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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
Wed Jun 20 2018
Journal Name
Al-academy
The Performance of the Actor (Sami Abdul-Hameed) in the Picturesque Theatre of the play Director (Salah AL-Kassab)
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The researches discusses the style of acting used by (Sami Abdul-Hameed) in one of the play director (Salah AL-Kassab) production whine he called; Picturesque.
The problem of this research is to discover the differences between the performance of (Sami Abdul-Hameed) in the Picturesque Theatre and the other theatre.
The goal of the research is to get to know the style of acting used in (king Lear) directed by (Salah AL-Kassab).
After defining the term (picturesque theatre), the researcher discusses the elements of the Visual theatre and the components of the stage picture according to (Alexander Dean) and he refers to those well-known director who had emphasized the Visual elements. Such as (Gordon Grieg) and (Franco Zeferrel

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Publication Date
Fri Apr 01 2022
Journal Name
Chalcogenide Letters
The dependence of the energy density states on the substitution of chemical elements in the Se6Te4-xSbx thin film
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The energy density state are the powerful factor for evaluate the validity of a material in any application. This research focused on examining the electrical properties of the Se6Te4- xSbx glass semiconductor with x=1, 2 and 3, using the thermal evaporation technique. D.C electrical conductivity was used by determine the current, voltage and temperatures, where the electrical conductivity was studied as a function of temperature and the mechanical electrical conduction were determined in the different conduction regions (the extended and localized area and at the Fermi level). In addition, the density of the energy states in these regions is calculated using the mathematical equations. The constants of energy density states are det

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Publication Date
Thu Jun 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Prevalence and localization of the posterior superior alveolar artery in relation to the floor of the maxillary sinus and alveolar crest among sample of Iraqis using computed tomography
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Background: Posterior superior alveolar artery (PSAA) is branch of the maxillary artery. It usually supplies the lateral wall of the sinus and overlying membrane. Evaluation and awareness of the anatomy of maxillary sinus before surgery is crucial to avoid surgical complications. The aim of this study is to examine the prevalence, location of the (PSAA) in relation to the floor of the maxillary sinus and alveolar crest using computerized tomography (CT) scans. Materials and Methods: This study included 180 Iraqi subjects (99 males and 81 females) with age more than 16 years old. CT scans for (right and left) Maxillary sinuses were done for each patient. The information obtained was assessed in a coronal multi planar reconstructions images (

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Publication Date
Fri Dec 01 2023
Journal Name
Political Sciences Journal
¬The Role of the European Union in Conflicts Resolution in the Eastern Neighborhood: Selected Models
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The launch of the EU’s Eastern Partnership in 2009 intended to signal a new, elevated level of EU engagement with its Eastern neighborhood. Yet there remain several long-simmering and potentially destabilizing conflicts in the region, with which EU engagement thus far has been sporadic at best. The Union’s use of its Common Security and Defense Policy (CSDP) in the region and to help solve these disputes has been particularly ad hoc and inconsistent, wracked by inter-institutional incoherence and undermined by Member States’ inability to agree on a broad strategic vision for engagement with the area.

The three CSDP missions deployed to the region thus far have all suffered from this incoherence to various extents. In particu

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Publication Date
Mon May 27 2019
Journal Name
Al-academy
Improvisation Effectiveness in the Performance of the Actor in the Theatrical Show: مصطفى عباس خلف
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Improvisation is that spontaneous automatic achievement which is formed by a new cognition that is not based on something prior to it or a previous cognition. It is instantaneous. Whereas in art, improvisation also inters in all types of applied and performance arts as a foundation for launching and initiating it in music, painting, cinema, television and theater. In order to study the improvisation of the actor, the researcher put forward a theoretical study that included two sections. The first section is (the improvisation concept) and the second section is (improvisation in the show). The researcher, in the research procedures, took an intentional sample that was represented by the theatrical show (Rehearsal in Hell Play) and after t

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
The War Importance of Basra in the Islamic Conquests in the Rightly Guided Caliphs Period
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There are many reasons made Basra a good defense, first of all was the
establishment of the famous Arab tribes, like Bakir bn. Wail and Tamim. Besides there were
A lot the armed forces. In addition to that the strategic place of Basra. All these reasons
played a good part when the war broke out.
The Arabic tribes played a good part in the war to engaged Persians, and prevent
them from sending any helps to their armies against the Kufain who were fighting Persians in
the North of Iraq. While the Basrain army aiming to Conquer the south of Iraq.
Basra become the first strategic place for the Islamic movement of the conquers.
Latter on Kufa and Bahrain were the second and third.
The Muslims guranted the pupils of

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Publication Date
Sun Dec 31 2023
Journal Name
College Of Islamic Sciences
The relationship between the rule of mental improvement and ugliness and the objectives of Sharia And its impact on rulings
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The research addresses a fundamental Islamic jurisprudential Purposeful issue, which is (Sharia), and to indicate the impact of this on Islamic jurisprudence, deriving rulings and extracting purposes, and to repel the illusion that this issue is only doctrinal, and clarifying the aspects of similarities and links between them by explaining the origin of deriving the purposes of Islamic Law (Sharia) through the meanings and wisdom learned from the texts and the explanation of the rulings. The rulings of Islamic Law (Sharia) have urged bringing benefits and repelling harms, and that the path to do so is reason and its production. I began the research by defining the purposes of Islamic Law (Sharia), then defining the rule of rational right

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Leadership styles and their role in enhancing the intellectual capital Field research in the Ministry of Foreign
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This study has taken into consideration two vital variables (leadership, leadership styles and intellectual capital). The research aim through the relations between the leadership styles and intellectual capital, to building conceptual frame for the variables of study and exploring the nature of correlation relations between these variables and their effects in enhancing intellectual capital.

      The research was conducted at the Ministry of foreign in Iraq, and included a sample of leaders and subordinates amounted to (186), has been using the questionnaire as a key tool to collect data on the sample.

      For the dealing with

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Publication Date
Tue Jan 30 2018
Journal Name
International Journal Of Science And Research
The Morphological Description and Histological Structure of the Liver in Marsh Harrier Bird in Iraq (Circus aeruginosus)
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The liver of marsh harrier grossly appeared as large, bi-lobed organ divided into left and right lobes, which are approximately equal in size and not divided into secondary lobes. Histologically, the liver of marsh harrier was found to contain numerous lobules which are not well defined by the connective tissue of the septa except that surrounded the portal triads. The parenchyma of liver composed of irregular branching cords of hepatocytes organized in double rows alternating with tortures path sinusoids which are lined with flattened endothelial cells and large, irregular outlined kupffer cells. Hepatic cords arranged in a radial pattern around the central vein of the liver lobule while in a subscapsular region they run parallel to the ca

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Standards of creditworthiness of customers and their impact on the liquidity of Iraqi private: Applied research in a sample of Iraqi private commercial banks
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Customers' creditworthiness standards are the key means employed by private commercial banks in assigning a suitable credit assessment for each customer. Accordingly, it had an instrumental role in indicating the degree of solvency of the potential customer before granting the required credit. The research problem reveals the nature of the relationship between the criteria of customer’s creditworthiness and banking liquidity. The most critical objectives of the study shed light on the role of using creditworthiness criteria as a tool for credit analysis of customers by banks that help reducing credit risks and thus increase banking liquidity. The questionnaire that was distributed to bank employees, the research sample, which w

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