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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
Tue Jun 30 2015
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Indicators Trends Of Populaion Structure Composition In Iraq And Their Relationship With Dependency Rates For The Period (1986-2010).: Indicators Trends Of Populaion Structure Composition In Iraq And Their Relationship With Dependency Rates For The Period (1986-2010).
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Iraq within the ranks of the fledgling communities characterized by a broad base of the population pyramid, because they pose the age group (under 15 years) of a large proportion of the community, as it exceeded the proportion (40%) during the years of research extended (1986-2010) Despite the relative decline in the rates fertility during that period, but the proportion of young people remained high, especially for groups of at least five years, amounting to about 14% in 2012, a little more than the proportion of what constitutes age group (5-9 above) years, where it was (13%) and this naturally predicts continuing population increases in coming decades, due to the entry of those numbers of individuals in the reproductive stage,

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Publication Date
Tue Dec 15 2020
Journal Name
Al-academy
Treatments with Graphic Techniques for the Scene in Theatrical Show (Applied study): عماد هادي عباس -محمود جباري حافظ
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The current research studies the digital techniques in order to identify the treatments with graphic techniques for the theatrical scene, which includes a number of programs and treatment tools with digital technique to identify the visual and aesthetic dimensions and outputs achieved in the design of the theatrical scene in addition to the options, that they provide in the design of a system of hypotheses for the theatrical world, In order to be an experimental mediator in achieving the creative hypothesis, which limited the research with a pivotal objective which is: identifying the digital techniques employed in the graphic digital design for the scene in the theatrical show. The research lies in its objective limits stated in the met

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Publication Date
Sun Sep 04 2016
Journal Name
Baghdad Science Journal
A Combinatorial Approach to Obtain the Yield Probability Distribution along a Linearly-Loaded Cantilever Beam
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The substantial key to initiate an explicit statistical formula for a physically specified continua is to consider a derivative expression, in order to identify the definitive configuration of the continua itself. Moreover, this statistical formula is to reflect the whole distribution of the formula of which the considered continua is the most likely to be dependent. However, a somewhat mathematically and physically tedious path to arrive at the required statistical formula is needed. The procedure in the present research is to establish, modify, and implement an optimized amalgamation between Airy stress function for elastically-deformed media and the multi-canonical joint probability density functions for multivariate distribution complet

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Publication Date
Sun Jan 24 2016
Journal Name
Al-academy
The Instagram from a media tool to a marketing tool: بتول السيد مصطفى جواد أحمد
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The subject of this study is one of the most interactive media networks, which is the Instagram.The study uses a descriptive approach and focuses on how Instagram turns from a media tool to a marketing tool. The study problematic consists of this question: How Instagram turns to a marketing tool, and what are the advantages and the disadvantages for that?This study highlights the definition of Instagram, the creation of it and its improvement, the Instagram in Bahrain, the Instagram uses, the Instagram as a marketing tool, and the advantages and disadvantages of using Instagram for marketing.The study confirms that Instagram is a new media network, and focuses on how it develops on later stages and mentions the increase of the percentage

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Publication Date
Thu Sep 28 2023
Journal Name
International Journal Of Membrane Science And Technology
Morphological and Anatomical Study of Some Species of Ziziphus L. (Rhamnaceae) Growing in Iraq
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The genus Ziziphus is one of the Family Rhamnaceae and consists of more than 170 species distributed in tropical and subtropical regions. All the species in the genus are of economical and medical importance. This study was conducted to identify the morphologically and anatomically features of the genus in Iraq.  The field survey was conducted across the study area where 4 species (Ziziphus jujube, Z. mauritiana, Z. nummularia and Z. spina-christi) were collected and used in the study.  The result showed that there is variation in morphological and anatomical features among the species in the stem cross-section and longitudinal section of leaves also the differences appeared in the epidermis of leaves.

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Publication Date
Thu Dec 02 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Study of Prevalence of Placenta Previa and Circumstances among Pregnant Women in Fallujah Hospital
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Placenta previa refers to placenta which is totally or partly implanted in lower segment of the uterus. Mortality and morbidity of mother increase with placenta previa due to the increase in the incidence of bleeding during pregnancy. This study aims to define placenta previa prevalence among pregnant women at AL-Fallujah teaching hospital and to determine the risk factors and their association with placenta previa incidence in al-Fallujah city population. This retrospective cohort study investigated medical registry of 6339 gravid women in al-Fallujah teaching Hospital in Iraq. We find 13 cases of placenta previa (0.21%) amongst the 6339 cases registered. The risk factors that strongly appeared to affect the complication of pregnancy with

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of an Educational Unit According To the Constructive Strategy in Developing Thinking Skills for Fifth Primary Students
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    The current phase distinguish by the rapid scientific development, which pushes individuals to have the necessities of scientific and practical life through the proper scientific thinking which contribute to the development of invention and creativity away from memorizing and indoctrination and encouraging individuals to looking for information and then attempting to process and develop these information instead of being a passive receiver. The investment of minds becomes the logical investment in all societies by preparing the citizen to become able to face life changes and its necessities. It is very important to take care of individuals and develop their mental abilities and thinking skills. The constructive strateg

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Publication Date
Thu Apr 01 2021
Journal Name
Annals Of The Romanian Society For Cell Biology
Rehabilitation exercises accompanying ultrasound in the rehabilitation of the elbow joint for patients with tendinitis, aged (30-40) men
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The elbow joint is one of the important and mobile joints in a way that allows it to perform its functions. The injury occurs when the joint tendon and arm muscles are subjected to repeated partial ruptures as a result of excessive and repetitive work, as well as the patient not being subjected to correct rehabilitation programs, and only rest. From here, the researchers decided to study this problem by preparing rehabilitation exercises accompanying ultrasound and assessing their impact on the rehabilitation of the elbow joint. The sample included male patients aged 30-40 years, and the tests were determined, which included testing the range of motion of the elbow joint from the flexion position and the rotation outward position, the mu

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Publication Date
Sun Dec 15 2019
Journal Name
Al-academy
Creativity in the Draping on the mannequin of Young Girls Victorian Fashion between 1860-1890: نجلاء إبراهيم بن حمدان
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The history of civilizations in the past centuries is a rich source for creativity and inspiration in all areas of art and design, especially in the field of fashion design. Many designers draw their designs from previous eras; which is the aim of this research as we propose designing fashion the mannequin for the category of young girls aged between (10-18). The costumes were inspired by Victorian women's costumes during the time period (1860-1890) and were subdivided into three time periods (1860-1870), (1870-1880), (1880-1890) forming three designs for each time period , analyzing the nine designs to achieve the creative , functional and aesthetic aspects that are appropriate for the age group (research sample). The importance of the

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of progressive income tax on inflation in Iraq for the period from 1995 to 2020 : applied research
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                Inflation is one of the important issues that the economic authorities in all countries of the world care about, where the loss of money for its function is one of the most important and largest inflationary effects that this phenomenon leaves on the economy, and Iraq, like other countries, has had its share of the problem of inflation for a long time due to the circumstances that He went through it, whether it was the wars he fought or the economic blockade that was imposed on him in the nineties of the last century. Economically, the problem of inflation is addressed through the use of fiscal policy tools, including tax increases in order to abso

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