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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
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
DOMINATION OF CONTENT OVER FORM IS ONE OF THE PROBLEMS OF CHILDREN’S STORIES IN IRAQ
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The stories of children in Iraq during the past two decades have received a number of important scientific studies. Despite tyranny of the historical study method on most of these studies, they have been and still are very important, because they have established a chronicle of this literary style that has been neglected and based not only on the academic level and serious in-depth university studies but also on the enclosed sight that doesn’t consider studied art as an innovation with its specificity and its typical technical components. While many of the public impressions and self-reflections contributed to the dominance of some of the provisions and concepts that were circulated as critical remarks and adopted by som

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Publication Date
Sat Jan 12 2019
Journal Name
Journal Of The College Of Education For Women
Strategic Analysis for the Grain Grinders' establishments in Baghdad governorate and problems suffered by the industry, along with the possibility to predict its products
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Geography of industry has been considered a branch of important economic geographical branches. This importance has been regarded as a reflection on the industrial sector contribution in economies of any state since they contribute into the total national product ; it also assimilates a huge number of labor hands . The industry of grains grinding has been considered as one of the main food industries having a main role in satisfying the need of the population from the foods. The industry is continued to use the food as daily meal . Here, it should predict the population in Baghdad and for every district until the end of 2025 and knowing either these grains grinders are able to meet and satisfy the needs of populations of flours, making s

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Publication Date
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
ADVERTISEMENTS IN THE CINEMA STARTING FROM THE MID 20TH CENTURY
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At the time when many important political events and evolutions took place, the cinema has been pretty active, and witnessed the historical events before and after the two world wars and the cold war. During the first half of the 20th century, the cinema had great interest from the major countries and their politicians, as well as the commercial turnout of large companies to invest in that field for the profits.  In the beginning of the 20th century, the major powers like the Soviet Union, the United States, Germany, Italy, England, and France started to compete in the development of their film industry and the investment of the new medium and the transformation of some famous works of fiction into films that perpetuate their cultur

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Publication Date
Tue Jan 01 2019
Journal Name
Plant Archives
The seasonal effect on the water bodies in Iraqi marshlands
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Publication Date
Wed Mar 30 2022
Journal Name
College Of Islamic Sciences
What are the unique words used in the Holy Qur’an
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Summary:
We are aware that we cannot reach a correct level of understanding of the Arabic language without using the Quran as our main source in our research. Since the word of the Quran that put an end to all words which kneeled before it all the phrases that lead to the showcasing of the Arabic language in its best self.
Arab scientist realized this truth and gave all their attention to the singular and created from it an important subject for their research in the origins of the language and the science behind. Thus, since they dealt with the structure and studied the significance of the context through the use of vocabulary. Therefore, researching Islamic words or the “surat” mentioned in the Qur’an was necessar

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Publication Date
Thu Dec 15 2022
Journal Name
Al-academy
Directing treatments to employ the place in the theatrical performance
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The most important topics that constitute the aesthetic and substantive aspect of the theatrical performance represented by the spatial environment of the presentation and the proposed virtual place that contains the technical and artistic elements of the presentation and highlights the strength of influence on it. In light of the above, the researchers divided the topic into four chapters.

The first chapter contained (the methodological framework), which included the research problem with regard to the directing treatments between the directors in establishing or creating theatrical venue, the importance of the research and the aim of the research, and the limits of the research to conclude the chapter by defining the terms.

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Publication Date
Tue Mar 22 2022
Journal Name
Journal Of Al-turath University College
The Turkish role in the US-Iran Crisis (2017-2020)
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New developments imposed different patterns of interactions between major international powers and Iran during 2018, ranging to varying degrees between cooperation and tension, the most important of which is the new measures taken by the United States to withdraw from the nuclear agreement and impose new US sanctions on Iran, which in turn insisted on not responding to pressure to which they are exposed to make changes in their policies and to negotiate again about the main contentious files, especially the nuclear program and ballistic missiles, and the roles they play for crisis countries, especially supporting some armed organizations in Syria, Lebanon, Iraq and Yemen. These differences have put the international forces before difficult

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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
The Indian Ghost in Lynn Riggs' Play The Cherokee Night
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This play is written in 1932 by Lynn Riggs who is half Cherokee. The play is set in Claremore Mound, Oklahoma almost a century after the Trail of Tears. Riggs presents mixed- blood, young Cherokees to portray a post-colonial state of spiritual loss and disruption of traditional community ties. The new generation lives in darkness, and the title of the play tells about the dramatist's view that night comes to his Cherokee Nation. The Indian ghost is one of the play’s characters.  It is an Indian ghost of a warrior. It comes to remind Cherokees of their heritage and traditions. The ghost sees the new generation as nothing as ghosts because they are neither good for themselves nor for their nation. This paper is important as it discu

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Publication Date
Wed Jun 03 2020
Journal Name
Political Sciences Journal
nternational will in the Security Council Towards the Syrian crisis
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Nations witnessed since its existence a state of wills conflict as a result of the intersection and intertwining of interests, through which it sought to achieve its goals and objectives, and this has often led to direct military conflicts and countless wars, and witnessed the entry into global wars in which humanity lost millions of lives and losses .Despite the great changes in the international arena, especially in recent decades, the conflict of wills has not ceased, although some of its features and forms have changed, and it has become more complicated after the withdrawal of this conflict to international organizations and bodies, including the Security Council. It is mandated under the Charter of the United Nations to wor

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Publication Date
Thu Apr 16 2015
Journal Name
Frontiers In Physiology
Dopaminergic signaling within the primary cilia in the renovascular system
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