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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 Jul 30 2016
Journal Name
Hepatology
Farnesoid X receptor activation increases reverse cholesterol transport by modulating bile acid composition and cholesterol absorption in mice
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Activation of farnesoid X receptor (FXR) markedly attenuates development of atherosclerosis in animal models. However, the underlying mechanism is not well elucidated. Here, we show that the FXR agonist, obeticholic acid (OCA), increases fecal cholesterol excretion and macrophage reverse cholesterol transport (RCT) dependent on activation of hepatic FXR. OCA does not increase biliary cholesterol secretion, but inhibits intestinal cholesterol absorption. OCA markedly inhibits hepatic cholesterol 7α‐hydroxylase (Cyp7a1) and sterol 12α‐hydroxylase (Cyp8b1) partly through inducing small heterodimer partner, leading to reduced bile acid pool size and al

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
Evaluation of Adhesions Induced Intestinal Obstruction following Abdominal Penetrating Missile Injuries
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Objectives: To evaluate the incidence of adhesions
induced intestinal obstruction after explorative laparotomy
due to bullet/shell injury in Al-Kindi teaching
hospital/Baghdad.
Results: Thirty-six out of the 76 cases with adhesions
induced intestinal obstruction (A.I.I.O.) had history of
laparotomy for penetrating missile injury, 26 of them were
explored as a method of management of A.I.I.O. with
mean age (22 for those explored, ٣٧ for those treated
conservatively), 16 of them presented within a year or less
from the previous surgery.
Methods: Comparative interventional prospective study of
cases with adhesions induced intestinal obstruction
admitted to the surgical wards in Al-Kindi teaching
h

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Publication Date
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Evaluation of Patients with Liver Injuries Treated by Perihepatic Gauze Packing
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Background: The liver is one of the most common organs
injured after blunt abdominal trauma. The control of severe
hemorrhage remains a problem.
Methods: One-hundred thirty-eight patients diagnosed as
liver injury between 09/2003 and 08/2006 had been evaluated
prospectively in Al- Kindy Teaching Hospital.
A distinction was made between hemodynamically stable and
unstable patients. Different modalities of surgical procedures
were done concentrating on perihepatic gauze packing.
Results: (60 out of 138) patients included in the study were
clinically evaluated as hemodynamically stable. The average
abbreviated injury severity score (ISS) was 25. Twenty
patients underwent abdominal surgery. In 12 of them

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Publication Date
Sat Dec 31 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
RELATIONSHIP OF LHX3 GENE POLYMORPHISM TO FERTILITY RATE IN LOCAL AND SHAMI GOATS: RELATIONSHIP OF LHX3 GENE POLYMORPHISM TO FERTILITY RATE IN LOCAL AND SHAMI GOATS
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ABSTRACT

The study was conducted at the ruminant research station of the general commission for agricultural research/Ministry of Agriculture, as well as the laboratory of genetic resources of the department of livestock/Ministry of Agriculture and the laboratory of the college of agriculture engineering science, with the aim of determine the genotypic of the expression region (intron 2 and part of exon 3) of the LHX3 gene And its relationship to the fertility rate in local and Shami goats. For this purpose, the RFLP technique was used, and the percentages of genotypes for the LHX3 gene in the local goat sample were 29.17, 50.00, 20.83 for the TT, AT, and AA genotypes, respectively, while in the Shami goa

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Publication Date
Mon May 01 2023
Journal Name
Rimak International Journal Of Humanities And Social Sciences
THE EFFECT OF ARRANGING WOMEN'S ISSUES IN THE IRAQI ELECTRONIC NEWSPAPERS' WEBSITES ON THE COGNITIVE LEVEL OF IRAQI UNIVERSITY FEMALE TEACHERS A FIELD STUDY OF A SAMPLE OF FEMALE TEACHERS AT THE UNIVERSITY OF BAGHDAD
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Women are considered the real power to build societies, as they are half of society, and it is their responsibility to raise generations، as human history testifies to the recording of great names with their giving and achievement in various scientific, social and humanitarian disciplines. Because of the importance of women in our lives, society must give them special care, whether at home or within the community structure to which they belong, so that they contribute to the image that brings about a transformation in the public scene, as well as providing them with support to take charge of bringing about change themselves, and this explains the interest of the press at all levels. Women's issues and topics through various journal

