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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 Oct 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The Sources and Effects of Risks of Forms of Islamic Financing in the Islamic Branches of the Commercial Bank
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Proved Islamic banks in many countries where they are present, whether Muslim or non-Muslim in the wake of the global financial crisis, it is more efficient, profitable, and stable compared with the conventional banks, so went many of the worlds towards providing Islamic banking through Islamic windows to Besides financial services and products offered by the traditional, or the initiative to enter formulas Islamic finance is fully compliant with the principles and rules of Islamic law and is Brokerage basic function of conventional banks and Islamic alike ) and that means working on the mobilization of savings from surplus units and directed towards the financial units of the fiscal deficit) , which operates commercial banks

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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of Baghdad College Of Dentistry
A Comparison between the Horizontal Condylar and Bennett Angles of Iraqi Full Mouth Rehabilitation Patients by Using Two Different Articulator Systems (An In-Vivo Study)
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Background: Errors of horizontal condylar inclinations and Bennett angles had largely affected the articulation of teeth and the pathways of cusps. The aim of this study was to estimate and compare between the horizontal condylar (protrusive) angles and Bennett angles of full mouth rehabilitation patients using two different articulator systems. Materials and Methods: Protrusive angles and Bennett angles of 50 adult males and females Iraqi TMD-free full mouth rehabilitation patients were estimated by using two different articulator systems. Arbitrary hinge axis location followed by protrusive angles and Bennett angles, estimation was done by a semiadjustable articulator system. A fully adjustable articulator system was utilized to locate th

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Publication Date
Fri Mar 31 2017
Journal Name
Journal Of Engineering
Experimental Measurements of Viscosity and Thermal Conductivity of Single Layer Graphene Based DI-water Nanofluid
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Experimental measurements of viscosity and thermal conductivity of single layer of graphene . based DI-water nanofluid are performed as a function of  concentrations (0.1-1wt%) and temperatures between (5 to 35ºC). The result reveals that the thermal conductivity of GNPs nanofluids was increased with increasing the nanoparticle weight fraction concentration and temperature, while the maximum enhancement was about 22% for concentration of 1 wt.% at
35ºC. These experimental results were compared with some theoretical models and a good agreement between Nan’s model and the experimental results was observed. The viscosity of the graphene nanofluid displays Newtonian and Non-Newtonian behaviors with respect to nanoparticles concen

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
A model of a proposed audit program to audit the strategies of municipal institutions and its impact on achieving sustainable development: An applied research in the municipal institutions of Karbala Governorate
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Abstract

                  The study aimed to prepare a practical guide for procedures for auditing the strategies of municipal institutions in achieving sustainable development by adopting the idea of ​​the audit matrix through which a classified report is prepared according to the dimensions of sustainable development, by preparing a specialized audit program for the purpose of auditing strategies for achieving sustainable development and emptying the results of the application of each of the paragraphs The program in the audit matrix that was prepared for the purpose of determining the impact of each observation and linkin

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Publication Date
Sun Dec 16 2018
Journal Name
Al-academy
The Eloquence of the Sound in the Production of Mental Image in the Feature Film
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Publication Date
Sun Dec 16 2018
Journal Name
Al-academy
The Eloquence of the Sound in the Production of Mental Image in the Feature Film
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The ideas and information obtained by the viewer in the cinema have always been the source of the visual image, but that doesn’t negate the fact that the mental image can produce a lot of the information and ideas in the cinematic art and the most important means to achieve this mental image in the film is the eloquent cinematic sound. This research is conducted to show this important and effective contribution of the sound in the production of the mental image. Hence the importance of this research is in that it addresses an important issue which is the eloquent performance of the sound and its role in the production of the mental image inside the space of the feature film. This research concerns those working the field of cinema and

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Publication Date
Thu Jun 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Use of the Regression Tree and the Support Vector Machine in the Classification of the Iraqi Stock Exchange for the Period 2019-2020
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 The financial markets are one of the sectors whose data is characterized by continuous movement in most of the times and it is constantly changing, so it is difficult to predict its trends , and this leads to the need of methods , means and techniques for making decisions, and that pushes investors and analysts in the financial markets to use various and different methods in order to reach at predicting the movement of the direction of the financial markets. In order to reach the goal of making decisions in different investments, where the algorithm of the support vector machine and the CART regression tree algorithm are used to classify the stock data in order to determine

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Publication Date
Mon Mar 25 2019
Journal Name
Al-academy
The Dialectic of the Living Body (the actor) and the Dead Body (the Sinography Item) in the Construction of the Staged Image of the Play: جاسم كاظم عبد - عماد هادي عباس
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The current research deals with the dialectical relationship resulting from the conflict in the violent combination and construction of the living ( the actor)and the dead (the item) in the structure of the Sinography construction and the emergence of the theatrical play space , which can be summed up by the following question: what is the nature of the dialectical relationship between the living (the actor) and the dead( the item) in the Sinography creation, which limited the research in a central objective : to identify the controversy of the living (actor) and the dead (item) in the performance unit of the theatrical scene . The research, in its objective limits set forth in its methodological framework, analyzes this controversy in o

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Publication Date
Sun Oct 21 2018
Journal Name
Iraqi Journal Of Physics
A simple voice communication using the modulation of the reflected light
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There is no adopt in the importance of the optical communications in scientific civil and military applications because of it’s simplicity in manufacturing and it's low cost. The method of optical communication depends upon bearing the light beam the translated informations by a method called the light modulation. This method depends upon changing some light properties as frequency, amplitude and pulse duration according to the translating informations. The changes in the first two properties are concerned optically with the analog modulation while the third one concern at most with digital modulation. All past methods are expensive with low efficiency and needs electrical or magnetic fields. In this technique the source of voice used

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Publication Date
Thu Jun 08 2023
Journal Name
University Of Thi-qar Journal Of Agricultural Research
A review: Machine relationship with the tractor and its effect on the productivity and compaction of agricultural soil
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The influence of process speed (PS) and tillage depth (TD) , on growth of corn (Zea mays L) yield, for Maha cultivar, were tested at two ranges of PS of 2.483 and 4.011 km.hr-1, and three ranges of TD of 15,20 and 25cm. The experiments were conducted in a factorial experiment under complete randomized design with three replications. The results showed that the PS of 2.483 km.hr-1 was significantly better than the PS of 4.011km.hr-1 in all studied conditions. The , slippage ratio (SR) and the machine efficiency (ME), the physical soil characteristics represented by the soil density and porosity (SBD and TSP), and the plant characteristics represented the roots dry weight, PVI and the crop productivity (CP), except adjective of the fu

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