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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
Spatial Variation of the Manifestations of Visual Pollution in the Municipality of Shula
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The research deals with the problem of visual pollution, as it is one of the most important urban problems that cities suffer from. The concept of visual pollution has recently emerged to describe the deformation and degradation of the urban environment. Visual pollution is defined as any component of the surrounding environment that is inconsistent and not homogeneous with its natural and human components. The volume of visual pollution has doubled due to the non-compliance with the laws, regulations and controls set by the Municipality of Baghdad by the citizens, and to the weak municipal role that the municipality plays in implementing these laws. Therefore, it has become necessary to know the manifestations of visual pollution and th

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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the reality of the problem of banking stumbling in Rafidain Bank
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The process of granting loans by banks is the confidence they give to their customers, but this trust should not be a cornerstone in granting loans even if granted these loans on the basis of sound banking should involve risks that may be exposed to the bank because of the failure of the client to meet The bank's financial obligations to the bank due to the unexpected economic conditions affecting the customers, which makes them in a state of faltering, which weaken the ability of banks to provide loans, which are the most important sources of revenue and profits, so the problem of non-performing loans is one of the main problems facing most of the banks Which impede the functioning of its work and the reasons that led to the agg

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Publication Date
Tue Apr 18 2023
Journal Name
Corporate Reputation Review
The Absorptive Capacity of Knowledge as an Approach for Building Strategic Reliability in the Sponge Organizations/Small Organizations in Kirkuk Governorate as a Model
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Publication Date
Sat Oct 26 2024
Journal Name
Zac Conference Series: Social Sciences And Humanities
A Comparative Study of Postwar Literature (Iranian Defense and Vietnam’s War) a Komunyakaa’s and Aminpour’s Poems
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The comparative study tries to find the common points in two different authors’ works and in this kind of studying so many other common but the hidden points may be revealed. Postwar literature is somehow one of the best literary genres for finding the common factors and features that the poets have tried to present in their works elements such as desire to be winner, cruelty, inhumanity, and absurdity of the war.  The Iranian poet late Qaisar Aminpour(1961-2007)  and Yusef Komunyakaa ( 1947) from  Bogalusa, Louisiana, are among the great American and Iranian  poets whose works so many times have been  interpreted and analyzed. The finding the outstanding and the most important points and themes in the postwar poems of these

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Publication Date
Fri May 15 2009
Journal Name
Journal Of Planner And Development
Study of Change in Regional Land Use Using Remote Sensing Technology and Geographic Information Systems / Study Area (Hawr Al Huweiza) for the Years 1973-1990-2004
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his project try to explain the using ability of spatial techniques for land cover change detection on regional level with the time parameter and did select for explain these abilities study case (Hewaizah marsh ) . this area apply to many big changes with the time. These changes made action on characters and behaviors of this area as well as all activities in it . This Project concerting to recognize the Using importance of remote sensing and GIS Methodology in data collecting for the changes of land use and the methodology for the analyses and getting the results for the next using as a base data for development and drawing the plans as well as in regional planning .This project focus on practical

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Publication Date
Wed Oct 12 2022
Journal Name
College Of Islamic Sciences
The semantic research of Al-Maarri in his book the ulna feel and its ablution
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Abu Al-Ala Al-Ma’arri is a linguist and writer who showed his prowess in poetry, so he had poetry collections, including “The ulna fell,” which is one of the books that attracted the attention of scholars such as (Tabrizi, Al-Khwarizmi, Al-Bateliusi and Al-Zamakhshari) .

 

To explain his language in it, the investigators’ hands finally revealed an explanation of this book, which was the work of Abu Al-Ala Al-Ma’arri himself. Those who studied the Divan (The Zind) and its explanations or the character and language of Al-Ma’arri did not pay any attention to it. Therefore, I made this research a continuation of those efforts, using semantic research as a means of revealing Al-Maarri's ef

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Publication Date
Wed Feb 04 2009
Journal Name
Ibn Al- Haitham J. For Pure & Appl. Sci
The Life Cycle and Larval Development of Neoechinorhynchus iraqensis (Acanthocephala: Neoechinorhynchidae) in the Intermediate Host
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The Life Cycle and Larval Development of Neoechinorhynchus iraqensis (Acanthocephala: Neoechinorhynchidae) in the Intermediate Host

Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Knowledge Management and Developing Human Resources in the Secretariat of the Central Library- Baghdad University
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Knowledge management contribute to the overall private university libraries to develop libraries for the purpose of creating human and technological resources by investing research and development, as well as education and training for life.
This study followed the methodology of the descriptive and historical pillars of knowledge management for the years 1990 to the present day in 2017, depending on statistical figures obtained by the researchers from the General Secretariat of the Central Library at the University of Baghdad, and the Human Resources Division, which specialized human resources training after 2004 (and before those years from 1982 until 2002, where the continuing education was committee of the fixed committees are wor

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Publication Date
Sun Jun 11 2017
Journal Name
Al-academy
The Theory of knowledge And Their Repercussions On the Journalistic Image In Electronic Designs Websites
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represent websites link support of human communicate and cohesion of cultures different depending on their languages and their environments around, it was the evolution of one of the most important means of communication of services for electronic networks, the Internet active role in containing the world Bbodqh science and knowledge to Taatlaqah cultures from which derives its intellectual and cognitive cupboards continuity and as a link language for each those environmental Altdadat, linguistic, religious, political, economic . We all know that these electronic means difficult promise ring intellectual and mental connectivity for the masses polarized without being of the image as an element Kravekaa supporter of the electronic media an

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Publication Date
Tue Nov 27 2018
Journal Name
Al–bahith Al–a'alami
The Role of Local Satellite Channels toward the Social and Cultural Development in U.A.E Society
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The study seeks to analyze the perceptions of audience in UAE towards the performance of Emirates Satellite TV Channels. It analyzed the exposure motivations of audience to satellite TV channels, its positive and negative aspects and to what extent they abide by media ethics. A survey is conducted with a sample of four hundred. The study shows significant differences between male and female towards the characteristics of TV channels, its positive and negative aspects and its commitments to media ethics.

            The study also shows that the expectancy value model and third person effect model are applicable in studying the perceptions of audience and media people in UAE t

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