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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 Oct 01 2020
Journal Name
Biochemical And Cellular Archives
MORPHOLOGICAL DESCRIPTION AND HISTOLOGICAL STRUCTURE OF THE JEJUNUM IN THE IRAQI BLACK PARTRIDGE (FRANCOLINUS FRANCOLINUS)
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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Disclosure and Transparency Criteria In Saudi Banks on The Financial Ratios Indicators
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The study aimed to measure the effect of applying the disclosure and transparency standards criteria adopted by the Saudi Arabian Monetary Authority on improving performance indicators in the Saudi banking sector, by measuring the extent of the impact of the bank's financial indicators represented by liquidity, profitability and return on assets in Saudi banks by applying the criteria of disclosure and transparency, which is one of the Main principles in the list of governance, which was approved by the Saudi Arabian Monetary Authority. The analytical approach was followed to achieve the goal of the study, as the financial statements of Saudi banks were analyzed during a period of 8-year to test four hypotheses related to measuri

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Crossref
Publication Date
Thu Oct 01 2020
Journal Name
Biochemical And Cellular Archives
MORPHOLOGICAL DESCRIPTION AND HISTOLOGICAL STRUCTURE OF THE JEJUNUM IN THE IRAQI BLACK PARTRIDGE (FRANCOLINUS FRANCOLINUS)
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Scopus
Publication Date
Mon Jun 15 2020
Journal Name
Al-academy
The importance of Kurdish songs and games in building the child's personality: كونا قادر محمد
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  The popular Kurdish songs and games for children are among the simplest types that can be close to the child’s interest, because we estimate that this segment is limited by its meanings and goals charged with competition and the fall of its innate biological energies, in the early years of the stages of development and growth of human mental, psychological, and muscular skills, Passionate about knowing and discovering the general decree of life, and getting acquainted with the logical rulings that surround his new law, but instinctively it approaches everything that is simple in terms of understanding and palatability, as these games and songs are simple and easy in their melodic elements and elegance Conscious and kinetic are a

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Publication Date
Sun Sep 05 2010
Journal Name
Baghdad Science Journal
The susceptibility test of vaginal yeasts and their relationship with the age in Iraqi women
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This study aims to isolate the pathogenic yeasts from genital tract and investigate their relationship with the age .The results clarified that the most pathogenic yeast isolated from genital tract was Candida albicans , also the results of C.albicanas isolates susceptibility test, to different antifungal revealed that they were sensitive to Miconazole, Ketoconazole and Clotrimazol and were resistant to Nystatin and Grisofulvin. The study of relationship of vaginal infection with the age showed that the incidence of infection with Candida was high among females age group (19-39 years).

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Publication Date
Sun Jun 06 2010
Journal Name
Baghdad Science Journal
The effect of wastewater disposal on the water quality and phytoplankton in Erbil wastewater channel.
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In this study, phytoplankton density, chlorophyll-a, and selected physico- chemical parameters were investigated in Erbil wastewater channel. The surveys were carried out monthly from May 2003 to April 2004. Samplings were established on three sites from headwaters to the mouth. The results showed that pH was in alkaline side of neutrality, with significant differences (P<0.05) between sites 1 and 3. TSS concentration decreased from site 1 toward site 2 (mean value, 80.15 to 25.79 mg.l-1). A clear gradual increase in mineral content (TDS) observed from site one of the channel towards the mouthpart. Soluble reactive phosphate has a concentration maximum mean value reached 48.4 µg.l-1 which is recorded in site 2. A high positive relat

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Crossref
Publication Date
Wed Mar 16 2022
Journal Name
Journal Of Educational And Psychological Researches
Psychological counseling skills and their relation to the power of the ego in educational counselors
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The study aimed to identify the psychological counseling skills and the strength of the ego in the educational counselors, and to identify the relationship of statistical significance between the psychological counseling skills and the strength of the ego in the educational counselors, and to identify the differences of statistical significance in the relationship between psychological counseling skills and the strength of the ego in the guides according to the gender variable(male, Females), the number of sample (100) guides, including (50) males and (50) females from the area of ​​Atifiya and Qadissiya and Ameriya in the Directorate of Education Karkh / 1, the researcher adopted a scale of psychological counseling skills prepared b

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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Southwest Jiaotong University
The Dynamics of an Eco-Epidemiological Model with Allee Effect and Harvesting in the Predator
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The aim of this study was to propose and evaluate an eco-epidemiological model with Allee effect and nonlinear harvesting in predators. It was assumed that there is an SI-type of disease in prey, and only portion of the prey would be attacked by the predator due to the fleeing of the remainder of the prey to a safe area. It was also assumed that the predator consumed the prey according to modified Holling type-II functional response. All possible equilibrium points were determined, and the local and global stabilities were investigated. The possibility of occurrence of local bifurcation was also studied. Numerical simulation was used to further evaluate the global dynamics and the effects of varying parameters on the asymptotic behavior of

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Crossref
Publication Date
Sun Jun 05 2022
Journal Name
Sport Tk-revista Euroamericana De Ciencias Del Deporte
Visual spatial attention and its impact on the accuracy of the diagonal spike in volleyball
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The primary aim of this research was to study visual spatial attention and its impact on the accuracy of the diagonal spike in volleyball. A total of 20 volleyball players of Baghdad participated in this study. The sample was homogeneous in terms of height, weight and age of the players. The tests used in the present study were: 1) Visual Spatial Attention Test. 2) Volleyball Spike Test. Based on the findings of the study, the researcher concluded that visual spatial attention has a significant impact on the accuracy of the diagonal spike in volleyball.

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Crossref
Publication Date
Tue Jul 01 2025
Journal Name
Journal Of Studies In Humanities And Educational Sciences
The Effect of the Needham Constructivist Model on the Achievement of Third Year Biology Department Students in the Subject of Teaching Methods
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The current research aims to know the effect of Needham's constructivist model on the achievement of third-year students in the Life Sciences Department in the teaching methods subject. To achieve the research objectives, the experimental method was followed for the experimental and control groups with dimensional measurement of the achievement variable of the teaching methods subject. The research sample included (62) students in the third year of the Life Sciences Department, distributed into two equal groups in the variables (self-assessment of learning methods - chronological age in years - intelligence level - previous information). To measure the level of students' achievement, an achievement test was constructed consisting of (40) te

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