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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 Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Architecture design quality in build competitiveness for contracting companies in The Ministry of Housing and Construction of Iraq
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The study aimed at interpreting the role of architectural design quality in in build competitiveness model in accordance with the proposal included the idea of ​​architectural design quality for its removal; interesting design factors of the environment, good design of the spaces, and design aesthetic explanatory variable. The competitiveness dimensions; the level of innovation, stimulate research, and the quality of the company's products, and activating the role of human resources, entrepreneurship, profitability, market share and competitiveness, variable responsive. The study of construction companies in the Ministry of Housing and Construction has taken the Iraqi society for the study. The sample consisted of (48) manage

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of the Role of Interleukein-2 and Interleukein-4 in the Immunopathogenesis of Steroid Therapy Resistance in Iraqi Asthmatic Patients
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Interleukins (IL-2 and IL-4) are increased in asthmatics and were reported to induce resistance to steroid therapy in some patients who fail to get benefit from glucocorticoids when used in full dose and for long period of time. In this context, the present study was conducted on Iraqi patients to provide additional laboratory mean, beside the clinical diagnosis, for the decision whether the asthma is steroid sensitive or resistant by monitoring the level of immunoglobulins, complement proteins and interleukins among asthmatic patients (steroid sensitive or resistant) and the possible contribution of other factors like age, sex and environments in the development of steroid resistance. A total number of 55 asthmatics and 28 normal subjec

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Publication Date
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
LOCAL NEWS SOURCES IN THE IRAQI NEWSPAPERS: Local news sources in the Iraqi newspapers (An analytical study of local news sources In the newspaper Al-Zaman for the period from 1/6/2006 to 06/30/2006)
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Local news is an important topic of the press because of its importance to readers. It touches their daily life in one way or another, which makes them interested in and followers of them. Hence the importance of local news, as it interests a wide segment of readers.
There are many sources of newspapers for obtaining local news, as these sources are distributed to the newspaper's own sources and external sources.

Self-sources are the newspaper's own sources, through which it is possible to obtain this news, such as the representatives of the newspaper and its correspondents and the journalists working in it. This is the example in this way.
The external sources are distributed to local and international news agencies and sa

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Effect of measurement and analysis of quality costs on continuous improvement: Applied research in the Directorate General for the distribution of electric power in the Middle Euphrates
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The research aims to identify the theoretical foundations for measuring and analyzing quality costs and continuous improvement, as well as measuring and analyzing quality costs for the Directorate of Electricity Supply / Middle Euphrates and continuous improvement of the distribution of electrical energy,The problem was represented by the high costs of failure and waste in electrical energy result to the excesses on the network and the missing (lost) energy,Thus, measuring and analyzing quality costs for the distribution of electrical energy and identifying continuous improvement leads to a reduction in missing and an increase in sales, as the research reached many conclusions, the most important of which is the high percentage o

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the international auditing standard IAS 540 "Auditing accounting estimates and related disclosures" in limiting income smoothing practices in the financial statements (from the point of view of Iraqi auditors)
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                The current research aims to show the impact of the international auditing standard IAS 540 in reducing income smoothing practices in Iraq. To achieve the objectives of the research, the researcher adopted a questionnaire for a sample of auditors in Iraq. Where 60 forms were distributed and after the questionnaire was retrieved and statistical analysis was done using the SPSS program, The research reached a number of results, the most important of which are: the existence of a statistically significant effect of the application of the international auditing standard IAS 540 in reducing income smoothing practices, The research recommended the necess

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Publication Date
Wed Sep 15 2021
Journal Name
Al-academy
Contemporary experimental currents and its impact on the structure of the contemporary Iraqi theatrical text "The epic theater as a model": هيثم حمزة سلمان الحمداني
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  In this research study, I tried to trace the epic effect to learn how it was understood and how it was used. Following the descriptive and analytical approach in the research, the first chapter dealt with a presentation of the methodological framework of the problem, the goal, the limits of the research, the importance and the need for it and the definition of terms, as well as the theoretical framework which consisted of two topics, including the impact of the epic theater on the world theater and the second the effect of the epic theater on the Arab theater, This came by tracing the epic impact on the world stage of the Greeks, the Middle Ages, the Renaissance, and the Arab theater of the twentieth century.
As for the second

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Publication Date
Sat Jan 01 2022
Journal Name
Vostok. Afro-aziatskie Obshchestva: Istoriia I Sovremennost
The carrier of word-formation meaning in russian and arabic gramatic traditions: the word model in the russian-arabic translation algorithm
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The article is devoted to the Russian-Arabic translation, a particular theory of which has not been developed in domestic translation studies to the extent that the mechanisms of translation from and into European languages are described. In this regard, as well as with the growing volumes of Russian-Arabic translation, the issues of this private theory of translation require significant additions and new approaches. The authors set the task of determining the means of translation (cognitive and mental operations and language transformations) that contribute to the achievement of the most equivalent correspondences of such typologically different languages as Russian and Arabic. The work summarizes and analyzes the accumulated exper

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Publication Date
Mon Jan 27 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Analysis of the relationship between the Premiums and compensations in Life Insurance: An Applied Research in the General Iraqi Insurance Company
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           Communities seek to achieve the economic growth through the optimal use of resources. The human resource is considered the most important of those resources where the insurance institutions take the larger role in the protection of this resource and reducing the impact caused by dangers realization that endures. The general Iraqi insurance company is considered the leading in the field of life insurance since it was founded, and until now.

          This research is based on an analyzing the relation between premiums and compensations   of life insurance, for individual and the group insurance, and a reality of the

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Publication Date
Sun Nov 23 2025
Journal Name
Journal Of The College Of Basic Education
The effect of rehabilitation exercises with different resistances in the water medium according to some variables and biomechanics in restoring the flexibility and strength of the thigh muscles for those with knee roughness
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It included the introduction to the research and its importance, as the knee joint is one of the important joints in the human body that are susceptible to injury, and among these injuries is the roughness of the knee that occurs as a result of weakness and imbalance in the work of the quadriceps muscle, so its treatment is through rehabilitation exercises to treat weakness and gain flexibility and strength.Hence the importance of the research by developing rehabilitation exercises with different resistances in the water medium and restoring flexibility and muscular strength for patients with knee roughness for ages from 30-40 years, and the experimental method was used to solve the research problem, and the research sample included (6) of

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Publication Date
Mon Jun 15 2020
Journal Name
Al-academy
The narrative and dramatic construction between the vision of the script and the director: بان جبار خلف
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  The relationship between the vision of the scenario and the director is represented in the second search for new mechanisms and possibilities that possess the direct effect and synonyms of the vision of the scenario, so he works on investing them in achieving his ideas and visions with more effectiveness and flexibility to achieve creative potentials, without resorting to the installations and expressive structures themselves that have exhausted their meaning, and lost their luster due to Its prevalence and familiarity on the one hand, and its activation on the other hand to achieve modernity at the level of aromas, after the director takes a method or approach that has privacy and exclusivity, and based on the foregoing, getting

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