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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
Tue Dec 01 2009
Journal Name
Iraqi Journal Of Physics
The Calculation of the Charge Density Distributions and the Longitudinal Form Factors of 10 B Nucleus by Using the Occupation Numbers of the States
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The charge density distributions of 10 B nucleus are calculated using the
harmonic oscillator wave functions. Elastic and inelastic electron scattering
longitudinal form factors have been calculated for the similar parity states of 10B
nucleus where a core of 4He is assumed and the remaining particles are
distributed over 3/ 2 1p and 1/ 2 1p orbits which form the model space.
Core-polarization effects are taken into account. Core-polarization effects are
calculated by using Tassie model and gives good agreement with the measured
data.

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
The Role of Education in Enhancing the Value of Citizenship in Children through the Interactive Life Process in Educational Institutions
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The aim of the research is to diagnose the methods of enhancing the value of citizenship in children through the interactive life process in educational institutions; the descriptive approach was used to achieve the objective by identifying social theories that corresponded to the national value or the theoretical principles of citizenship education. The study focused on educational activities and their role in establishing values, national educational philosophy in interactive activities, as well as the presentation of previous studies on the subject of citizenship, and maps of each of the strategies of active learning, skills in the process of interactive life in the field of education, Institutions that have the responsibility to prom

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Publication Date
Mon Feb 19 2018
Journal Name
Al-academy
The problem of overlapping concepts in the interpretive practices of literary text (The texts of Shakespeare model)
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The scientific studies that deal with Herminutia (interpretation) as the art of reading the interpretation practiced by the recipient after his understanding of the literary texts and works of art that he sees or read them so that these readings to make the act of reading and allow him the opportunity to mature and rational reflection of each text or artistic work.

Based on this, the researchers considered the establishment of the problem of their research through the search for the problematic overlap of concepts in the interpretive practices of the literary text?

The second chapter dealt with the definition of the term interpretation as well as interpretation as a theory and concept, and then the indicators reached by t

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Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The evaluation of the procedures of excution the national strategy of unti - corruption in Iraq (2014-2010)
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    Corruption has become the subject of great interest, and the subject of research and scrutiny in recent years, because of its penetration in all fields of life,  whether these fields are political, economic, social, and administrative. It is one of the biggest challenges and problems that are facing communities. Therefore, this study is focused on the evaluation of measures implementing the national strategy to combat corruption in Iraq.

This study was launched, first because of its intellectual dimensions to ensure a conceptual presentation of the strategy and operational management in general with a special focus on the processes of implementation and control str

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The impact of the of Six Sigma to improve the performance of dentists in albaladeat specialized Dental
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The research aims at introducing the principles of six sigma and if it had any effect of the dimensions of six sigma to improve the performance of the dentists and the availability of an appropriate environment in the center Specialist respondent to the application of six sigma principles and how to adopt Specialized Center under the dimensions of the six sigma and if there informed enough with the management methodology six sigma, and if you can adopt six sigma as one of the entrances to reduce medical errors. So  Search creating six sigma five dimensions and are (the commitment and support of senior management, the focus  on the patient, continuous improvement, training and civil, and infrastructure) as a variable int

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The role of segment reporting requirements in enhancing the volume of segmental disclosure of the Iraqi corporations
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The aim of this research was to analyze the financial reporting requirements of segmental information that stipulated by the Iraqi accounting rules, investigating the extent of it compliance with the requirements of the International Financial Reporting Standard No.8 (IFRS 8) and the Statement of Financial Standards No.131 (SFAS 131). Also the research aimed to identify the segmental disclosure practices in listed corporations on Iraq Stock Exchange (ISX), basing on a hypotheses said that “the insufficient  of Iraqi financial reporting requirements of segmental information affect<

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
The extent of including logical intelligence in the Book of chemistry for the fifth Grade of science
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The aim of the current research to determine the extent of logical intelligence in the book of chemistry for the fifth grade of science and to achieve the goal the researcher has prepared a special criterion in the areas of logical intelligence main and sub-to be included in the book after reviewing the previous literature and studies in this regard may be the final form after presentation to experts and arbitrators in the field of Educational and psychological sciences, curricula and teaching methods from (3) main areas and (21) sub-fields, then the researcher analyzed the book Bibih and applied branches and adopted the idea of ​​both explicit and implicit as a unit of registration and repet

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Publication Date
Thu Jan 01 2015
Journal Name
Al–bahith Al–a'alami
The role of television talk shows in shaping the political awareness of the students of Diyala University
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The  study aimed to exposure young university students and students talk programs offered by satellite TV exposure, as it represents these programs great importance Information Public Knowledge in general And the  youth in  private  Including Posed From Opinions And ideas About Different  Issues Raised Which Charges Opinion, And that Through Application Study Survey To Sample From Students of Diyala University, the  Researcher display Public Accrediting Theory To Information Which Provided Means Media To achieve Objectives And satisfy Needs   And hypotheses  . The Problem Search was Determined  Through Study of students of Diyala  University exposure  Programs Talk And measured&

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Publication Date
Wed Sep 07 2022
Journal Name
International Journal Of Asia Pacific Studies(ijaps)
Investigating the Aesthetic Effect in the Arabic Translations of Gibran’s the Prophet
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Publication Date
Wed Oct 05 2016
Journal Name
Al-academy
The Stylistic Development in the Crafts of the Sculptor Mohammed Ghani Hikmat
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The present study aims at examining the stylistic development in the crafts of the sculptor Mohammed Ghani Hikmat. It gives answers to the following two questions: what is the nature of the stylistic development? And what are these principles and techniques led him to this development? The researcher has used the descriptive, analytic approach in examining the selected five samples out of the sculptor’s displayed crafts. The observational technique is used as a tool of examination. Among the main findings are: integrating space in the cubic crafts, represented by the existence of holes within this general construction of that space; the evident influence of critical contemporary orientations through the direct insertion of recipients i

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