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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
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Nurses' Knowledge and Role in the Management of Thalassemic Patients in Sulaimania Thalassemia Center
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The aim of this study is to assess nurse's knowledge and role in the management of thalassemic patients in the Sulaimania Thalassemia Centre. Methodology: This study utilized a qualitative approach to explore nurses’ knowledge about thalassemia through semi structured group interviews. Questionnaire was synthesized through a comprehensive review of literature. Results: The results show that nurses in Kurdistan region of Iraq have a limited role in terms of decision making and there is lack of nursing documentation other than that of recording abnormal events, and a lack of knowledge about and engageme

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Publication Date
Sat Sep 30 2023
Journal Name
Al–bahith Al–a'alami
Trends in Media Discourse during International Crises: An Analytical Study of the US Withdrawal from the Nuclear Deal
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The research focuses on the withdrawal of the United States from the nuclear agreement signed between the permanent members of the United Nations Security Council and the Islamic Republic of Iran concerning its nuclear program. This withdrawal has caused disruption in the official media discourse of the concerned countries. Therefore, the main question can be posed: Are there differences in the positions of countries related to the nuclear agreement, as well as those countries affected by it, before and after the official withdrawal of the United States on May 8, 2018?
The research aims to shed light on the trends in media discourse of the countries that signed the nuclear agreement and those affected by it b

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Publication Date
Mon Jan 26 2026
Journal Name
Risalat Al-huquq Journal
The role of the Basel committee in reducing systemic risks that threaten systemically important.
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Publication Date
Thu Apr 14 2022
Journal Name
Plos One
The passage of time in Iraq during the covid-19 pandemic
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The covid-19 global pandemic has influenced the day-to-day lives of people across the world. One consequence of this has been significant distortion to the subjective speed at which people feel like time is passing. To date, temporal distortions during covid-19 have mainly been studied in Europe. The current study therefore sought to explore experiences of the passage of time in Iraq. An online questionnaire was used to explore the passage of time during the day, week and the 11 months since the first period of covid-19 restrictions were imposed in Iraq. The questionnaire also measured affective and demographic factors, and task-load. The results showed that distortions to the passage of time were widespread in Iraq. Participants co

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Publication Date
Mon Jun 28 2021
Journal Name
Journal Of The College Of Education For Women
The Effect of Using the Fear of Failure Motivation Teaching Technique on the Achievement of Students from the Department of the Holy Quran and Its Sciences at Khawlan Faculty of Education in Sana'a University: عبدالغني علي المقبلي
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Nowadays, university education stands in front of both students who feel they are weak and teachers who are addicted to using traditional and dependent teaching. This has led to have negative repercussions on the learner from different aspects, including the mental aspect and the academic achievement process. Therefore, the present research is concerned with finding a new teaching method that adopts the motivation by the fear of failure technique. Thus, the study aims to examine the effect of adopting this method on students’ academic achievement. To achieve this aim, an experimental method was used, and an achievement test was built for the curriculum material of level two students. The pretest test was applied on 17 male and female s

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Publication Date
Thu Dec 01 2022
Journal Name
Journal Of Engineering
Effect of Diameter of Micropile on the Minaret Behavior during Earthquake, Virtual study
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This study aims to suggest a technique for soil properties improvement of AL- Kadhimin shrine Minaret and to support the foundation, which has a tilt of roughly 80 cm from the vertical axis. The shrine of the AL- Kadhimin is made up of four minarets with two domes set in a large courtyard. The four minarets have skewed to varying degrees due to uncontrolled dewatering inside the shrine in recent years. However, the northeast minaret was the most inclined due to its proximity to the well placed inside shrine courtyard. When the well near the minaret is operated, the water level drops, increasing the effective stresses of the soil and causing differential settling of the minaret foundation. To maintain the minaret's foundation from potenti

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Publication Date
Sat Dec 30 2023
Journal Name
Basrah Journal Of Surgery
Can Hyaluronic acid gel enhance wound healing faster than Advanced Platelets Rich Fibrin following surgical removal of impacted mandibular third molars? A Randomized Controlled Trial
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Publication Date
Tue Sep 03 2019
Journal Name
Rawal Medical Journal
Evaluation of Radial Nerve Injury Associated with Closed Humeral Shaft Fracture by Early Pre-operative Ultrasonic Evaluation and Correlation with Surgical Exploration
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Traumatic radial nerve injury in humeral shaft fracture is the most common traumatic nerve injury in long-bone fracture, with overall prevalence 2-18%, ranging from traction to complete transection. Spontaneous recovery may reach 88%. The aim of the study is to assess the sensitivity & specificity of the ultrasound to detect the radial nerve injury and to see if this can be used as a diagnostic test. This is a prospective study on 17 adult patients with a closed fracture of the humeral shaft, dividing into two groups, the first group of 7 patients had signs and symptoms of radial nerve palsy at presentation and the second group of 10 patients had intact radial nerve function was considered as a control group. All these patients had at leas

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Scopus
Publication Date
Tue Mar 30 2021
Journal Name
College Of Islamic Sciences
Taking Over The Judiciary By Women And The Position Of Law From That: مثالا
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لمقدمة

     الحمد لله رب العالمين والصلاة والسلام على سيد الأنبياء والمرسلين نبينا محمد صلى الله عليه وسلم وعلى  واصحابه أجمعين  ومن تبعهم وأهتدى بهداهم الى يوم الدين اما بعد :

        فوظيفة القضاء وظيفة سامية يراد منها اقامة العدل ولا يستقيم حالهم الا به دفعاّ للظلم ، ولقد اولى النبي صلى الله عليه وآله وسلم ومن بعده الخلفاء الراشدون

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
“The Theme of Deliberate Contrasting Coincidence in Beckett's "All That Fall"”
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In most of Beckett’s plays , there are prominent elements of absurdity that are landmarks of his style and the way of his writing like : the physical and the spiritual decay of characters, the disintegration of language as it becomes no longer a means of human communication because there is an inability to establish any kind of mental contact among them. These elements are quite apparent in Beckett’s “All That Fall”. The play exhibits a list of  conflicts: one is between powerful forces as that between the force of life represented by Maddy and the forces of death represented by Dan .The second is  the conflict and contempt between the old generation and the new one in the case of Dan’s desire to kill the boy fetching

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