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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 Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
Identifying the leading sector in the Iraqi economy through the interrelationships between sectors - applied research
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   Analyzing the size of the interrelationships between the main economic sectors in the Iraqi economy is an important necessity to know the impact of each sector on other economic sectors on the basis of the interrelationships and reciprocity between them, and what these relationships have achieved in terms of enhancing development and increasing the gross domestic product. To achieve the objectives of the study, we relied on mathematical (quantitative) analysis using user-product tables. Issued by the Ministry of Planning / Central Bureau of Statistics and Research (Directorate of National Accounts) for the economic sectors that make up the Iraqi economy. The study conc

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Publication Date
Sun Apr 17 2016
Journal Name
Al-academy
Conditions The chromatography in the design the positions waiting passenger transport buses: مصعب حسن عبد
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running the requirement color important place in object of life activity both public and private, Fallon makes represents energy expressive and aesthetic in designing furniture street, especially (positions waiting buses passenger transport)which took looms large in attention receiver designer also, through civilized development and urban and change the city. Requirement, The positions of waiting progress jobs service and that would interact to produces Photos aesthetic Furniture for space street and understand receiver, affect the operation his life and the development of his environment and his psyche and culture of because they entity variable and sophisticated, impose on us to find foundations a design and conditions of chromatic esp

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Publication Date
Fri Dec 31 2021
Journal Name
Political Sciences Journal
The development of Russian-Iraqi relations for the period (2011-2019)
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Receipt date: 12/28/2020 accepted date: 20/1/2021 Publication date: 12/31/2021

Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

Russia has emerged as a rising and influential power in the international arena, especially with Vladimir Putin's assumption of power and his desire for the rise of Russia and the end of the "unipolarism" represented by the hegemony of the United States of

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Publication Date
Sat Mar 30 2013
Journal Name
College Of Islamic Sciences
 The choices of Ibn Muqasim (354 AH) from the Qur’anic readings
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This research examines aspects of Imam Al-Qurtubi's efforts in matters related to the topics of faith that he dealt with in his interpretation (the provisions of the provisions of the Qur’an); and it has been shown that Imam Al-Qurtubi in most of the doctrinal issues dealt with in his interpretation approximates the doctrine of the Sunnis of Ash'aris, Maturids and people of impact. He had responses to some of the teams, such as stereoscopic, karami, and Mu'tazilite, reinforcing the responses with transfer and mental evidence.
    It was found that Imam Al-Qurtubi says that there is an increase in faith and a decrease in it, that the increase is through actions (so obedience increases and decreases in sin) and that the

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
The concept of sohba when the Golden Imam Through his books
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Scientists were interested in the statement of the concept of companions and the definition of the companion in terms of his status or his novel or inherent to the Prophet of Allah (peace be upon him) and was for those who did not walk in the translations and the abundant share in this work, and among these scientists Hafiz Shams al-Din al-Dhahabi, which was translated to the companions His books, indicating their status and effort, and who had a novel of them - what we will see in the folds of the research, God willing -

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Publication Date
Thu Nov 01 2018
Journal Name
International Journal Of Computing And Digital Systems
The Perception of Information Security Threats Surrounding the Cloud Computing Environment
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Publication Date
Thu Jan 30 2020
Journal Name
Journal Of Engineering
The The Optimum Reservoir Performance of Nahr Umr/Ratawi Oil Field
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Reservoir study has been developed in order to get a full interesting of the Nahr Umr formation in Ratawi oil field. Oil in place has been calculated for Nahr Umr which was 2981.37 MM BBL. Several runs have been performed to get matching between measured and calculated of oil production data and well test pressure. In order to get the optimum performance of Nahr Umr many strategies have been proposed in this study where vertical and horizontal wells were involved in addition to different production rates. The reservoir was first assumed to be developed with vertical wells only using production rate of (80000–125000) STB/day. The reservoir is also proposed to produce using horizontal wells besides vertical wells with pr

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Publication Date
Mon Sep 30 2013
Journal Name
International Journal Of Network Security &amp; Its Applications
Evaluating the Performance of the Secure Block Permutation Image Steganography Algorithm
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Recently, a new secure steganography algorithm has been proposed, namely, the secure Block Permutation Image Steganography (BPIS) algorithm. The new algorithm consists of five main steps, these are: convert the secret message to a binary sequence, divide the binary sequence into blocks, permute each block using a key-based randomly generated permutation, concatenate the permuted blocks forming a permuted binary sequence, and then utilize a plane-based Least-Significant-Bit (LSB) approach to embed the permuted binary sequence into BMP image file format. The performance of algorithm was given a preliminary evaluation through estimating the PSNR (Peak Signal-to-Noise Ratio) of the stego image for limited number of experiments comprised hiding

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Publication Date
Sun Jan 04 2015
Journal Name
Journal Of Educational And Psychological Researches
The Effect of the Problem Based Learning on EFL Learners’ Achievement
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The present study discusses the problem based learning in Iraqi classroom. This method aims to involve all learners in collaborative activities and it is learner-centered method. To fulfill the aims and verify the hypothesis which reads as follow” It is hypothesized that there is no statistically significant differences between the achievements of Experimental group and control group”. Thirty learners are selected to be the sample of present study.Mann-Whitney Test for two independent samples is used to analysis the results. The analysis shows that experimental group’s members who are taught according to problem based learning gets higher scores than the control group’s members who are taught according to traditional method. This

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Publication Date
Tue May 30 2006
Journal Name
Baghdad University
Unpublished Cuneiform Texts From The Reign Of The King Ammi Şaduqa
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The cuneiform texts considered one of the most important resources which play an important role help us to know how was the economic , politic and religious manner and every thing have relation of the history of Mesopotamia which contain many of information that enrich our knowldgement every side of Mesopotamia civilization since using writing as away to register the science and human knowldgement . The city of Sippar (Abu –Habba ) was one of most important city of ancient Mesopotamia which mentioned as one of first five Mesopotamian cities found before floating and it exposed through excavating rich one of them tablet which some of it dated to old Babylon period . The king Ammi-Saduqa has a big share of tablet we study number of thi

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