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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
Sun Mar 04 2012
Journal Name
Baghdad Science Journal
The effect of crude alcoholic extracted for the Seeds and Leaves of Apium graveolens Var dulce. In the level of some female hormones in albino Mice.
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The quantitative determination of the estrogen E2, Progestron P4 & follicle stimulating hormones FSH in the serums of Albino mice used in the experiments & treated by crude alcoholic extracted 95% of the seeds & leaves of Apium graveolens was a significant increase in the concentration of estrogen of different kinds of the extracted in comparison with the values of the coefficient of the control group, that is the study recorded a significant increase of the concentration of estrogen; it was the highest in the mice which was administrated by the methanolic extracted 95%, then it was less in the mouse which was administrated by the ethanolic extracted., and it was the least in the mice which were administrated by the crude ethanolic-methano

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Publication Date
Sun Sep 15 2019
Journal Name
Al-academy
Use of Multimedia in the Design of Educational Websites and their Role in Enhancing the Cognitive Aspect of the Learner: احمد ناجي علي-يوسف مشتاق لطيف
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Multimedia is one of the most important elements of modern educational media and must be used in educational websites in order to disseminate knowledge on a large scale and should be used to provide scientific information to all, as the current research tried to explore the possibilities of employing them in the design of educational websites and highlight their role in promoting the scientific aspects of the user. This study included four axes, the first of which was devoted to the introduction which includes the problem of research, its importance, objectives and its objective, temporal and spatial limitations, which were limited to the study of the main pages of Arabic educational websites published in 2019.  The second axis cont

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Measure the impact of the age structure of the population on the gross domestic product in Iraq
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   يهدف البحث إلى التعرف على The research aims to identify the effect ofاثر التركيب العمري للسكان على الناتج المحلي الإجمالي في العراق وتحديد الفئات العمرية من أطفال ومنتجين أي من هم في سن العمل والمسنين لأهمية ذلك لإغراض التخطيط الاقتصادي.إنeffectofeee age structure of the population on GDP in Iraq and determine the age groups of children and any of the producers wham are of working age and the elderly of the importance for the purposes of economic planning. نسبة الفئة العمرية Proportion of the age group (00- -4 4سنوات اقتربت من

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Publication Date
Thu Jun 02 2022
Journal Name
International Journal Of Early Childhood Special Education
The effect of special exercises in the rehabilitation of the shoulder muscle for the youth wrestling category
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shoulder joint by preparing special exercises for the youth-category wrestling, and through the researchers' follow-up to the wrestling game and their work in the field of rehabilitation and physical therapy, noticing that most of the wrestling players suffer from the shoulder joint pain despite their visit to the specialist doctor and take Treatment, so the researchers saw to study this problem and restore the recovery of the injured through special exercises and a suitable qualification program for the shoulder joint muscles, the goal of research in preparing special exercises and knowing its effect on the rehabilitation of the background muscle of the shoulder for the youth wrestling category. The researchers assumed that there are stati

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Publication Date
Tue Jun 13 2023
Journal Name
International Journal Of Engineering Business Management
The role of environmental management accounting information in the design process of environmental and sustainable products
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The aim of this study is to investigate the effect of environmental management accounting information (EMAI) on the design process of environmental and sustainable products of Iraqi industrial companies. This process has five different sub-processes: research process, analysis process, conceptual design process, detailed design process and design production process. The study uses the quantitative approach as the questionnaire was designed and distributed to 87 quality managers, production managers, design managers and financial managers. The MANOVA analysis shows that EMAI has a positive and significant effect on three of these processes, namely research process, analysis process and detailed design process, while EMAI has an insi

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Publication Date
Sun Apr 03 2011
Journal Name
Journal Of Educational And Psychological Researches
Satisfy of life and it's relationship; with the bige factors of character in the university student
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This research aim to recognize
satisfy of life in the university's student and balance in satisfy of life
according to two type aveirable sex specific and find type and
relationship's director between satisfy of life and character big factors.
and known hom much that Factors in satisfy of life, the research sample
consist of (401) student male and female and from both specified in
Baghdad's University, researcher bult scale of Costa &McCrae Fore the
fire big Factors to Personality, research result That the university's
student low level of satisfy of life and there are no different statically if
they are scientific or human in their study. And there is positive and there
is positive and indicate relation

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
The Properties of Tourism Services and Entertainment in the City of Baghdad ( Baghdad Island Park ,Tourism)
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Baghdad Lake Touristic is suffering from a lake of tourism and entertainment services
efficiency provided to their visitors , knowing that this type of services as they are the basics
to achieve economic and socialist development because of their indicators where their goal is
to serve human in city as they represent lungs which population breathe within .
The Parks are resorted as human usually in search of quiet and funny places , away from
the noise of the city and its complex , as well as they give the city a beauty manifestations ,
that give happiness.
The study reached that there is deficiencies in service present, inability to provide
services and inadequate for the population and bad distribution. So the s

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of government and private banks in the financing of small projects: An Applied Research
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Abstract:

 Sought the search to find out what small businesses, the importance of funding, and the role of funders in supporting such projects, which have been addressed in the search through a sample of government banks (Rafidain and Rasheed) and private banks (the Middle East, the Gulf, North, Assyria) and a sample of Small projects borrowed from these banks, but in order to achieve that rely researchers on scientific methods discreet marked by the curriculum descriptive analytical method which is based on the compilation of facts and information then collated and analyzed to reach acceptable results, as well as data collection tool (checklist) was whereby examine questions of a sample of

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Publication Date
Wed Apr 10 2019
Journal Name
Journal Of The College Of Education For Women
Environmental Impact in the Cultural Output of the Civilizations of Ancient East, Iraq and Eygpt sample
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Our research subject (environmental impact in the cultural output of the civilizations of ancient East) the environmental impact on human civilization and how her and adapted to serve in various cultural aspects especially in ancient cultures whether punches or sculptures and other addresses as well as tracing precious stones and raw materials.  It was the environment of the civilizations of Mesopotamia and Egypt and another effective impact in drawing ancient history through human interaction and responsiveness.  The Iraqi environment was marked by poverty and cruelty on the one hand and on the other cultural elements contributed to the civilization in General and research dealing with technical and product sourcing raw materi

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Publication Date
Sun Jun 20 2021
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
ON THE ECOLOGY AND SPECIES DIVERSITY OF THE FRESHWATER GASTROPODS OF SPRINGS IN ANDIJAN REGION, UZBEKISTAN
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This study examines the species composition, biodiversity, zoogeography, and ecology of freshwater gastropods of 12 springs in Andijan region of Uzbekistan. The study used generally accepted malacological, faunistic, ecological, analytical, and statistical methods. As a result of research in the springs, 14 species of freshwater gastropods belonging to 2 subclasses, 5 families, and 10 genera were recorded. 7 of them are endemic to Central Asia. When indicators of biodiversity of mollusks were analyzed according to the Shannon index, it was found that the highest value was recorded in the springs besides the hills. According to the biotope of distribution and bioecological features, they were divided into cryophilic, phytophilic, pelophil

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