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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
Tue May 30 2023
Journal Name
Dirasat: Human And Social Sciences
The Family of Minister Al-Sayyid Al-Ajall: A Study of Its Political, Administrative, and Urban Role (7th-8th Century AH / 13th-14th AD)
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Objectives: The study aimed to clarify the role of Al-Sayyid Al-Ajall and his family in the service of the Mongol Empire. They worked to develop its administrative and military institutions, benefiting from their extensive experience in administration, politics, economics, and urban affairs. Due to their capabilities, they received the patronage of Genghis Khan and subsequent generations, earning the confidence of the ruling Mongol authority. As a result, they were granted significant powers within the state.       Methods: The study relied on the analytical method to analyze historical texts, compare them with others, and discuss them accurately. Results: The study yielded several results, including the minister's keen interes

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Publication Date
Wed May 01 2024
Journal Name
Journal Of Physics: Conference Series
A study of the Electrical and Dialectical proprieties of S<sub>60-</sub>Se<sub>40-X</sub>-Pb<sub>X</sub>Chalcogenide Compound
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Abstract<p>In this study, the melting-cooling method was used to prepare the chalcogenide compound S<sub>60</sub>-Se<sub>40-X</sub>-Pb<sub>X</sub>. Four samples were obtained by partial replacement of Selenium with Lead in the weight ratios x = 0, 10, 20, and 30, respectively. The materials were mixed separately, ground, placed in quartz ampoules, and heated to 500 degrees Celsius. After conducting several operations on the samples, their insulating properties were studied, represented by the real dielectric constant and the imaginary dielectric constant, and the electrical conductivity was measured as a function of the frequency. It was found that partial replacement plays an impo</p> ... Show More
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Publication Date
Thu Feb 29 2024
Journal Name
Iraqi Journal Of Science
Monitoring the Expansion of Unplanned Urbanization and its Impact on Climate Change based on Google Earth Engine Service, a Case Study of Baghdad / Iraq
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     The earth's surface comprises different kinds of land cover, water resources, and soil, which create environmental factors for varied animals, plants, and humans. Knowing the significant effects of land cover is crucial for long-term development, climate change modeling, and preserving ecosystems. In this research, the Google Earth Engine platform and freely available Landsat imagery were used to investigate the impact of the expansion and degradation in urbanized areas, watersheds, and vegetative cover on the land surface temperature in Baghdad from 2004 to 2021. Land cover indices such as the Normalized Difference Vegetation Index, Normalized Difference Water Index, and Normalized Difference Built-up Index (NDVI, NDWI, an

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Publication Date
Thu Oct 18 2018
Journal Name
Al–bahith Al–a'alami
Public exposure to news satellite channels and its relationship to levels of preference and evaluation of programs: Survey study on a sample of the audience of Baghdad City Cente
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The media, especially the satellite channels in our time, are one of the most important pillars of daily life, public and private, for society and people, and are considered by sociologists and sociologists as one of the most important factors of social upbringing and the most important, as a result of the technological and technological development of the media as well as increasing their numbers and vertical and horizontal expansion locally, As well as entering into the lives of individuals and people and leading them to important sites within their interests and preferences, not to mention the long time spent exposure to those media and benefit from the programs offered or broadcast. , The problem of this research is that there is a l

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
The effectiveness of prediction and clairvoyance and its functions in the inner space
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The research dealt with the effectiveness of prediction and foresight in design as a phenomenon that plays a role in the recipient's engagement with the design, as it shows the interaction between the recipient and the interior space. The designer is keen to diversify his formal vocabulary in a way that secures visual values that call for aesthetic integration, as well as securing mental and kinetic behavioral understanding in the interior space.
As the designer deals with a three-dimensional space that carries many visual scenes, the designer should not leave anything from it without standing on it with study and investigation, and puts the user as a basic goal as he provides interpretive data through prediction and foresight that le

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Publication Date
Sun Sep 27 2020
Journal Name
Journal Of The College Of Education For Women
The Term Delay and its Jurisprudences in the Section of Punishments and Felonies
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Different Arabic and Islamic societies are free of evil instincts. Therefore, certain provisions of legitimacy came to stress the importance of the intentions of sharia to achieve the interests of all people that involve several aspects, including the five fundamental things: religion, oneself, offspring, mind and money. Almighty Allah has specified certain punishments on those who violate these things by imposing punishments on the part of the criminal to preserve souls. He imposes the penalty of theft to preserve property, the Hadd punishment for adultery to preserve the symptoms, the punishment on the drunk to preserve the mind, and the Hadd punishment for the apostate to preserve the religion. By the adherence to these punishments li

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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The study of tempromandibular joint disorders and anti-cyclic citrullinated peptide antibodies in serum and saliva of patients with rheumatoid arthritis
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Background: Rheumatoid arthritis is an autoimmune disease that affects mainly the synovial membranes and articular structures and is characterized by chronic, systemic inflammation involving multiple joints.Being a synovial joint, the Temporomandibular Joint is subject to the same disorders affecting other synovial joints, including RA.Beside it was considered as a specific serological marker for diagnosing RA disease ,antibodies to cyclic citrullinated peptide have proven to be associated with joints destruction, though; it may play a potential role in the prediction of the disease severity. Materials and Methods: Sixty nine individuals (69) were enrolled in this study, forty nine (49) were patients diagnosed with Rheumatoid Arthritis, a

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Publication Date
Sat Nov 22 2025
Journal Name
Journal Of Physical Education
The impact of a computerized program (cogniplus) to develop the strength to focus and perform kinetic chain on the balance beam
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Publication Date
Sun Dec 15 2019
Journal Name
Al-academy
Directorial Vision and its Relation to Scenographic Proposal in the Iraqi Theater Show- The Play of Darkness -A Model: رامي سامح زكي
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The increase of the scenographic designer role on account of the character of the director in the Iraqi theater constituted a clear phenomenon that has been manifested in many shows, which necessitated a stance on the nature of this relation and delimiting the work space for each one of them inside the theater show. The research focuses on determining the work relation between the directorial vision and the scenographic proposal in the Iraq theater show. The research is divided into four chapters, the first one addressed the methodological framework, where the research problem was stated in the following question (has the scenographic designer been able through his scenographic proposal to remove the director from his position being the

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Publication Date
Wed Jun 11 2008
Journal Name
Journal Of Al-nahrain University
ANALYSIS OF A MOLECULAR DYNAMICS SIMULATION OF THE ACETYLCHOLINESTERASE ENZYME AND ITS COMPLEX WITH (AXILLARIDINE-A) INHIBITOR
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Molecular dynamics (MD) simulations were carried out in order to investigate the binding mode of axillaridine-A at the active site of human acetylcholinesterase (AChE) enzyme. 2.0 nanosecond of MD simulations was made for the protein and the complex to dynamically explore the active site and the behavior of the ligand at the peripheral AChE binding site. These calculations for the enzyme alone showed that the active site of AChE is located at the bottom of a deep and narrow cavity whose surface is lined with rings of aromatic residues and Tyr72 is almost perpendicular to the Trp286 ring and forms a stable - interaction. The size of the active site of the complex decreases with time due to increase the interaction. Axillaridine-A forms

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