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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 Jul 01 2022
Journal Name
Aip Conf. Proc. 2450, 020031 (2022)
The study of the identification and association of adiponectin and Interleukin-6 and some variables. Biochemical parameters in the Iraqi cord blood of newborns
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t. The current study was conducted on the umbilical cord blood of newborns in the Banks Hospital in Baghdad, Diyala, and Khalis in Diyala, where the study included 90 samples of blood, and samples were collected for the period from the 1st of October;2020 to The first of February;2021 AD, where the study included measuring levels of interleukin-6;Adiponectin,glucose and bilirubin in the blood, comparison study between the study variables with the child's weight (greater than 3 kg),(less or equal 3 kg),the mother's age (greater than 25 years, less or equal to 25 years),the sex of the child (male, female).The results of our study showed that there were no significant differences between the variables of the current study between the two sex

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Publication Date
Wed Sep 01 2021
Journal Name
Review Of International Geographical Education
A New Approach in Determining the Criteria of Equations for Morphometric Characteristics of River Basins - Applied Morphometric Study of The Mamaran Basin
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This study aimed at some of the criteria used to determine the form of the river basins, and exposed the need to modify some of its limitations. In which, the generalization of the elongation and roundness ratio coefficient criterion was modified, which was set in a range between (0-1). This range goes beyond determining the form of the basin, which gives it an elongated or rounded feature, and the ratio has been modified by making it more detailed and accurate in giving the basin a specific form, not only a general characteristic. So, we reached a standard for each of the basins' forms regarding the results of the elongation and circularity ratios. Thus, circular is (1-0.8), and square is (between 0.8-0.6), the blade or oval form is (0.6-0

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
(Determine the Impact of Public Relations Ethics in Strategic Decisions) Descriptive Analytical Study of a Sample of Administrative Leadership in the Ministry of Higher Education
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Role of public relations (PR) and from one community to another, depending on the different cultures of these societies in General, and different ethical values established by their practitioners in these communities organizations  , public relations in developed societies, and in  some developing countries have taken great strides to contribute to the strategic planning and decision-making, in the framework of their commitment to the values and ethical standards for practitioners, In contrast, we find that applied in Iraq still skips phase coordinate with different communication means with the aim of advertising and publicity for the organization. As a result of the limited recognition of the strategic and vital 

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Publication Date
Sat Sep 30 2023
Journal Name
Al–bahith Al–a'alami
Political Use of the Photograph: A Semiotic Study of the Photograph of Al-Kadhimi's Visit to Fallujah on the Anniversary of the Victory Over ISIS
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The research aims to determine what a photograph intends to convey as a visual text. Photographs are not captured randomly, especially those of politicians. Each photograph carries a message, even if interpretations of that message vary from person to person. The research adopts a methodology based on semiotic analysis, applying Laurent Gervero's model to analyze a photograph of the Iraqi Prime Minister Mustafa Al-Kadhimi's visit to Fallujah on the anniversary of the victory over ISIS. The photographs in question constitute a visual language built upon a sequence of iconic symbols and signs. These elements coalesce to give rise to an image centered around a particular theme, one designed to convey a precise messag

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Organizational Change in the Development of the Insurance Service: (applied study in The National Insurance Company)
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تشهد بیئة الأعمال المعاصرة جملة من التغیرات والتطورات التكنولوجیة وتزایداً في حدةالمنافسة، وأتساع الفجوة بین العاملین والإدارة ، وقدرة الإدارة على التمییز بین الموظفین، والمشاركة فيإتخاذ القرارات، الامر الذي یلقي على عاتق شركة التأمین إجراء التغییر التنظیمي لتحقیق تطور فيالخدمات التأمینیة التي تقدمها للجمهور من تنوع التغطیات التأمینیة )الوثائق( والسرعة في تسویةالتعویضات وغیرها من الانشطة التي تمارسه

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Publication Date
Mon Jan 01 2018
Journal Name
African Journal Of Hospitality, Tourism And Leisure
An analytical study of the strategic flexibility variation as a function of the dynamic capabilities based on supply chain management (Case study: The General Petroleum Products Distribution Company in Baghdad)
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Publication Date
Tue Jan 01 2019
Journal Name
Ieee Access
Sensing Performance of Modified Single Mode Optical Fiber Coated With Nanomaterials-Based Ammonia Sensors Operated in the C-Band
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Publication Date
Mon Aug 01 2011
Journal Name
Journal Of Engineering
EXPERIMENTAL STUDY OF AIR FLOW RATE EFFECTS ON HUMIDIFICATION PARAMETERS WITH PREHEATING AND DEHUMIDIFICATION PROCESS CHANGING
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This research study experimentally the effect of air flow rate on humidification process
parameters. Experimental data are obtained from air conditioning study unit T110D. Results obtained
from experimental test, calculations and psychometrics software are discussed. The effect of air flow rate
on steam humidification process parameters as a part of air-conditioning processes can be explained
according to obtained results. Results of the steam humidification processes (1,2) with and without
preheating with 5A and 7.5A shows decreasing in dry bulb temperature, humidity ratio, and heat add to
moist air with increasing air flow rate, but humidification load, and total energy of moist air increase with
increasing air flo

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Publication Date
Sat Sep 28 2024
Journal Name
Journal Of Physical Education
The effect of cardiorespiratory fitness training on developing speed endurance, heart rate adaptation, and men's 1500-meter running performance
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The problem of the research is that there is a weakness in speed endurance, which has a direct impact on achievement, as it leads to early fatigue, lack of concentration, and a low level of effectiveness of performance, which made the researchers interested in this problem and finding solutions to it. Hence the importance of the research is evident: preparing cardiorespiratory fitness training to develop speed endurance and rate adaptation. The heartbeat that occurs in runners is a continuous result of training and the use of a type of training that suits the requirements of the 1500-meter running competition. The researchers used the experimental approach with pre- and post-testing for the experimental and control groups. The resea

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Research In Social Sciences &amp; Humanities
The Impact of Strategic Improvisation on Organizational Health: An Analytical Study of the Opinions of a Sample of the Leaders of the Dhi Qar Health Department
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The current research aims to identify the level of impact of strategic improvisation as an independent variable on organizational health. The dependent variable in the Department of Health of Dhi Qar to reach appropriate mechanisms in order to reach appropriate mechanisms and recommendations proposed to contribute to the achievement of organizational health in the Department of Health of Dhi Qar (the research department) and based on the importance of the subject of research in government institutions and the important and service role of the Department of Health of Dhi Qar in the Iraqi society. The descriptive analytical approach was adopted in the completion of the research based on the opinions of the leaders in the surveyed depa

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