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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 Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
Measuring the speed of response of the exported quantity of crude oil to the increase in its prices using the model Impulse Response Functions (IRF) (Iraq case study) for the period (1978-2017)
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Abstract

     Oil is considered a commodity and is still an important and prominent role in drawing and shaping the Iraqi economic scene. The revenues generated from the export of oil are considered the main source of the general budget in cash flows.  

     Since the revenues consist of quantity and price and the latter is an external factor which is difficult to predict, The effect of any commodity on its price, which is proven in the theory of micro-economic, but it is observed through the research that the response is slow, which means not to take advantage of the rise in prices, by increasing the quantity exported, the result of several facto

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Publication Date
Sun Dec 31 2017
Journal Name
College Of Islamic Sciences
The effect of the significance of the Qur'anic context in the allocation of the year
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Acting on the Holy Qur’an by contemplating its meanings, stopping at its commands and prohibitions, and everything in it that guides us to truth and mercy. The Holy Qur’an includes it for various purposes in one verse, and there is no doubt that this is part of the perfection of this great book, and one of the sciences of the fundamentalists is the indication of the context, and it is a great science of high rank, and it is one of the most important things that lead to the correct understanding of the miraculous and decisive book of God Almighty, and one of the best meanings of the Qur’an It was not from the context of the verses, and from here it can be said that the indication of the context is one of the origins of deriving lega

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Publication Date
Wed Sep 08 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the Central Bank of Iraq in housing finance and reducing the housing crisis in Iraq
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Finance is an essential element when developing any housing policy because of its role in providing funds to institutions concerned with housing lending. Therefore, the research aims to evaluate the financial aid provided by the Central Bank of Iraq in solving the housing crisis through the adoption of the Central Bank of Iraq initiatives to support the financing of the housing sector, and here The importance of the research is highlighted to determine the role of the initiative by drawing an effective strategy aimed at providing the housing sector with the necessary funding. By providing financing to financial institutions directed towards providing real estate credit, and that the percentage of the contribution of the implement

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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of tax exemption in attracting foreign investment and the possibility of activation in the Iraqi economy
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The tax exemption, whether wholly or partially, and for an unlimited duration of the investment or for a limited period of few years, is one of the encouraging things to the flow of foreign capital. And if necessary, impose tax on the profits of the invested capital, the promotion requires that not be discriminatory taxes or payments in the amount of money with the need to avoid double taxation. The tax exemption is granted by the government and the feature according to the law of a natural person or legal entity seeking from the government purports to achieve a set of political goals, economic and  social development. The reduction of taxes or grants partial exemption is one of the factors that encourage attract of direct foreign i

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
The Technicality and Spontaneity Paradoxes in the Art of the Playwright -Examples of Improvisation in Modern European Theater
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The research deals with the problems of improvisation in two basic subjects and applied a samples  and conclusion. The first topic focuses on the concept of improvisation and spontaneity and clarifies the confusion between them. The second topic deals with the foundations and principles on which the actor is based in his artistic preparation for the purpose of developing his improvisational abilities.

The research focuses on clarifying the dimensions of improvisational techniques and its multiplicity in the modern theater. It analyzes the method of improvisation and its use in the construction and composition of the theatrical performance. It deals with two important experiments, such as the experience of the Russian directo

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Publication Date
Mon Jun 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Estimation of the average sample size and defective ratio In a finite individualized inspection with a practical application
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The purpose of this research is to find the estimator of the average proportion of defectives based on attribute samples. That have been curtailed either with rejection of a lot finding the kth defective or with acceptance on finding the kth non defective.

The MLE (Maximum likelihood estimator) is derived. And also the ASN in Single Curtailed Sampling has been derived and we obtain a simplified Formula All the Notations needed are explained.

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Semantic features in the phenomena in the pottery of Dr. Ahmed Sulaiman Al-Ahmed / Trees behind fence as a sample: Semantic features in the phenomena in the pottery of Dr. Ahmed Sulaiman Al-Ahmed / Trees behind fence as a sample
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Abstract
This research deals with studying and analysis of a poetic group under the
title (Trees behind fence) of the great poet Dr. Ahmed Sulaiman AlAhmed
who is the some of the Shek , Sulaiman Al-Ahmed who is the linguist - poet
and famous jurist member in the Arabic scientific assemble in Damascus and
brother of the great poet Badawi Al-Jabal. This poetic group include two big
poetic legends : the first one is (Trees behind fence , ) which include one
hundred and eighty four line and the second one ( AZ-Mebadia ) which is
consists of one hundred and seventy eight line, both of them from the (Al-
Camil ) meter which is free rhyme which bears a many meaning and pictures
and just the great poet composite the

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Publication Date
Sun Dec 15 2019
Journal Name
Al-academy
Artistic Integration of Aesthetic Manifestations in the Andalusian Islamic Style into the Interior Architecture (Mansour Laalaj's Door / Meknes a Case Study): شهريار عبد القادر محمود -سعد جرجيس
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The Islamic architectural heritage constitutes a civilized fortune that has to be preserved and protected and work should be done to maintain its development to be more convenient for the circumstances of the age and the civilization transformations. Due to the fact that architecture represents the civilization pot and cultural identity, its originality has to be preserved and work has to be done to prevent the strange architectural invasion that changes its character and make it lose the identity and the character and detached from its roots and environment.    

Decoration, in the interior design, as a concept is connected to ornamentation process of interior spaces, which is a process of adding certain items

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Publication Date
Tue Sep 30 2014
Journal Name
Iraqi Journal Of Science
The Prevalence of Autoimmune Thyroiditis in A sample of Infertile Iraqi Women
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In the present study, the aim was made to identify the relationship between thyroid autoimmunity (TAI) and female infertility. The study was performed on 30 infertile women and 22 age-matched healthy fertile control age (33 ± 5 years). Overall, serum prolactin (PRL), thyroid stimulating hormone (TSH) assay is the key test for the diagnosis and management of hypo and hyperthyroidism. Anti-TPO Ab and anti-TG Ab were measured. The mean ± SE of serum PRL (31.080 ± 3.06) ng/ml was significantly (P<0.05) higher in infertile group compared with control (16.191±1.36) ng/ml. Serum TSH was significantly (P<0.05) higher in infertile group (5.689 ± 1.12) µIU/ml compared to control group (2.282 ± 0.18) µIU/ml. The prevalence of positive

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Publication Date
Tue Jun 01 2010
Journal Name
Journal Of The College Of Languages (jcl)
Nature of a holy book in the poetry of Ibn Arabi Mohi
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The paper discusses the lack of a uniform definition of politeness due to the constant tension between its universality and language specificity, and argues that some of the theoretical debate could be resolved if the distinction between politeness as a commonsense notion and politeness as a theoretical construct were clearly addressed and acknowledged in the research.

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