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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 Oct 11 2023
Journal Name
Journal Of Educational And Psychological Researches
Linguistic Competencies Required for Teachers of the Arabic Language for the Preparatory Stage
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The current research aims to determine the necessary linguistic competencies for Arabic language teachers of the preparatory stage (fourth grade preparatory), which were five main competencies: Arabic grammar competencies, literary competencies, cultural competencies, rhetorical competencies, and expression competencies. To achieve the objective of the research, the researcher developed a questionnaire as the main tool for collecting data based on literature, it consists of (28) items including the five main competencies. The questionnaire was administered to (60) male and female teachers at Al-Karkh's first Education Directorate in the city of Baghdad. The findings of the research indicated that Arabic language proficiency got the highe

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Publication Date
Wed Sep 01 2010
Journal Name
Al-khwarizmi Engineering Journal
The Stress Distribution on the Zygapophyseal Joint of Lumbar Vertebra by ANSYS Program
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Zygapophyseal joints (or facet joints), are a plane synovial joint which located between the articular facet processes of the vertebral arch which is freely guided movable joints. Ten dried vertebrae were used for the lumbar region and taking (L4) as a sample to reveal stress pathways across the joints by using ANSYS program under different loading conditions which used Finite Elements Analysis model. Results obtained from the ANSYS program are important in understanding the boundary conditions for load analysis and the points of stress concentration which explained from the anatomical point of view and linked to muscle and ligament attachments. This model used as a computational tool to joint biomechanics and to prosthetic im

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Publication Date
Sun Jan 03 2010
Journal Name
Journal Of Educational And Psychological Researches
The non right behavior appearance for the kindergarten children and its relation with the kindergarten teaching style
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The kindergarten teacher play a role in fixing the children behavior so she must plant the value and the habits that make a positive behavior and accepted by the society so the teacher must know all the right educational psychological styles to fix the children behavior and make them accepted psychologically and socially so the problem of the research start from knowing the relation between the methods of dealing with the kindergarten’s teachers and the non right behavior appearance for the kindergarten children. The current research aims to measure the negative behavior appearance of the children of kindergarten and distinguish it according to (sex and levels) and to distinguish the most using styles by the teachers of kinderg

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Publication Date
Wed Jun 29 2022
Journal Name
Journal Of The College Of Education For Women
The Degree to which Islamic Education Teachers Employ the Strategy of Directed Discovery in Teaching to Develop Higher-Order Thinking Skills
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The study aimed to know the degree to which Islamic education teachers employ the strategy of directed discovery in teaching to develop higher thinking skills (analysis, synthesis, and evaluation) among sixth-grade students at the basic stage in East Nile Province, Khartoum State - Sudan. The researcher used the descriptive-analytical method, and adopted a questionnaire that consisted of (15) indicators representing the skills of analysis, synthesis, and evaluation as a tool of the study. A random sample of (175) Islamic education teachers was selected, from the Department of Basic Education. The data were analyzed according to the Statistical Packages for Social Sciences (SPSS) program, and the results of the study have shown that the u

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Publication Date
Sun Mar 06 2016
Journal Name
Baghdad Science Journal
The Protective Effect of Radish (Raphanus sativus) Seeds Against the Oxidative Stress Induced by Sodium Nitrite in Male Rabbits (Oryctolagus cuniculus)
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The aim of this study is to investigate the protective effect of Radish (Raphanus sativus) seed alcoholic extract 70% against oxidative stress induced by sodium nitrite NaNO2 Twenty five adult male rabbits were devided into five groups of (five rabbits in each group) and treated daily for 30 days. Group T1: intubated orally 20 mg/kg NaNO2, Group T2: intubated orally 20 mg/kg NaNO2 + 50 mg/kg of alcoholic extract from Raphanus sativus seeds, Group T3: intubated orally 20 mg/kg NaNO2 + 100 mg/kg of alcoholic extract from Raphanus sativus seeds, Group T4: intubated orally 20 mg/kg NaNO2 + 200 mg/kg of alcoholic extract from Raphanus sativus seed as well as Group C: control intubated orally distilled water. In comparison with normal ra

