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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
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Comparative Effects of Fentanyl, Medazolam, Lignocaine and Propranolol on Controlling the Hemodynamic Pressor Response during Laryngoscopy and Intubation
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Laryngoscopy and tracheal intubation are considered the most invasive stimuli in anesthesia. They provoked cardiovascular responses that include hypertension, tachycardia and dysrhythmias. Various pharmacological approaches have been used to blunt or attenuate such pressor responses. The present study was designed to evaluate the effect of medazolom, lignocaine and propranolol as a valuable adjuvant to fentanyl in attenuating hemodynamic responses to endotracheal intubation in normotensive patients. Thirty two patient with physical status I or II according to the score of American Society of Anesthesiologist (ASA), scheduled for elective surgery under standard general anesthesia, were randomly allocated into four groups (8 patients in ea

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Publication Date
Thu Jul 18 2024
Journal Name
Journal Of Economics And Administrative Sciences
The Role Of Cognitive Sharing In Enhancing The E-Learning Quality An Analytical Study Of A Sample Of Iraqi Universities
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The world faced many communication challenges in 2020 after the Covid-19 pandemic, the most important of which was the continuation of schooling. Therefore, the research aimed to analyze the current reality of the studied universities in terms of strengths and weaknesses and measure the implementing level of quality requirements of e-learning. This research studies the impact of knowledge sharing in its dimensions (behavior, organizational culture, work teams, and technology) on the e-learning quality and its dimensions (e-learning management, educational content, evaluation ,and evaluation). After conducting the survey, there was a difference in the universities’ application of the quality requirements of e-learning, as the study

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Publication Date
Tue Nov 24 2015
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
The role of e-commerce in the insurance industry and its impacts on consumer rights (In the case of the National Insurance Company study): The role of e-commerce in the insurance industry and its impacts on consumer rights (In the case of the National Insurance Company study)
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The e-commerce is one of the best achievements of the twentieth century, since the conduct commercial transactions via the Internet may be the consumer easy selection process and purchase convenient manner different from traditional methods, and with the beginnings of the new millennium impose the emergence of e-commerce term significant challenges to the insurance industry as an important economic sectors Generally, and insurance companies in particular as a result of scientific development, which has led to a reduction in costs and innovation in the production, which led to intense competition on both levels local or global. The insurance industry is a vital part of the economy and it has a varied impact to the community and individual

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Publication Date
Wed Jun 01 2022
Journal Name
Political Sciences Journal
Terrorism and its impact on the right of Human in development - A study case of ISIS (Daesh) in Iraq
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       Iraq is one of the most important countries in the world that has received its share of terrorist acts by the terrorist organization the Islamic State of Iraq and al-Sham (ISIS), which has caused instability, especially during the period of ISIS's control of seven Iraqi provinces (2014-2017). This stage has caused a decline in the levels of human and economic development and its inconsistency with the capabilities and needs of the Iraqi population. Therefore, this study aims to investigate the hypothesis that there is a close relationship between the decline in development in Iraq and the brutal practices of ISIS that it committed during his period of control over many Iraqi cities and regions. This study used several method

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The research is based on a thesis not discussed: Test the strategy of the General Organization based on the model Wichler and Bakov A case study at the Iraqi Ministry of Interior
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The study aimed at identifying the strategic gaps in the actual reality of the management of public organizations investigated to determine the strategy used based on the study model. The study relied on the variable of the general organization strategy in its dimensions (the general organization strategy, the organization's political strategy and the defense strategy of the organization) The sample of the study was (General Directorate of Traffic, Civil Status Directorate and Civil Defense Directorate), formations affiliated to the Ministry of the Interior, for the importance of the activity carried out by these public organizations by providing them In order to translate the answers into a quantitative expression in the analysi

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Publication Date
Sun Oct 01 2023
Journal Name
Nasq
The Impact of Harold Pinter’s Drama Upon the Iraqi Theatre: A Case Study
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THE IMPACT OF BRITISH THEATER UPON IRAQI DRAMA

Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
A study of the Zn:Sn mixing ratio effect on the gas detector properties
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Semiconductor-based metal oxide gas detector of five mixed from zinc chloride Z and tin chloride S salts Z:S ratio 0, 25, 50, 75 and 100% were fabricated on glass substrate by a spray pyrolysis technique. With thickness were about 0.2 ±0.05 μm using water soluble as precursors at a glass substrate temperature 500 ºC±5, 0.05 M, and their gas sensing properties toward CH4, LPG and H2S gas at different concentration (10, 100, 1000 ppm) in air were investigated at room temperature which related with the petroleum refining industry.
Furthermore structural and morphology properties were scrutinize. Results shows that the mixing ratio affect the composition of formative oxides were (ZnO, Zn2SnO4, Zn2SnO4+ZnSnO3, ZnSnO3, SnO2) ratios ment

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
The role of an active teacher in developing the curriculum by using educational techniqes a theoretical study
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Preparing teacher occupies the attention of many thinkers and philosophers since the age of
kaldinics ( people of mesoptam / 2342 pH ) to the Islamic age where moslems philosophers
focus their attention on thought and philosophy where the philosophy of that teaching
depends on : teacher , student and family begin .
So , the issue of preparing and training teacher occupies the attention of education scientists
depending on his vital and important role in implementing of teaching policies in philosophies
and Islamic educational thought , therefore , the preparing and development of the teacher
regards as one of the basics of teaching development because of its importance in
development of teaching performance and th

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Publication Date
Sun Jun 04 2017
Journal Name
Baghdad Science Journal
A comparative study to determine the native eye lens protein in the some types of Iraqi vertebrates
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This study showed that the lens in baloot muluki fish Chondrostoma regium is transparent, spherical shape, and solid in textures, while in the tree frog Hyla arborea savignyi, freshwater turtles Clemmys caspia caspia, white–eared bulbul Pycnonotus leucotis and brown rat Rattus norvegicus are transparent, soft and biconvex, it is very soft in white–eared bulbul. There are many significant differences have been recorded between the average weight lens and the total concentration of the protein in the lens all studied animals. Electrical migration process for lens proteins showed that there is one bundle of crystalline –? and one bundle also crystalline–? in all studied species, either crystalline–? may represent one bundle character

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Publication Date
Fri Jan 01 2021
Journal Name
Review Of International Geographical Education
Evaluating the performance of project management using network diagrams methods: A case study in the Ramadi Municipality
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This study came for the reason that some project administrations still do not follow the appropriate scientific methods that enable them to perform their work in a manner that achieves the goals for which those projects arise, in addition to exceeding the planned times and costs, so this study aims to apply the methods of network diagrams in Planning, scheduling and monitoring the project of constructing an Alzeuot intersection bridge in the city of Ramadi, as the research sample, being one of the strategic projects that are being implemented in the city of Ramadi, as well as being one of the projects that faced during its implementation Several of problems, the project problem was studied according to scientific methods through the applica

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