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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 Mar 31 2022
Journal Name
Journal Of The College Of Education For Women
The Phonetic Connotation of the Appending Letter Alef in the Holy Qur’an
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Appending is a morphological term which means the addition of one or two letters to a structure to be similar to other structures of well-known abstractor additional nouns and verbs constructions. The goal of appending is to organize what have been expanded linguistically and collect similarities to reduce the syntactic rules. This is because the appended word exists for expanding purposes; however, it has no construction of its own. An appending was included with another construction with mentioning the additional letter. This by itself means that appending as a process is a term that helps organize rather than expand language. Scholars further noticed that the appending letter is not semantically significant, and so it differs from the

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Providence of the Rosaly's family to the Intellectual Movement in Yemen
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The Providence of the Rosaly's family to the Intellectual Movement in Yemen

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Publication Date
Sat Oct 01 2016
Journal Name
Al–bahith Al–a'alami
The Absence of the Applied Semiotic Approach in Analyzing the Media Phenomenon
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the contemporary Arab scholars deal with semiotics as an approach that helps them understand the texts, its meaning, and its structural functionalism . that’s why every now and then we find some
studies and researches using semiotics as an approach in study and comparatives, some of them even used the semiotic approach in analyzing old and new texts, while others think that semiotic holds and important place in critical approaches .
even though some of them considers semiotic just a trend of fashion this really didn’t lessen the value of semiotic as a scientific and procedural approach in literary and media studies as well as in analyzing literary and journalistic texts. for this reason it is considered as an important approa

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Publication Date
Thu Dec 15 2022
Journal Name
Al-academy
The deliberative dimension of the visual sign in the contemporary Iraqi poster
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The current research dealt with (the deliberative dimension of the visual sign in the contemporary Iraqi poster) in an attempt to identify the importance of the contemporary poster and the role of the international dimension of the visual sign of exceptional importance.
What is the international dimension of the visual mark?
- What is the effect of the visual label on the contemporary Iraqi poster?

The current research aims to identify the pragmatic dimension in the contemporary Iraqi poster.
Across the temporal and spatial research boundaries of the year (2000-2020) in Iraq. The limits of the objective research The limits of this study on the pragmatics in the visual sign and the determination of the relationship betwee

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Publication Date
Thu Oct 10 2019
Journal Name
Journal Of The College Of Education For Women
Constitutional Review of 1992 and 1996 and the role of the Party of Progress and Socialism
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Constitutional Review of 1992 and 1996 and the role of the Party of Progress and Socialism

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Publication Date
Thu Aug 01 2024
Journal Name
The American Journal Of Management And Economics Innovations
THE ROLE OF ECONOMIC DATA ANALYSIS IN MANAGING MEDIUM AND SMALL COMPANIES TO MAKE STRATEGIC DECISIONS AND IMPROVE PERFORMANCE: AN ANALYTICAL STUDY
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Economic analysis plays a pivotal role in managerial decision-making processes. This analysis is predicated on deeply understanding economic forces and market factors influencing corporate strategies and decisions. This paper delves into the role of economic data analysis in managing small and medium-sized enterprises (SMEs) to make strategic decisions and enhance performance. The study underscores the significance of this approach and its impact on corporate outcomes. The research analyzes annual reports from three companies: Al-Mahfaza for Mobile and Internet Financial Payment and Settlement Services Company Limited, Al-Arab for Electronic Payment Company, and Iraq Electronic Gateway for Financial Services Company. The paper concl

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Publication Date
Thu Jun 25 2020
Journal Name
International Journal Of Drug Delivery Technology
The Effects of Salvia officinalis Gel as an Adjunct to Scaling and Root Planning in Patients with Periodontitis (Clinical and Immunological Study)
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Background: Phytotherapy is the usage of herbal species with medicinal properties for the management of various diseases. Gingivitis and periodontitis are diseases that involve the role of both the bacteria and the host immune response. Over the years, various researches have shown the importance of herbal products in the management of periodontal diseases. Aims of the study: To evaluate the efficacy of locally applied Salvia officinalis gel as adjunctive in the treatment of chronic periodontitis. Subjects and methods: Fourteen patients (10 males and 4 females) with chronic periodontitis were enrolled in the present study with total number of twenty-eight periodontal pockets utilizing a split mouth design, the pockets were divided i

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Publication Date
Fri Oct 02 2020
Journal Name
Biochem. Cell. Arch.
MORPHOLOGICAL DESCRIPTION AND COMPARATIVE HISTOLOGICAL STUDY OF THE LIVER IN TWO IRAQI MAMMALS : WEASEL (HERPESTES JAVANICUS) AND EASTERN GRAY SQUIRREL (SCIURUS CAROLINENSIS
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The results of the current study showed that the liver of H. javanicus appeared as large lobulated organ divided into six distinct lobes, that filled the cranial region and little extended to the middle region of abdominal cavity. On the other hand, liver of S. carolinensis laid against the diaphragm, occupied the cranial region of the abdominal cavity and consisted of five lobes. The liver is surrounded with a thin capsule of dense regular collagenous connective tissue and few numbers of smooth muscles fibers can be seen in the capsule that covered the squirrel liver. The liver parenchyma divided into a large number of interconnected hepatic lobules marked only by the abundant amount of connective tissue bordered the triads, and within the

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Publication Date
Tue Dec 16 2008
Journal Name
Journal Of Planner And Development
The system of urban stability in the Kurdistan Region of Iraq
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The developing countries can be distinguished by spatial disparities and by this a wide gap between urban and rural settlements were produced as well as the appearance of primate cities. The effect of spatial development as a dynamic and continuous process can be perceived in the state of population distribution inside settlements inter and intra regions as well as the hierarchy of urban settlements according to time series. The research proved that the improvement judgment of the structure of the urban system using Gene factor is not accurate because it cannot be accounted for the internal components of the system which make a contrariety between the whole judgment (country) and partial components (Provinces including Sulaimaniy

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Role of inherited occupations in cohesion of the family system
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This study aims to study the inherited occupations which are considered to be a cultural, civilized and social legacy that effected by the Prevailing social and economic circumstances in the Iraqi society .
The study aimed to achieve several goals, including:
Identify the relationship between the urbanization and inherited occupations in the old city Al-Karkh.
Identify the relationship between the ecological construction and inherited occupations in the old city Al-Karkh.
Recognize the factors and motives inherited occupations in the study area .Identify the role of inherited occupations in promoting opportunities cohesion of the family system in the study area.
The field of the study had concentrated on a sample of famili

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