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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
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
The role of satellite channels in the dissemination of consumer culture
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This study is concerned look at the role of satellite channels in the dissemination of
consumer culture that has become part of our everyday lives , which is a dangerous
phenomenon on society , so the study is aimed at introducing the concept of consumer culture
and the risks to individuals , which conducted a field study on a sample of students from the
University of Baghdad, as they represent an important category of the society they are a class
of young people to get to know the impact of satellite television on them through their various
programs and serials, films and ads may develop consumer culture they have , including in
respect of ideas and information , where the questionnaire was developed to ensure diffe

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Publication Date
Tue Jan 01 2019
Journal Name
Lambert
The concept of Evil in J.R.R.Tolkien Novel Lord of the Rings
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Evil pervades the narrative scene in Tolkien. Hence; his major themes in The Lord of the Rings are shown to be the Evil Nature of Power, the Tyranny of Technology and War as a Destructive Agent. Evil is not as powerful as good. The Boethian conception of evil comes through evil beings such as Melkor Morgoth in The Silmarillion or Sauron ,who cannot do good things but only pervert or mock things; In The Lord of the Rings; Tolkien seems to suggest that there is no absolute evil. The other conception of evil is the Manichaen, a conception which receives more emphasis in Tolkien's trilogy and which sees the world as a battle-ground for warring forces of good and evil. Tolkien frequently personifies the Ring as if it were acting with a will of i

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Publication Date
Mon Dec 30 2019
Journal Name
College Of Islamic Sciences
His eloquence of Quranic verses in the verses of the Resurrection
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 The research tagged (eloquence of the Qur’anic verses in the resurrection verses) deals with study and analysis of the aesthetics of miracles in the Qur’anic poems centered on the horrors of the Day of Resurrection, and aims to clarify the role of the Qur’anic unique and its impact the miraculousness of the Qur’anic style systems, the accuracy of the unique selection and its wonderful harmony in form and content, voice and meaning, composition And a picture with its context and denomination; based on that, the research was based on the analytical method to reach its goal, and the research plan imposed its division into two preamble and two topics, the first topic dealt with: the rhetoric of the nominal Qur’anic verses in

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Publication Date
Sat Jan 12 2019
Journal Name
Journal Of The College Of Education For Women
The geomorphological associated of Sebkha in the Mesopotamia- plain of Iraq
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The Sebkha of geomorphological aspects of evaporative where climate leads active role, which forms part of the earth's surface in the form of Iraqi Mesopotamia plain who of the most fertile land, and because of natural factors and human Common turned most of the arable land to the territory of Sebkha. It was to determine the exact geomorphological associated of Sebkha formats by field work such as: Alnbaka, lakes, salt flats, and other forms of Small is: bridges salt, mud cracks, salt ponds, Rectangles and polygons salt, Sahaf salt, salt domes, salt gravel, bumps saline (salt points), Ash salt, salt bows, in detail and accurately documented Terrestrial Photogrammetry field and were compared to the levels and standards varieties have been

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Publication Date
Thu Aug 12 2021
Journal Name
Applied System Innovation
The Role of Correlation in the Performance of Massive MIMO Systems
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Massive multiple-input multiple-output (m-MIMO) is considered as an essential technique to meet the high data rate requirements of future sixth generation (6G) wireless communications networks. The vast majority of m-MIMO research has assumed that the channels are uncorrelated. However, this assumption seems highly idealistic. Therefore, this study investigates the m-MIMO performance when the channels are correlated and the base station employs different antenna array topologies, namely the uniform linear array (ULA) and uniform rectangular array (URA). In addition, this study develops analyses of the mean square error (MSE) and the regularized zero-forcing (RZF) precoder under imperfect channel state information (CSI) and a realist

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Publication Date
Thu Oct 10 2024
Journal Name
Pakistan Journal Of Criminology
The Role of Environmental Bonds in the Settlement of Environmental Debts
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The concept of environmental debt, which has several dimensions, emerged in the nineties. One of these dimensions is spatial, referring to the debts that southern countries sustain due to the extraction of natural resources and environmental damage inflicted upon northern countries. Another dimension, the temporal dimension, concerns the environmental debts that current generations owe to their predecessors. That means past generations are culpable for overuse of natural resources and mismanagement. The debt issue is complex, despite many mechanisms to resolve it. Most important are the recently introduced environmental bonds, an important step forward in the field of sustainable financing of environmental debts.

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Publication Date
Wed Jun 10 2009
Journal Name
Iraqi Journal Of Laser
Real Time Quantum Bit Error Rate Performance Test for a Quantum Cryptography System Based on BB84 protocol
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In this work, the performance of the receiver in a quantum cryptography system based on BB84 protocol is scaled by calculating the Quantum Bit Error Rate (QBER) of the receiver. To apply this performance test, an optical setup was arranged and a circuit was designed and implemented to calculate the QBER. This electronic circuit is used to calculate the number of counts per second generated by the avalanche photodiodes set in the receiver. The calculated counts per second are used to calculate the QBER for the receiver that gives an indication for the performance of the receiver. Minimum QBER, 6%, was obtained with avalanche photodiode excess voltage equals to 2V and laser diode power of 3.16 nW at avalanche photodiode temperature of -10

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Publication Date
Wed Mar 30 2016
Journal Name
College Of Islamic Sciences
The impact of the Qur'anic expression on the poetic picture In Oriental poetry in the eighth century AH
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This research deals with the poetic image of poets of the eighth century poetic, where they embodied the features of the religious life in which they live, and their impact on the Koranic text in the reflection of the image on their poems, where it becomes clear the ability of the poet at that stage to clarify the aesthetic components of the poetic text; Investigations, singled out the first topic: the analogy, and the second metaphorical picture, and the third: the picture.

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Publication Date
Mon Nov 24 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Immunohistochemical expression of P53, as a marker of apoptosis in Hodgkin’s and Non Hodgkin’s lymphoma of the head and neck region
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Background: Malignant lymphomas represent about 5% of all malignancy of the head and neck region which can involve lymph nodes as well as soft tissue and bone of the maxillofacial region. Apoptosis is considered a vital component of various processes including normal cell turnover, proper development and functioning of the immune system. Inappropriate apoptosis is a factor in many human conditions including neurodegenerative diseases, ischemic damage, autoimmune disorders and many types of cancer. Expression of p53 Proteins in Hodgkin׳s and Non Hodgkin׳s lymphomas suggested that it can help in monitoring of patients and the markers may aid in controlling the progression of lymphoma and detect the degree of aggressiveness of the diseas

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Publication Date
Mon Nov 24 2025
Journal Name
Sciences Journal Of Physical Education
The relationship of explosive power and mechanical moments of rotation of the torso and the aiming arm Advanced Discus Throwers
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The discus throwing event is one of the complex events in athletics, and it is characterized by a performance method that depends on the principle of mechanical moments and requires high explosive capabilities of the thrower in addition to some physical specifications,which depends effectively and effectively on the biomechanical aspects in generating large moments during rotation. The importance of the research is highlighted by the interest in athletics, especially the effectiveness of the discus throw and the continuation of its development process, the importance of kinetic analysis in revealing the most important weaknesses and strengths of shooters, and the importance of explosive power And the moments generated in the rotation of the

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