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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 Dec 31 2017
Journal Name
College Of Islamic Sciences
The saying of Al-Azhar in the fatwas with it from the words of Imam Zafar (may God have mercy on him) by Imam Pirizadeh Al-Hanafi (d. 1099 AH)
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It is no secret to anyone that studying and investigating books of jurisprudence, despite their suffering, is a pleasure that cannot be compared to pleasure, and it has benefits and importance that cannot be limited and summed up, and it has great fruits that researchers and students of knowledge reap, as well as enriching libraries with jurisprudential material, after dusting them and taking them out to the light of libraries to be seen. Researchers and scholars, generation after generation, so that this nation can benefit from this pioneering intellectual and scientific product that was written for us by our first ancestors of working scholars who enriched human civilization with this scientific material, which has become a beacon guid

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Publication Date
Sun Dec 28 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Salivary Inflammatory Biomarkers (Interleukin-6, C - reactive protein) in Relation with Caries-Experience among a Group of 12 Year Old Obese Boys
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Background: Obesity and dental caries are multifactorial diseases related to poor eating habits and show a close relationship with the sociodemographic characteristics of individuals presenting these diseases. This research aimed to investigate the severity of dental caries among group of obese boys aged 12 year in relation to salivary interleukin-6 (IL-6) and C-reactive protein (CRP) of unstimulated whole saliva in comparison with normal weighted boys of the same age. Materials and Methods: The study group included 40 obese boys, with an age of 12 year. The control group included 40 normal weighted boys of the same age. The total sample involved for nutritional status assessment using Body Mass Index specific for age and gender according t

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluation of direct withholding tax procedures as a tool to increase tax proceeds : applied research in the General Tax Authority / Direct Deduction Department
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The research aims to evaluate the direct deduction department’s procedures for the process of collecting income tax using the direct deduction method for state departments and the public sector in light of direct deduction tax instructions No. (1) of 2007 and Income Tax Law No. (113) of 1982 (amended) through Giving a clear idea of ​​the reality of tax collection procedures because this type of tax is one of great importance because it contributes to the provision of financial revenues to the state to finance its expenses and direct the economy towards achieving its social, economic and political goals. The researcher makes comparisons between the procedures of the General Tax Authority in collecting the tax and what was approved b

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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of The College Of Languages (jcl)
Theoretical asp ects of trans lation of a lite rary text in the fram ework of lingu istic and cult ural analysis: Теоретические асп екты перевода художес твенного текста в рам ках лингвокультурологического ана лиза
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          The present art icle discusses the prob lems of understanding and translating the lingu istic and cult ural aspect of a foreign lite rary text. The article considers the trans lation process through the pr ism of cult ural orientation. In the process of transl ation, the nati onal cultural iden tity should be expressed to the max imum extent, through all me ans of expre ssion that include imagery and inton ation. In addi tion to the author's sty le, special atte ntion should al so be pa id to tro pes, phraseological uni ts, colloquial wo rds and dial&n

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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Proposal of Using Principle of Maximizing Entropy of Generalized Gamma Distribution to Estimate the Survival probabilities of the
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Abstract

In this research we been estimated the survival function for data suffer from the disturbances and confusion of  Iraq Household Socio-Economic Survey: IHSES II 2012 , to data from a five-year age groups follow the distribution of the Generalized Gamma: GG. It had been used two methods for the purposes of estimating and fitting which is the way the Principle of Maximizing Entropy: POME, and method of booting to nonparametric smoothing function for Kernel, to overcome the mathematical problems plaguing integrals contained in this distribution in particular of the integration of the incomplete gamma function, along with the use of traditional way in which is the Maximum Likelihood: ML. Where the comparison on t

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Publication Date
Tue Jan 01 2019
Journal Name
Plant Archives
Effect of different concentrations of bovine serum albumin on some of the frozen sperm characteristics of the rams
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This study was conducted in the Faculty of Agricultural Engineering Sciences - University of Baghdad in the field of sheep and goats in the Department of Animal Production. Effect of different concentrations of bovine albumin on some semen characteristics of frozen rams. Used in this experiment, 3 rams and their ages ranging from 2.5-3 years. The sample of the semen was diluted with Tris dilution with the addition of 10 ml of egg yolk per 100 ml, the sample by 1:1 with the tris and then the collection of sperm samples (Pooling) after the semen was divided into four treatments Control and bovine albumin at concentrations of 5, 7.5 and 10% and then complete dilution 10: 1, at 5C, dilution 20: 1, containing 5% glycerol per 100 ml. The results

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Scopus
Publication Date
Thu May 18 2023
Journal Name
Journal Of Engineering
The Impact of Varying of Structural & Formal Urban Types on the Coherence of Elements of Dense Urban Fabric
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Planning for a city with human identity considers the needs of human being that exist in the traditional cities where it was so easy creating place there, on the other hand, modern cities refuse these values and reduce the human characters of urban fabric elements , and the searching for the concept of " Urban Coherence " considers the knowledge about urban theory, especially Morphological attitudes finding three sides of making the coherence of dense urban fabric which are " Functional Complementarily , Formal Complementarily ,

Contextual complementarily “and the differentiation of these sides within the variety of spatial structural patterns between the organic type of traditional city and the gridiron type of modern city. To

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Publication Date
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Causes of maternal death in Mizan Aman and Gebretsadik shawo general hospitals from 2011 – 2015: A case - control study using propensity score matching analysis
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Objective: To identify causes of maternal death in Mizan Aman and Gebretsadik shawo general hospitals
Methodology: A case control study on 595 charts, 119 cases and 476 controls was conducted in Mizan
Aman & Gebretsadik shawo general hospitals. Data was analyzed by STATA 13.1. Propensity score
matching analysis was used to see causes of maternal death.
Results: Hemorrhage were the main direct causes of maternal death which accounts 47.9% (β =0.58
(95% CI (0.28,0.87)) in hospital but when projected to population based the sample (β =0.26 (95% CI
(0.22,0.31)). Followed by infection 36 (25.21%) (β = 0.50 (95% CI (0.08, 0.92)). when projected to
population based the sample PIH 7.6%) is significant cause (β = 0.16

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of some methods for estimating the parameters of the binary logistic regression model using the genetic algorithm with practical application
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Abstract

   Suffering the human because of pressure normal life of exposure to several types of heart disease as a result of due to different factors. Therefore, and in order to find out the case of a death whether or not, are to be modeled using binary logistic regression model

    In this research used, one of the most important models of nonlinear regression models extensive use in the modeling of applications statistical, in terms of heart disease which is the binary logistic regression model. and then estimating the parameters of this model using the statistical estimation methods, another problem will be appears in estimating its parameters, as well as when the numbe

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Publication Date
Wed Mar 18 2020
Journal Name
International Journal Of Research In Social Sciences And Humanities
THE EFFECT OF USING THE SCHOOL THEATER ON LEARNING SOME SKILLS OF THE GROUND MOVEMENT MAT GYMNASTIC ART FIFTH GRADE PRIMARY
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