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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
Thu Dec 15 2022
Journal Name
Al-academy
Discourse the presence of animals in Mesopotamian sculptures "The lion and the bull as an example"
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Showing animal shapes is one of the primary topics since the discovery of cave drawings, with semantic discourses, as they appeared in the ancient civilization of Iraq, with their discourse and intellectual structure, and their reflections on their plastic achievements. The research deals with three topics: the first (an introduction to the concept of discourse), the second: (the historical roots of animal forms), and the third (the manifestation of animal forms and their discourse, in Mesopotamia). Mesopotamian fauna and its concepts? What are the?, Its importance was also represented in: the presence of animals and their semantic and conceptual discourse, especially the sculptures (the lion and the bull), with the aim of revealing the

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Publication Date
Wed Mar 29 2023
Journal Name
Journal Of The College Of Education For Women
The Counselor Brent Scowcroft and his Role in Achieving the Requirements of the American National Security
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       Despite the multiplicity of institutions contributing to the decision-making process in the United States of America, they interact to crystallize positions regarding international and strategic situations. The formulation of the national security policy depends on a number of institutions that complement each other in order to achieve an advanced security situation. Thus, the decision reflects the process of interaction of the existing regulatory institutions. This is because the essence of the national security and achieving its requirements also stems from the existence of a coherent system of shared beliefs and principles in the American society. Besides, these elements are the bases for achieving

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Publication Date
Sun Nov 23 2025
Journal Name
Al–bahith Al–a'alami
The Boundary between Advertisement and Mass Media Overlapping Levels in the Press (The Case of Iraq)
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The advertisement is important in maximizing the resources of journalistic institutions. It helps them to perform their duties and also establishes their independence. However, this type of communication has often overlapped with other types of communication, including media and publicity.

Those in charge of the press bear responsibility in this regard, as some of them harness the advertisement for personal purposes; or detrimental to media content. Many communication authorities have drawn attention to the danger of confusing the concepts and levels of the three activities and have moved towards establishing rules to reduce overlap between them.

The aim of this research is to try to disengage the concept of advertising,

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Effectiveness Of the Poetic Text Between the Presence and Absence in Abu Firas al_Hamdani Romyate
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Abu Firas al- Hamdani is one of the most prominent abbasid poets Who characterized their poetry with high artistic quality especially in his Romyate which blended the quality of feelings of grief, sorrow, longing and nostalgia that makes sensitive self conflict that stems with time from one hand and with place on the other hand. Because we are dealing with a poet lived west spatial coercive which it has been hurt him within a time conflict swinging between despair and some times patience and hope other times between the present and his painful reality also between the past and the beautiful times.
This researcher is to stand on this Romyat by monitoring effectiveness of the poetic text based on conflict between the presenc

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The history of rational thought for the investment by human capital and the investing in it.
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The investment however "was its description and meaning, it remains a resident" in the composition of capital assets located in the forefront of the creation of productive assets, and this means that the investment in the productive sectors is a priority in achieving capital accumulation, on any other investment that takes place with the stages of advanced development of formation , not forgetting "to humans and investment humans as head of real money product, the source of the economic surplus and accumulation, and the source of producing values, and if human labor was the source of value, and the human was the source of work, therefore humanitarian work on different levels and skills presents capital", so the investment in huma

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Publication Date
Sun Jan 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
Numbness of the Mind Paradigm in Haruki Murakami’s After the Quake and Iraq’s After the Quake
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Haruki Murakami (1949-present) is a contemporary Japanese writer whose works have been translated into fifty languages and won him plenty of Japanese and international awards. His short stories are well constructed in a weird realistic manner and are mixed with elements of surrealism. His novels and short stories fall under the genre of magical realism. One of the major revolving themes that Murakami wrote about was the haunting feeling of emptiness and disconnectedness in a world which seems to care much for materialism and self-interests.

    The paper explores two of Murakami’s short stories in his book After the Quake (2000) and the relevance of their themes and characters to Iraq after the q

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
Spatial contrast of the slums in the unity of the new municipal of Baghdad
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The slums one of the main problem plaguing the city of Baghdad in general and
the unity of municipality of New Baghdad, especially, where the characteristics of the study
area a prominent role in population growth and the emergence of slums where a private,
although the region suffer from the housing crisis is the lack of the number of housing units
compared to the number of families in which, With high land prices and the level of rent
which was accompanied by the absence of the law, which was followed by the year 2003, has
become the study area and one of the most municipalities of the city of Baghdad Contain
slums which took fills abandoned buildings and acquires vacant land agricultural ones and
allocated to d

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Organizational Relaxation of Employees of the Educational Directorates in the Sultanate of Oman
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Abstract

The current research aims to identify the level of organizational relaxation among the employees of educational directorates in the Sultanate of Oman. The descriptive approach was used, as well as a questionnaire of two parts to collect data. The questionnaire consists of (15) items divided into three themes about the relaxing level. It was applied on a sample of (406) male & female employees of the educational directorates who were randomly selected. The results of the study showed that the level of organizational relaxation was low. The study results also found that there were no statistically significant differences at the level of significance (α ≤ 0.05) of the study sample in the level of org

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Publication Date
Sat Sep 30 2023
Journal Name
College Of Islamic Sciences
Features of visual formation in the poetry of the poets of the Umayyad era
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Abstract

The Umayyad poets tried to invest all artistic tools in order to achieve a measure of creativity in their texts. The phenomenon of visual composition is breaking the familiar writing system, with the aim of increasing the number of possible connotations. The visual in the Umayyad poetry tries to replace it through expression with the visual image, and its manifestations were manifested by the multiplication of punctuation marks in the body of the poetic text and the tearing of the single poetic line by cutting it into several sentences or repetition.

Keywords: visual formation, poetic writing, Umayyad poetry, recipien

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Publication Date
Tue Jun 30 2020
Journal Name
Dialogo
The Problems of Applying Psychological, Educational and Political Measurement Instruments in light of the Prevalence of the Corona virus (Covid-19)
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