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Publication Date
Mon Dec 28 2020
Journal Name
Journal Of The College Of Education For Women
Expressing the Bewilderment of the Modern Man through Silence in Samuel Beckett’s Happy Days: بسعاد ماهر محيل, ومنذر عبد الرزاق سبع
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Samuel Beckett’s Happy Days (1961) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Samuel Beckett to use a lot of pauses and silences in all plays written instead of using words. To express the bewilderment of the modern man during the 20th century, Beckett adopts the use of no language strategy in the dramatic works. After World War II, people were without hope, religion, food, jobs, homes, or even countries. Beckett gave them a voice. He used a dramatic language out of everyday things, in which silence was part of the syntax as a poetic repetition. Language is no more important to the modern man; instead, he us

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Publication Date
Sat May 09 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
The Role of Human Resources Strategic Management on Enhancing Talent Success Factors; Exploratory analytical research in the General Authority for Tourism
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The research aims to verify the role of the Human Resources Strategic Management (HRSM) in enhancing the strategic success factors for talent (SSFT) in the General Tourism Authority by distributing a questionnaire consisting of (36) paragraphs on an intentional sample represented by the higher departments as it reached (50) and the sample valid for testing was (44) Person and to test the relationships between the two research variables, the researchers used statistical methods represented by (Bartlett test / mean / simple regression coefficient / difference coefficient, alpha- cronbachAch, confirmatory factor Analysis ) through the statistical program (SPSS v.23 & AMOS v.23). In enhancing the factors of success for talent management in the

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Publication Date
Mon Nov 17 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Photogrammetric analysis of facial soft tissue profile of Iraqi adults sample with Class II div.1 and Class III malocclusion: (A comparative study)
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Background: The purposes of this study were to determine the photogrammetric soft tissue facial profile measurements for Iraqi adults sample with class II div.1 and class III malocclusion using standardized photographic techniques and to verify the existence of possible gender differences. Materials & methods: Seventy five Iraqi adult subjects, 50 class II div.1 malocclusion (24 males and 26 females), 25 class III malocclusion (14 males and 11 females), with an age range from 18-25 years. Each individual was subjected to clinical examination and digital standardized right side photographic records were taken in the natural head position. The photographs were analyzed using AutoCAD program 2007 to measure the distances and angles used in t

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Publication Date
Mon Dec 30 2013
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Permeability Prediction of Un-Cored Intervals Using FZI Method and Matrix Density Grouping Method: A Case Study of Abughirab Field/Asmari FM., Iraq
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Knowledge of permeability is critical for developing an effective reservoir description. Permeability data may be calculated from well tests, cores and logs. Normally, using well log data to derive estimates of permeability is the lowest cost method. This paper will focus on the evaluation of formation permeability in un-cored intervals for Abughirab field/Asmari reservoir in Iraq from core and well log data. Hydraulic flow unit (HFU) concept is strongly related to the flow zone indicator (FZI) which is a function of the reservoir quality index (RQI). Both measures are based on porosity and permeability of cores. It is assumed that samples with similar FZI values belong to the same HFU. A generated method is also used to calculate permea

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Level of Administrative Work Quality of Private Schools Principals at Southern Governorates of Palestine form the Teachers Point of View
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The study aimed at identifying the level of administrative work quality of private Schools principals at Southern Governorates of Palestine from the teachers' point of view in their schools. To achieve the objectives of this research, a questionnaire was prepared by the researcher consisted of (28) items. It was applied to a sample of (350) teachers. The researcher adopted the descriptive-analytical approach. The results of the study showed that the degree to which principals of private schools in the southern governorates of Palestine practice Administrative Work Quality from the viewpoint of their teachers was very high, with relative weight (85.00%). The results also showed that there are statistically significant differences at the l

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