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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 Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of projects during the trial operation period in accordance with the cost, quality and time - applied research in the Directorate-General for the distribution
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Research includes evaluation of projects implemented and which entered into trial operation period in accordance with the evaluation criteria and of (cost, quality and time) to determine the size deviations gap for the sample of projects during the years of assessment (2011-2012-2013-2014) of each of the three evaluation criteria, and then followed by a calculation the size of the overall gap to the problem based on the research problem to determine deviations from the specific implementation of each project by answering several questions to answer turns out the reasons for these deviations occur.

The importance of research Focus on the evaluation of received projects from contractors executing the projec

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Publication Date
Wed Jan 01 2020
Journal Name
Periodicals Of Engineering And Natural Sciences
Forecasting the exchange rate of the Iraqi dinar against the US dollar using Markov chains
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Publication Date
Fri Jan 30 2026
Journal Name
Journal Of Studies And Researches Of Sport Education
The effect of rebound jumping exercises on the development of the special strength of the lower limbs among the players of the National Center for the Nurturing of Talented Sports in the high jump.
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The high bounce activity according to the fosbery way is regarded as of the difficult sports concerning its way of training and perfection due to hard technique of its performance on one hand and because it depends on the player’s ability to overcome body weight resistance against the gravity. In addition to the strong ability to control the body posture when leaving the land and flying over the barrier. This activity needs to high plosion power at the moment of bouncing and this plosion depends on the period of bouncing, so the two researchers aimed to use a mechanical bouncing platform and an electronic one through several training by one foot and both feet in different directions and positions in order to reduce the time of bouncing an

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
a study of the womens collages in usa
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The study aims to identify the colleges women in the USA where he was browsing the Internet for five universities and sixty-two women's college located these colleges in 25 states only three general and other civil 51% supported by the churches and religious associations of various began its founding in Alqrnn eighteenth and continued in the nineteenth and twentieth and to provide an opportunity for women to complete higher education, while most men's colleges opened their doors to the admission of women and turned it on coeducation

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Publication Date
Thu Nov 01 2012
Journal Name
Ijcsi International Journal Of Computer Science
Implementing a novel approach an convert audio compression to text coding via hybrid technique
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Compression is the reduction in size of data in order to save space or transmission time. For data transmission, compression can be performed on just the data content or on the entire transmission unit (including header data) depending on a number of factors. In this study, we considered the application of an audio compression method by using text coding where audio compression represented via convert audio file to text file for reducing the time to data transfer by communication channel. Approach: we proposed two coding methods are applied to optimizing the solution by using CFG. Results: we test our application by using 4-bit coding algorithm the results of this method show not satisfy then we proposed a new approach to compress audio fil

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Publication Date
Fri Sep 01 2023
Journal Name
Iraqi Journal Of Physics
Photometry Technique to Map Elements’ Distribution on Comets’ Nuclei Surfaces Using a New Method
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This study is unique in this field. It represents a mix of three branches of technology: photometry, spectroscopy, and image processing. The work treats the image by treating each pixel in the image based on its color, where the color means a specific wavelength on the RGB line; therefore, any image will have many wavelengths from all its pixels. The results of the study are specific and identify the elements on the nucleus’s surface of a comet, not only the details but also their mapping on the nucleus. The work considered 12 elements in two comets (Temple 1 and 67P/Churyumoy-Gerasimenko). The elements have strong emission lines in the visible range, which were recognized by our MATLAB program in the treatment of the image. The percen

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Publication Date
Thu Mar 19 2015
Journal Name
Spie Proceedings
Role of testosterone in resistance to development of stress-related vascular diseases in male and female organisms: models of hypertension and ulcer bleeding
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Publication Date
Sat Apr 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Effect of Blue and Red LED Light and some Plant Extract on Lettuce Growth and Yield in NFT Technique
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Abstract<p>This experiment was carried out in the College of Agricultural Engineering Sciences, Univ. of Baghdad, during autumn 2021 growing season to investigate possibility study of increase lettuce antioxidant and biological yield, growing and producing lettuce hydroponically under film technique (NFT) using a globally approved standard solution (Cooper solution), Nested design with three replications adopted in the experiment, each of them included in main plot the first factor, which is LED light (B and R), Then levels of second factor were randomly distributed within each replicate, which included spraying with organic nutrients which was Cymbopogon citratus and Hibiscus sabdariffa at two </p> ... Show More
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Publication Date
Sat Jun 29 2024
Journal Name
Journal Of Humanities And Social Sciences Researches
Measuring and Analysis the Relationship between the Internal Public Debt and the Exchange Rate in the Iraqi Economy for The Period 2004 – 2022
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The scholastic view of public religion differed, and this difference was on two extremes. All economic schools agreed that public debt is a monetary liquidity that was unjustly deducted from the income and output cycle as a result of the imbalance in the economic balance and the departure from the conditions of balance between aggregate demand and aggregate supply. Debt is a waste of financial resources allocated to productive accumulation. Except for the Keynesian school, which considers public debt to be an addition to aggregate demand after the decline in the role of the private sector in investment as a result of pessimistic expectations that warn of signs of economic contraction. Public debt is linked to the ex

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of The College Of Education For Women
The Problem of Paradox and its Manifestations: A Study in the Titles of Najm Wali's Novels
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The irony pushes us to inquire about what is in the text of contradiction, irony, suspense, and other acts of paradox, as well as a departure from what is logical, or familiar, that attracts the attention of the addressee, and this is what drives us to introspect the text and interrogate it in order to get to know the intended product of the text or its real or metaphorical intent. On the other hand, the irony is more in the literary text than in the scientific texts. Therefore, critics add the word literature to it in their definition.

 As it is represented by the paradox, we will seek to study the paradox of the title and the problematic that it may pose as the beginning of the text, and i

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