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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 Jan 10 2019
Journal Name
Journal Of The College Of Education For Women
Similar and different between Arabic and Arabian peninsula Accents balance linguistic Study Voice of the Sein typically
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    Languages were not found in our life in a way utter coincidence , and it’s not flounce on people’s tongue randomly ‚ but laws are the controlling in languages‚ these laws could be lift to the same level of natural laws‚ phonetics form the main part in producing those languages‚ the Arabic language is one of those languages ‚ it’s largest dialects in Arabian Peninsula according to speakers number ‚ Arabic language link with these dialects through properties and phenomena sound and grammar‚ from this point my topic search is came Similar and different between Arabic and  Arabian peninsula Accents balance linguistic–study voice of the Seine typically ) . and  Similar and different of the ph

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Publication Date
Mon Dec 31 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY THE SYNERGISM EFFECT OF ALCOHOL EXTRACT OF Thymus vulgaris WITH ANTIBIOTICS AGAINST pseudomonas aeruginosa.: STUDY THE SYNERGISM EFFECT OF ALCOHOL EXTRACT OF Thymus vulgaris WITH ANTIBIOTICS AGAINST pseudomonas aeruginosa.
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The current study includes 144 samples were 106 bacterial samples belonging to the clinical sources, 38 bacterial samples belonging to the environmental sources to investigate the presence of bacteria P. aeruginosa. The results of diagnosis clarified that there are 45 bacterial isolates belonging to the bacterium P. aeruginosa The examination of the sensitivity of all bacterial isolates was done for elected 45 isolation towards the 11 antibiotic by spread method on the dishes. The results showed that the resistance ratio toward Cefixim, Cefotaxim, Tetracycline, Amoxicillin, Cloxacillin, Methicillin, Erythromycin and Naldixic acid was 77.7, 73.3, 84.4, 82.2, 80, 77.7, 77.7 and 73.3 respectively, While most isolates were sensitive to all o

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Publication Date
Wed Jul 13 2022
Journal Name
International Journal Of Health Sciences
Study of the reliability of serum vascular endothelial growth factor and its soluble receptor as markers of diabetic nephropathy in type 2 diabetes patients
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The levels of circulating angiogenic and anti-angiogenic factors, namely vascular endothelial growth factor–A (VEGF-A) and soluble vascular endothelial growth factor receptor-1 (sVEGFR-1), have been linked to the development of renal dysfunction due to the proliferation of microvasculature within the kidneys of type 2 diabetic (T2DM) patients. The study aims to scrutinize serum levels of VEGF and sVEGFR-1 in a sample of Iraqi diabetic nephropathy patients to support their reliability as markers for the prediction of nephropathy in type 2 diabetes mellitus patients as well as to assess the ACE inhibitor’s effect on the levels of these two markers. Method: The ninety participants of this case-control study were split into three gr

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Publication Date
Mon Nov 24 2025
Journal Name
Iraq Journal Of Market Research And Consumer Protection
Study of the qualitative characteristics of oils derived from fish waste running Asian Silurus triostequs and use of organic solvents in certain food systems
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Publication Date
Mon Dec 21 2020
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
COMPARATIVE STUDY OF SEVERAL MORPHOLOGICAL AND REPRODUCTIONAL ASPECTS FOR SOME SPECIES OF THE BELLEVALIA LAPEYROUSE, 1808 AND ORNITHOGALUM LINNAEUS, 1753 (ASPARAGALES, ASPARAGACEAE) IN CENTRAL AND NORTH OF IRAQ
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This study aims to study some morphological and reproductional characteristics in eleven species of two genera belonging to the family of Asparagaceae, which are Bellevalia Lapeyrouse, 1808 and Ornithogalum Linnaeus, 1753 and the species are: Bellevalia chrisii Yildirim and Sahin, 2014; Bellevalia flexuosa Boissier, 1854; Bellevalia kurdistanica Feinbrun, 1940; Bellevalia longipes Post, 1895; Bellevalia macrobotrys Boissier, 1853; Bellevalia paradoxa Boissier, 1882; Bellevalia parva Wendelbo, 1973; Bellevalia saviczii Woronow, 1927; Ornithogalum brachystachys C. Koch, 1849; Ornithogalum neurostegium Boissier, 1882 and Ornithogalum pyrenaicum Linnaeus, 1753. These species were identified and compared with each other; the results showed th

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Dimensions of organizational immunity and its relationship Enhancing the strategic capabilities of the company: applied research in the Iraqi General Insurance Company
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The aim of the research is to diagnose the nature of the relationship between the dimensions of organizational immunity with its dimensions represented by (organizational memory, organizational DNA, organizational learning) in enhancing the strategic capabilities of the company with its dimensions represented by (marketing capabilities, administrative capabilities, technological capabilities, creative capabilities), and the degree of arrangement of those dimensions According to priority, as well as revealing the differences in the respondents’ response to the two variables according to the personal and functional variables, and the importance of the expected results, the researchers adopted the questionnaire as a tool for collecting da

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of forensic accounting in winning compensation claims and its impact on the profits of the National Insurance Company: applied research
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                The research aims to shed light on the importance of forensic accounting and its role in winning compensation claims against the company because of the ability of the forensic accountant (the judicial expert) to interpret and analyze the data. The research community represents the insurance companies in Iraq. The research sample was represented by the National Insurance Company. Coverage of the theoretical and deductive approach in covering the practical side, based on the financial records of the National Insurance Company for years of research.One of the most important conclusions reached by the researchers was that forensic accounting has a role

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Research Title: The Relationship Between Strategic Orientation and Organizational Performance (Applied research in the Ministry of Defense / Office of the Inspector-General)
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Abstract
The aim of the study is to study the relationship between strategic orientation and organizational performance. The strategic direction is the main purpose for which the organization is found. Therefore, it is the main engine for all the activities and tasks that the institution can carry out to achieve its objectives within the environment in which it operates. ,. The research problem was formed by several questions to determine the level of the strategic direction and the nature of its relationship with organizational performance in the Iraqi Ministry of Defense / Inspector General's Office as the field of application to answer. The sample was selected by a sample of 60 individuals, department managers, And the que

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Publication Date
Wed Feb 22 2017
Journal Name
Geological Society, London, Special Publications
Role of facies diversity and cyclicity on the reservoir quality of the mid-Cretaceous Mishrif Formation in the southern Mesopotamian Basin, Iraq
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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Teaching Practices of Science and Mathematics Teachers Based on the National Framework for Future Skills in the Omani School
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Abstract

The research aims to identify the level of effectiveness of the teaching practices of science and mathematics teachers in light of the national framework for future skills in Omani schools. To achieve the objectives of the study, the researchers used the descriptive approach, as he designed a note card consisting of (30) phrases distributed on three axes: basic skills, practical skills, and technical skills. After verifying the validity and reliability of the tools, they were applied to a sample of (116) teachers. The results of the research revealed that the level of effectiveness of the teaching practices of mathematics teachers has recorded a medium degree with a mean (3.05). The results a

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