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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
Fri Nov 01 2019
Journal Name
Science International (lahore)
IRAQI WOMEN IN THE CIRCLE OF COMBATTING A STUDY OF CIVIL-MILITARY RELATIONS IN A GENDER PERSPECTIVE
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The current research includes a look at the participation of Iraqi women in the combat roles, which starts from the assumption of the democratic transition that must be led - in one of its aspect - until the army or the military foundation to become a "citizen army," the matter which is represented a demand increasingly needed in the experiences of Democratic transformation that facing serious security challenges such as in Iraq, this means that the army or security foundation - which is involved in counterterrorism - should not reflect a specific group in society , and hence embody the most important democratic principles, which are equality and equal opportunities, especially gender equality. On the other hand, the influence of armed conf

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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The applicability of green productivity tools: An analytical study in a sample of industrial companies in the province of Nineveh
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                The current research aims to identify the most important green productivity tools GPT and the possibility of applied in industrial companies in general and the companies operating in the province of Nineveh, in particular, as well as the study of some personality characteristics and functional, which is believed to be an impact on the application of these tools in industrial companies. Accordingly, the research community of managers in the company of medicines and medical supplies ready-made clothes _ operating in the province of Nineveh, who are (80) while the manager was subjected to research procedures (49) Director representing (61.25%)

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Managerial Skills and It`s Role in Strengthening the Competitive Edge of Companies: A Case Study in the General Company for Construction Industries
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This research tries to reveal how to manage and control the competitive edge for business by building managerial skills in various organizational levels. Our research aims at finding out the nature of various technical, human and in tellectual skills of a new president whose superiority is his competitive ness in the application field at general company for construe tioual  industriesand testing the surveyed minor and major changes through a questionnaire to collect information from officials. The sample was composed of (45) director. The data was analyzed  using some methods and statistical programs. The most prominent of these is (SPSS) that was used to extract the arithmetic mean, standard deviation, correlation coefficient

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Publication Date
Wed Dec 15 2021
Journal Name
Al-academy
Realism in the painting of Iraqi Kurdistan artists "A Study in methods of expression"
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The tagged research (realism in the Paintings of Iraqi Kurdistan artists, “a study of expression methods”) dealt with realism in an objective way, as well as the complexity of its concepts through its formations and formations. On realism and its historical dimension in concept and meaning, as for the second chapter, the research was focused on the methods of expression in painting, while the third chapter was concerned with the procedural applications of realistic methods of expression in the drawings of Iraqi Kurdistan, and according to these axes and to achieve the goal of the research, a number of Among the results are:
1- Realism documented the life of the Kurdish society in line with the developments of the era, as the sty

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Publication Date
Sun Sep 29 2024
Journal Name
مجلة نسق
The diplomatic role of IGAD in regional peacemaking: Sudan after 2011 as a case study
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The research discusses the most important goals and means of IGAD in making peace in Sudan and then regional peace.

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Publication Date
Sat Jul 01 2017
Journal Name
Al–bahith Al–a'alami
A Dubbed Turkish Drama and their Effects of the Behavior of Algerian Women: A Survey Study of a Sample of Women – The City of Mesila is a Model
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The study aims to identify the effects of dubbed Turkish drama on the public through the application of a sample of the views of women. The study also attempts to monitor the causes and motives due to the act of observation and to identify the various effects of this act. In order to achieve these goals, the researcher relies on the descriptive approach in addition to the questionnaire and interviews to collect data. It ends with a number of results such as: The study aims to identify the effects of dubbed Turkish drama on the public through the application of a sample of the views of women. The study also attempts to monitor the causes and motives due to the act of observation and to identify the various effects of this act. In ord

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Evaluating the reality of applying the curriculum axis according to the Iraqi academic accreditation standards / a comparative study of a sample of governmental and private universities and colleges
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The research aims to get acquainted with the evaluation of the reality of the application of the curriculum axis from among the eight Iraqi academic accreditation standards in a sample of governmental and private universities and colleges in Iraq and to identify the main and secondary reasons for it as well as to provide proposed mechanisms and procedures to help reduce gaps, If the research problem is represented in the weak availability of the requirements of the curriculum axis in universities and colleges (the study sample) due to the weak documentation and successful implementation of them and interest in them is still below the level of ambition, In order to arrive at scientific facts, the researchers adopted the comparativ

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The Influence of Different Fabrication and Impression Techniques on the Marginal Adaptation of Lithium Disilicate Crowns (A comparative in vitro study)
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Background: The marginal adaptation has a key role in the success and longevity of the fixed dental restoration, which is affected by the impression and the fabrication techniques .The objective of this in vitro study was to evaluate and compare the marginal fitness of lithium disilicate crowns using two different digital impression techniques (direct and indirect techniques) and two different fabrication techniques (CAD/CAM and Press techniques). Materials and Methods: Thirty two sound upper first premolar teeth of comparable size extracted for orthodontic reason were selected in this study .Standardized preparation of all teeth samples were carried out with modified dental surveyor to receive all ceramic crown restoration with 1 mm deep

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
A book in the science of rhyme for the father of conquest Othman bin Jinni ‹v 392 e›: Investigation and study
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This book in our hands is a 'book in the science of rhymes' written by the linguistic and grammatical world 'Othman bin Jenni' 'T 392 AH', and included in it: the concept of rhyme, its characters, movements, and disadvantages, with mention of its ramifications, defining them by definition, clarification and martyrdom poetry, It is concise in size, but it is a book containing a full science in its content.
The study was divided into two parts, the first: the study, and included a study of the author and the author, I talked first about his life, such as his name and origin, and scientific status, and the words of scientists in it, and so on, and secondly: the name of the book, and his percentage, and the time of its composition, etc. I

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Publication Date
Thu Dec 30 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Design a system for an approved video copyright over cloud based on biometric iris and random walk generator using watermark technique
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