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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 Jan 01 2011
Journal Name
Iraqi Journal Of Science
A CRYPTOGRAPHIC TECHNIQUE BASED ON AVL TREE
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Publication Date
Sat Mar 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Strategic Performance Evaluation Using Benchmarking Technique: Applied Research In The Sample Of Offices Of Inspectors General
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In light of the rapid changes in the business environment and the entry of administrative leaders in the challenges of the atheist and twenty- increasing competition between sectors and the desire to acquire the skills, the traditional methods are no longer viable, which requires doing evaluates performance according to a more holistic, rather than limiting the performance evaluation on the financial hub that has not longer enough alone, as well as benchmarking method that has proven successful in developed countries as a way to develop and improve products and services.

I've touched your search to the development of indicators evaluating the performance and preparation of a mechanism for making comparisons of reference between o

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Publication Date
Sun Oct 01 2017
Journal Name
International Journal Of Oral And Maxillofacial Surgery
Characteristics of mandibular injuries caused by bullets and improvised explosive devices: a comparative study
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The purpose of this study was to investigate the difference in mandibular trauma caused by two mechanisms for the delivery of missile injuries: firearms and improvised explosive devices (IEDs). The data investigated included sex, age, mechanism of injury, and other clinical and radiographic manifestations. Seventy consecutive patients, predominantly male, with a mean age of 28.6 ± 14 years (range 2–60 years) were enrolled: 38 patients (54.3%) sustained mandibular fractures caused by bullet injuries and 32 patients (45.7%) had mandibular fractures caused by IED explosion injuries. The study revealed that the differences in most of the investigated variables were not statistically significant; the only significant differences were the inci

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Publication Date
Thu Feb 07 2019
Journal Name
Iraqi Journal Of Laser
Gingival Enlargement Management using Diode Laser 940 nm and Conventional Scalpel Technique (A Comparative Study)
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Diode lasers are becoming popular in periodontal surgery due to their highly absorption by pigments such as melanin and hemoglobin their weak absorption by water and hydroxyapatite makes them safe to be used around dental hard tissues. Objective: The aim of the present study was to evaluate the efficiency of diode laser in performing gingivectomy in comparison to conventional scalpel technique in patients with chronic inflammatory enlargement. Materials and methods: Thirty patients were selected for this study. All of them required surgical treatment of gingival enlargements and were randomly divided into two groups: Control group (treated by scalpel and include sixteen patients) and study group (treated with diode laser 940nm and includ

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Publication Date
Thu Mar 30 2023
Journal Name
College Of Islamic Sciences
The effect of readings on the multiplicity of explanatory significance of a single Qur’anic word, a study through the interpretation of Ibn Attia al-Andalusi
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The study aimed to clarify the meanings learned and inferred from reading books، letters and messages in Surat Al-Qur’an. The inductive method، the analytical method، and the deductive method، One of the most prominent results of the research: that the multiplicity of Qur’anic readings produces a variety and expansion in the meaning that has a clear impact on the interpretation by clarifying the meaning of the verse.

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Dilemmas in teaching human rights and democracy between the current realityand the difficulties in seeking to spread a culture of human rights
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In the age of information and communication revolution, education as one of life
aspects has influenced with that revolution by integrating technology in education, which
have become as an important learning tools of the whole educational process . Technology,
when used appropriately, can help make science classroom a site of active learning and
critical thinking, furthering student inquiry and connections with different materials. It is
necessary to develop human rights education programs and materials for discretionary and
extracurricular activities as it provide them with the skills and tools so that they are
empowered to take action to realize their rights. Human rights education is a critical means of
instill

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Publication Date
Sun Jul 07 2013
Journal Name
Journal Of Educational And Psychological Researches
Effect of Using Computer in Getting and Remaining Information at Students of First Stage in Biology Subject
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Effect of Using Computer in Getting and Remaining Information at Students of First Stage in Biology Subject MIAAD NATHIM RASHEED LECTURER Abstract The recent research goal is to know the influence of computer use to earn and fulfillment information for students of first class in biology material and to achieve that put many of the zeroing hypothesis by researcher as follow: There were no differences between statistical signs at level (0,05) between the average students' marks who they were study by using computer and between the average student ' marks who they were study in classical method of earning and fulfillment. The researcher chose the intentional of the medical technical institute that included of two branches the first class (A

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Publication Date
Sat Sep 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Difficulties of scientific research in the financial and administrative fieldaccording to the quality standardsfrom the point of view of the teachers
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The research aims to identify the most important difficulties facing the scientific research in the technical university in the financial, organizational and administrative according to the quality standards according to the paragraphs studied in the questionnaire questionnaire prepared for this purpose, including the research community on the Central Technical University, which includes several technical colleges and technical institutes were selected A sample of the researchers in the Institute of Technical Management where the number of training was 78 teachers took a random sample of researchers amounted to 40% of the questionnaire, and after the collection and classification of data were used statistical means, including the mean ar

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Publication Date
Mon Nov 29 2021
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The treatment of non complicated sacrococcygeal pilonidal sinus by minimal excision and primary closure technique
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Background: The surgical treatment of pilonidal sinus varies from wide excision and laying the wound open or excision with primary closure or excision with the use of skin graft in some special cases.
Objectives: The objectives of this study is to determine the efficacy of treating non complicated pilonidal sinus disease with minimal excision and primary closure technique, complications and recurrence rate.
Patients and methods: This is a prospective study conducted in shahid ahmed ismaiel hospital in rania – As sulaimania IRAQ during the period from December 2013 to January 2016 and was carried on one hundred (100) consecutive patients with non complicated non recurrent pilonidal sinus patients who were treated with minimal exci

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
A prospective study on sexual deviation deployed in Baghdad crimes
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The current research aims to identify the types and rates and the reasons for the crimes that are with the origin and sexual scattered deviation between the fabric of Iraqi society, which reticent about because of the culture of the community, where he offered a researcher investigator justice and tribal leaders and lawyers about proportion and the types and causes of crime is the origin of sexual deviance and finally a question asked a researcher in 1000 young lived their adolescence days of the former regime (1979-2003) from going to brothels researcher found that 920 people and 92% had gone to the house to practice adultery and that 70 of them, and by 7% had engaged in masturbation only and that 10 of them have not committed anything

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