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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
Mon Dec 30 2024
Journal Name
Iraqi Journal Of Science
The Impact of Fear and Anti-Predator Behavior on the Dynamics of Stage-Structure Prey–Predator Model With a Harvesting
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In this paper, an ecological model with stage-structure in prey population, fear, anti-predator and harvesting are suggested. Lotka-Volterra and Holling type II functional responses have been assumed to describe the feeding processes . The local and global stability of steady points of this model are established. Finally, the global dynamics are studied numerically to investigate the influence of the parameters on the solutions of the system, especially the effect of fear and anti-predation.

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The quality of the auditor's report in the local environment in compliance with the requirements of the ISA 701 standard
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The research aims to demonstrate the quality of the auditor’s report by analyzing a number of models represented by the auditor’s report based on the Iraqi audit evidence and the auditor’s report in light of the application of international auditing standards for the report and the auditor’s report in light of the application of the International Auditing Standard 701, in addition to explaining the impact of applying the International Auditing Standard 701. International Auditing 701 in enhancing the quality of the auditor's report, and in order to reach these goals, a comparison was made on international experiences before and after the application of the standard in addition to the results of the questionnaire distribut

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Publication Date
Mon Apr 01 2024
Journal Name
Journal Of Krishna Institute Of Medical Sciences University
Study of CD31 IHC expression in dysplastic and malignant lesions of the cervix and its correlation to IHC expression of HPV (16E6 + 18E6)
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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
The Culture of mother in the selection clothes of children in the Early Childhood
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Early childhood Is the of the important stages in the life of man and initiated full on others
reliability has been rise in growth toward independence and self-reliance, as is the transition
from the home environment to the kindergarten environment (kindergarten) (4-6) years where
starts in the interaction with the external environment, it is an essential stage in the
construction of sound personal to the child, and choose proper clothes at this age is one of the
important aspects in building the child's personality, as it reflects the clothing behavior and
taste his parents, especially his mother, she is the first responsible for providing clothes for
her children. Children at this stage are dependent the mothers in

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Publication Date
Wed Jun 14 2023
Journal Name
Al-academy
Representations of the event in the drawings of the civilizations of the ancient world (selected models)
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This research is concerned with studying the representations of the event in the drawings of the ancient civilizations of the world, and the research consists of two axes, the axis of the theoretical framework, which included (the research problem, its aim, its limits, and the definition of its terminology).
The research aims to reveal how the event pattern was formulated by the artist on the surface of his visual achievement, and the limits of the search were spatial in the ancient civilizations of Iraq, Egypt, Greece and Rome, but the limits of the temporal research could not be determined because they were before birth, and objectively:
representations of the event in the civilizations of the ancient world This axis also in

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Publication Date
Wed Oct 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The role of the moral aspect of the administrative accountant In the quality of accounting information
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The importance of the accounting profession in creating data and accounting information for economic resources and their sources and changes therein , through the effectiveness of this information and the degree of suitability and providing accurate and timely manner and in a form that makes it able to rationalize decisions and performance reporting , and there are several elements and behaviors control how the effectiveness of these reports and these behaviors work ethic that govern the work of management accountant when preparing performance reports , which are the ethics of the work of professional control principles and rules of accounting , legal, such as objectivity and reliability , neutrality and timeliness that must be a

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
The Scientific Journals in the websites of the colleges of University of Baghdad on the web
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The aim of the research is the knowing of the academic Scientific Journals of the colleges of University of Baghdad , through searching in the University of Baghdad website and the websites of colleges and thus studying the presentation of these journals in those website , and this is done by surfing the main pages of the websites for the colleges included in the research , and by analyzing the research made a menu for all the academic Scientific Journals for all institutes of the University of Baghdad , which simplifies the way for the researchers to publish these researches in the specific journals for their specialties .

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Publication Date
Fri Jun 30 2023
Journal Name
Diyala Journal Of Medicine
Correlation with renin-angiotensin-aldosterone and glomerular filtration rate in chronic renal failure patients
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Background: One of the more significant hormonal systems, the renin-angiotensin-aldosterone system, controls the kidney function, adrenal gland through its effect on the balance of sodium and potassium, blood pressure, fluid volume, and also manages the functions of cardiovascular. Objective: To clarify the interrelationship between renal dysfunction and renin-angiotensin-aldosterone system. Patients and Methods: One hundred samples were collected from December 1, 2022, to February 18, 2023, from Al Shams Medical Laboratories (56 male, and 44) female, age range (of 45-60 years), all of them were volunteers suffering from chronic renal failure in the third stage the average glomerular filtration rate was 35. 70 ± 0.37 12

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Publication Date
Wed Dec 27 2017
Journal Name
Al-khwarizmi Engineering Journal
A New Structure for Cascaded Single-Stage Distributed Amplifier Using Proposed Active Inductor Loads
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A modification to cascaded single-stage distributed amplifier (CSSDA) design by using active inductor is proposed. This modification is shown to render the amplifier suitable for high gain operation in small on-chip area. Microwave office program simulation of the Novel design approach shows that it has performance compatible with the conventional distributed amplifiers but with smaller area. The CSSDA is suitable for optical and satellite communication systems.

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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Economics And Administrative Sciences
The investment Decision Making According to the Preliminary Feasibility Study for the 100-Bed Teaching Hospital - Service Sector in Diwaniya Governorate (Case Study)
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     The research aims to prepare a preliminary feasibility study that shows the importance of preliminary feasibility study in investment decision making, carrying out of the local demand of service provided in accordance with international standards and statement of investment opportunities available to the private sector in several investment methods. In order to reach the objectives of the study was adopted as a method of partial analysis at the level of economic unity through the study demand, supply, costs, economic and social profitability.

      The health sector in Iraq is one of the service sectors facing today a continuous deficiency

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