problems had been prepared  and  consisting of (8) main areas which are (air and atmosphere pollution, water pollution, soil pollution, energy, disturbance of biodiversity and environmental balance, waste management, food and medicinal pollution, investment of mineral wealth). Of which (60) sub-problems,  at that time the researcher analyzed the two science books (two chemistry units) for the intermediate stage of the academic year (2020-2021) in light of the list that was prepared, and the validity and consisten

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Publication Date
Sun Sep 03 2017
Journal Name
Baghdad Science Journal
Study of epidermis characters and venation of certain species of Medicago L. in Leguminosae (Fabaceae) family in Iraq
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The anatomical study of the epidermis leaflet for seven species and variety wild belonging to the genus Medicago L. species are: M. constricta Dur., M. coronata L., M. intertexta L., M. intertexta.var. ciliaris L., M. laciniata L., M. lupulina L., M. minima L. and M. sativa L. were studied, The search included epidermis characters and stomatal complexes addition to venation system in leaflets. It is revealed through the study, epidermis leaflet type Amphistomatic (the stomata spread on the upper and lower surface) as well as the presence of three types of stomatal complexes namely: Anisocytic (the guard cells surrounded by three unequal cell size), Anomocytic (not differential from subsidiary cells in epidermis) and Anomotetracytic (four ce

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Faithful representation of accounting information according requirements width financial statements depending on international standard (IFRS-15) revenue from contracts with customers: Applied research in a sample of the joint stock companies listed on the Iraq Stock Exchange
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This study seeks to identify the possibility of achieving the property of faithful representation of accounting information and measure it by using the standard approach based on mathematical and statistical equations by comparing two financial periods before and after the application of (IFRS-15) Revenue from contracts with customers, during the period. (2014-2018), for the financial statements of the mixed joint stock companies listed on the Iraq Stock Exchange, which is one of the main pillars of the economic structure of the country, as a joint investment between the state and the private sector, and has importance in many aspects, including support for projects of public companies, S Absorption and employment of labor, as well as ra

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Leadership Skills and their Impact on Strategic Planning: Applied Research in the Iraqi Ministry of Planning
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The present search addressed the " leadership skills and their impact on strategic planning " Where has the objective of leadership skills and strategic planning of increasing importance at the present time , for being fairly modern topics ,which have a tremendous impact on the success of organizations..                                                                        &n

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Publication Date
Sun Sep 06 2015
Journal Name
Baghdad Science Journal
The age-specific fecundity life tables of Planococcus citri Risso and important predators attack in Baghdad
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Reproduction potential and age –specific fecundity of the Mealybug Planococcus citri Risso were studied in the laboratories of Biological control research unit,college of Agriculture –Baghdad university at 25± 2Cº and 60-70% R.H.with 16 light:8 dark photo period.The results showed that the survival ratio began to decline at the 38th day, the average female age was 20 days ,while the average age was 8 days at the first reproduction . Net reproduction rate ( Ro ) was 58.59 female female generation which prove that the population of the mealybug was of the unstable kind , intrinsic rate of increase (rm) was 0.118 femalefemale and the average length period of generation ( T ) was 34.30 days . Many local predators attack the mealybug

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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Al-nahrain University
Histopathological Studies of the Liver and Kidney in Mice Fed on Smut Wheat Infected with Tilletia
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The current study was designed to investigate the effect of Tilletia smut spores on histopathological changes in liver and kidney in mice. Twenty animals were divided into two equal groups, 10 mice each, control group fed on normal diet and the treated groups were fed on a mixture of 50% normal diet with 50% wheat infected with Tilletia for 30 days. Histopathological sections taken from liver and kidney treated with Tilletia revealed several alterations. The changes in liver included, multiple granulomatous lesions, area of coagulation necrosis, vacuolar degeneration in the cytoplasm of hepatocytes, proliferation of hepatocytes with formation of pseudolobull which initiates for procancer. Whereas in the kidney, the changes included

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