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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 May 18 2023
Journal Name
College Of Islamic Sciences
a base The origin of permissive things And its impact on Islamic law
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So I present in the hands of the honorable reader what God Almighty has made easy for me in terms of what I dealt with in the rule (the principle of permissive things) and what branches from it and what is related to it.
This research was divided into an introduction, a preface, three demands, and a conclusion.
The preamble is to explain the meaning of the rule in language and terminology and the definition of the legal rule and what is related to it. The first requirement is to explain the rule that we have in our hands and the words related to its text - and is it a fundamentalist or jurisprudential rule? .
As for the second requirement - in the difference of scholars and their opinions in whether the origin of things is permi

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Publication Date
Mon Jun 30 2025
Journal Name
Madenat Al-elem University College
The Ripple Effect of Plastic Pollution: Environmental and Public Health Perspectives: A review
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Abstract: Plastic pollution is a major issue of the current century. This waste is found in seas, freshwater, lakes, rivers, coastal areas, and soil. In this article, this article discusses the various sources of plastic pollution, including the manufacturing process of plastics and the addition of materials to improve their properties, as well as the use of single-use plastics that are not recyclable, in addition to burning and illegal waste disposal in the open. The impact on public health is through human exposure to toxins from plastics in the environment directly through inhaling dust and fumes, consuming contaminated food and drink, and skin contact. Indirectly, when marine creatures consume microplastics, they will find their way

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Publication Date
Wed Jun 14 2023
Journal Name
Al-academy
The effectiveness of the harvesting strategy in the collection of environmental art by the Institute of Fine Arts students
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 The current research aims to: (know the effectiveness of the harvesting strategy in the achievement of the students of the Institute of Fine Arts in environmental art.
- In order to know this effectiveness, the researcher put a main zero hypothesis and derived six sub-hypotheses from it. the usual way; As the research community reached (120) male and female students of the Fine Arts Institutes for the morning study in Baghdad. As for the research sample, it was chosen by the simple random method, and the number was (75) male and female students for the year 2021-2022 AD. The researcher applied a pre-knowledge test for the four groups of research to find out the level of previous experiences of students in the subject of environmen

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Publication Date
Mon Mar 01 2010
Journal Name
Journal Of Economics And Administrative Sciences
The economic feasibility of substituting different residues replaces part of the barley In the fattening of the Arabian lambs
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This experiment was carried out at the Grdarash field belongs to the Agricultural researches directorate/general Agriculture directorate-Erbil in September (2007)، 27 Arabic lambs aged (5-6 months) With average initial weight (39.178 Kg/lamb) were used. Lambs were divided in to (3) groups (9 lambs/group). Control group was fed on (85% barely، 10% bran and 5% straw)، and second and third groups were fed on various by-product in replacement with barely in loss and block shape respectively.

The total gain of three groups were (392708.32، 634826.52 & 445613.72 ID resp

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of the practice of professional doubt on the quality of the auditor's performance in Iraq: بحث استطلاعي
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              Due to the increasing interest in the quality of auditing by writers, researchers and regulators of the auditing profession. The matter necessitated a statement of the extent to which the auditor practices professional skepticism, because of its significant impact in discovering errors and material misrepresentations contained in the financial statements in order to give the financial community confidence in them and the success of the audit process. The research aims to clarify the concept and importance of the practice of professional skepticism and its effect on the quality of the auditor's performance in Iraq. To achieve the research objectives, the two re

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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Methods of using the periodic chart in the case of the missing values of the stable AR model (2)
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In this study, we investigate the behavior of the estimated spectral density function of stationary time series in the case of missing values, which are generated by the second order Autoregressive (AR (2)) model, when the error term for the AR(2) model has many of continuous distributions. The Classical and Lomb periodograms used to study the behavior of the estimated spectral density function by using  the simulation.

 

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Publication Date
Wed Jul 01 2015
Journal Name
Al–bahith Al–a'alami
The Position of the Oil Press about the World Oil Industry / OAPEC Bulletin 2011-2012 as a Model
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This research deals with the attitude of oil press towards oil industry in the world and the extent of their concerns with the stages of oil industry relating to the abundance of oil and natural gas, as it is an international strategic and complementary industry. The researcher uses the survey method for content analysis of the initial article and the press news for two: years (2011-2012). The results if the study are as follows
1- Oil press is concerned with developing and the stages of the Arabic oil industry in the interest of OAPEC in the first place.
2- It is concerned with exploring, extracting, and marketing oil in the first place, then with refining operations in refineries and petrochemical plants in the second place, an

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Publication Date
Tue Mar 02 2021
Journal Name
Humanitarian And Natural Sciences Journal
THE LINGUISTIC STRUCTURES OF THE HISTORIANS ALYAQOUBI (284 AH / 897 AD) ARE A MODEL
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The research in the linguistic structures of the historians Al-Yaqoubi is considered a model of the important topics in historical studies in general, given its importance in the lives of peoples due to its connotations and meanings that summarize interpretation, clarification, and prolonged speech, as it includes life meanings with many dimensions, these structures have been used in historical incidents Important, and throughout the different ages, as it can be used to support an opinion, solve problems, prove evidence, increase wisdom, and it needs rich life experiences, and a sound language, to use it, and needs a wide absorptive capacity for the recipient, the research included linguistic structures in the achievement of science , Lingu

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Internal control and its role in the reform of the tax work: Applied research in the General Commission for Taxes
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That internal control is particularly important in improvingperformance and tax reform، they play an important role in the regularity ofwork and development and the anti corruption and activating the decisionsand tax legislation، as contained in the organizational plan and the means،procedures and components designed from which to ensure a policy andimplementation plans The research aims to review the reality of the internalcontrol in the General Commission for Taxes and stand on the deficiencies init, with the strengthening of the role of internal control in the GeneralAuthority for taxes based on the laws and regulations and by using modernmeans to work as well as developing the performance of employees in thebody، including helpin

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Publication Date
Sun Sep 26 2021
Journal Name
Modern Sport
The effect of special exercises in developing the strength endurance of the arms of the national team players with the goal ball for the blind
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The importance of the research lies in preparing an experimental curriculum according to a scientific method that will contribute to the development of the special strength(endurance the strength of arms) in order to contribute to the attempt to develop the basic skills of the national team players ‏with the goal ball for the blind ‏As for the research problem, it lies in the weakness of the strength endurance of the national team players with the goal ball for the blind, as the research problem is clearly evident in the last minutes of the match, as well as the former studies in the field of goal ball game for the blind at the country level ‏The research aims to prepare special exercises for endurance of strength as well as t

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