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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
Thu Mar 31 2022
Journal Name
Journal Of The College Of Education For Women
Social Risks and Development Gaps in Iraq: A Social Study in the City of Baghdad
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Social risks posed a great challenge to the development path in Iraq, which resulted in widening the development gaps, whether these gaps were between rural and embargoed areas, or between Iraqi governorates, and the gender gap. Besides, the nature of the reciprocal relationship between the social risks and the development process requires the adoption of development trends that are sensitive to the risks that take upon themselves the prompt and correct response to these risks, away from randomness and confusion that Iraq suffered from for decades. However, currently, the situation has differed a great deal. This is because the size and types of such gaps have widened and become more complicated than before; a matter which has led to hav

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Publication Date
Mon Jun 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of dental enamel color after fixed orthodontic therapy using two types of protectors to prevent white spot lesions (A prospective clinical study)
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Background: The aim of this study is to evaluate the color change ∆E of the dental enamel following treatment with 2 kinds of protector (icon infiltrant, clinpro varnish) before fixed orthodontic treatment to avoid the possible white spot lesions. Materials and Methods: Fifty four subjects treated with fixed appliances were divided into 3 groups: the 1st group was control, while the 2nd and 3rd groups were treated with icon infiltrant and clinpro varnish before bonding procedure, respectively. Color parameters (L,a,b) were recorded for the middle and gingival thirds before and after bonding procedure to get the ∆E of each group. Results: One-way ANOVA test showed a non-significant difference in ∆E between the 3 groups a

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Reasons behind the decadence of the studies concerning the evening school in Salah al Deen A field study
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The Reasons behind the decadence of the studies concerning the evening school in Salah al Deen A field study

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Sustainable Accounting indicators that related with create value for the firm
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The business environment is witnessing great and rapid developments due to the economic and technological development that has caused damage to human beings, which requires the need to reduce this damage and work to protect the environment and participate in supporting the social aspects. This requires economic resources to be realized by the economic units. Economic development in preserving the environment that has caused damage and supporting the social aspects that preserve human rights, enhance their position and satisfy their needs in society. Global professional organizations, the United Nations and stakeholder representatives have been issuing the Global Reporting Initiative (GRI) to find guidelines for the preparation of

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
A Standard Study of the Role of the Tourism Sector in Achieving Economic Growth in Tunisia for the Period (1995-2017
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This study examines the relationship between the increase in the number of tourists coming to Tunisia and GDP during the period 1995-2017, using the methodology of joint integration, causal testing and error correction model. The research found the time series instability of the logarithm of the number of tourists coming to Tunisia and the output logarithm but after applying the first differences, these chains become stable, THUS these time series are integrated in the first differences. Using the Johansson method, we found the possibility of a simultaneous integration relationship between the logarithm of the number of tourists coming to Tunisia and the logarithm of GDP in Tunisia, and there is a causal relationship in one direc

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Role of the Auditor in Confirming the Integrated Reports - An Exploratory Study on a Sample of External Auditors in Iraq-
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  The aim of the research is to identify the extent of the ability to ensure the integrated reports by the auditor in verifying the credibility of these reports, and their implications for the benefit of all parties dealing with the economic unit, as well as measuring the impact of the assurance procedures followed by the auditors and their role in confirming these reports.

  The research methodology was designed after studying the previous literature related to the research variables, and then the relationship between these variables was tested, through the use of a questionnaire list. A questionnaire targeting the community of auditors in the local environment, and the results of the study wer

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Publication Date
Sun Mar 17 2019
Journal Name
Baghdad Science Journal
Fabrication and Characterization of Gas Sensor from ZrO2: MgO Nanostructure Thin Films by R.F. Magnetron Sputtering Technique
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Thin films ZrO2: MgO nanostructure have been synthesized by a radio frequency magnetron plasma sputtering technique at different ratios of MgO (0,6, 8 and  10)% percentage to be used as the gas sensor for nitrogen dioxide NO2. The samples were investigated by X-ray diffraction (XRD), atomic force microscopy (AFM), scanning electron microscopy (SEM), energy-dispersive X-ray (EDX) and sensing properties were also investigated. The average particle size of all prepared samples was found lower than 33.22nm and the structure was a monoclinic phase. The distribution of grain size was found lower than36.3 nm and uninformed particles on the surface. Finally, the data of sensing properties have been discussed, where the

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Publication Date
Wed Dec 01 2010
Journal Name
Iraqi Journal Of Physics
Current–voltage and capacitance-voltage characteristics of Se/Si heterojunction prepared by DC planar magnetron sputtering technique
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In this work, the effect of annealing temperature on the electrical properties are studied of p-Se/ n-Si solar cell, which p-Se are deposit by DC planar magnetron sputtering technique on crystal silicon. The chamber was pumped down to 2×10−5 mbar before admitting the gas in. The gas was Ar. The sputtering pressure varied within the range of 4x10-1 - 8x10-2mbar by adjusting the pumping speed through the opening control of throttle valve. The electrical properties are included the C-V and I-V measurements. From C-V measurements, the Vbi are calculated while from I-V measurements, the efficiency of solar cell is calculated.

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Publication Date
Fri Oct 01 2010
Journal Name
Iraqi Journal Of Physics
Evaluation of polyurethane and polyurethane /polyvinyl chloride blend coatings on steel as corrosion protection using EIS technique
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This paper was aimed to evaluate the polyurethane (PU) and polyurethane/polyvinyl chloride (90 wt. % / 10 wt. %) as organic coating of carbon steel substrate against marine environment (3.5 wt.% NaCl aqueous solution) as a severe corrosion environment . The electrochemical impedance spectroscopy (EIS) and fitting impedance data by ZsimpWin 3.22 software were used to estimate the physical barrier of the samples for different exposure times. Different equivalent electrical circuits were proposed for the physical barrier at different immersion times to get appropriate fitting .Both PU and PU/PVC coatings showed excellent corrosion protection ability for steel .The PU/PVC coating showed better protection and stability than PU coating against

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Publication Date
Fri Dec 31 2021
Journal Name
Political Sciences Journal
Role of the executive in federal experiences: a study of selected models
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Receipt date:06/23/2020 accepted date:7/15/2020 Publication date:12/31/2021

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

The executive authority differs from one country to another, as it differs from a federal state to another according to the nature of the applied political systems, so this research focused on federal states according to their political systems, then going into the details of the executive authority and its role In the federal states by referring to the four federal experiments

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