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Publication Date
Wed Dec 11 2019
Journal Name
Journal Of The College Of Education For Women
A Comparative Study in the (myth of Pygmalion) between Bernard Shaw and Sadik Hidayat: University of Ferdowsi - Iran
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  In our time, not too long ago, the universities of the world have been fast to take care of the study of an innovative type of technical and human studies, called the science of "comparative literature". Comparative research studies have grown and flourished rapidly in response to the demands of both mental and artistic life. This shows the increasing awareness at both the modern national and the international levels in order to develop through connecting with the international intellectual, nental and artistic currents to nurture ethics and originality. Comparative studies show that the beginning of the comparative literature goes back to the time when the Latin literature was connected to the Greek literature and th

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Publication Date
Fri Jun 01 2007
Journal Name
Journal Of The College Of Languages (jcl)
TECHNIQES OF SURREALISM: A STUDY IN TWO NOVELS BY THOMAS PYNCHON, V. AND THE CRYING OF LOT 49
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Surrealism is a twentieth-century literary and artistic movement oriented toward the liberation of the mind. Surrealism is a reaction to the philosophy of rationalism which was believed to be the cause of the disaster of World War I. It emphasizes the expression of the imagination as revealed in dreams and presented without conscious control, the unexpected juxtapositions of objects, the withdrawal of the self, and the exploitation of chance effects.
Surrealism began in Paris in the early 1920s, as Europe emerged from the devastation of World War I. A group of writers, artists, and filmmakers, led by the poet André Breton, adopted the word surréaliste (meaning, roughly, "super-real") as a label for their artistic activities. Influen

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Qualification Of Human Resources To Apply Electronic Management A case study In The Ministry Of Science And Technology
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     This research aims to shed light on the reality of the process of rehabilitation of human resources for the implementation of electronic management practice in the ministry, and availability requirements of the application of electronic management and diagnosis of the most important stages and steps that can be followed in the process of transition towards electronic management to keep abreast of developments in the field of information technology, has been the application of this research in the Ministry of science and technology on a group of heads of departments and directors of the people in the departments of the Ministry through the use of case study method, which includes cohabitation field intervi

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Publication Date
Tue Jun 01 2021
Journal Name
Arab Researcher
The Civil Liability of Hotels toward Victims of Sex Trafficking – A Study in Light of Iraqi and U.S. Law
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In view of the large profits made by the sex trade on the one hand, and the minor penalties imposed on the traffickers (brokers) compared with the severe penalties imposed on the drug trade and illegal weapons, on the other hand, this trade has become popular and spread in most countries of the world, and the cornerstones of this trade and A safe haven for them is hotels, especially luxury ones with international brands where their guests are rich and some may look for sex for money. Given the great physical and psychological damage to the victims, this research highlights the civil liability of hotels towards these victims in US and Iraqi law.In order not to limit the

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Influence of Organizational Power on the Achievement of Entrepreneurship for Business Organizations An Analytical Study of the Views of a Sample of Managers in the Iraqi Ministry of Education
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This research aims to study the influence of organizational power on the achievement of entrepreneurship for business organizations. It is an analytical study of the views of a sample of managers in the Iraqi Ministry of Education. The research highlights the contribution that can be made from the knowledge of the theory of business organizations in achieving organizational success. The organizational power of the organization contributes to achieving entrepreneurship in the business environment and achieving a competitive position in the work environment. The research dealt with two variables: the first is the independent variable, the organizational power in its dimensions (Expend Power, Structural Power, Prestige Power). And t

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