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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
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The role of monetary policy in reducing inflation in Iraq through monetary sterilization mechanism. post-2003
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The main objective of the central bank is to achieve price stability and target in fractionates. Therefore, the bank sought to use modern tools and policies in order to reduce the negative effects of the accumulation of foreign reserves represented by monetary sterilization, similar to developed and developing countries alike, but with different available tools that are possible and imposed by the local financial and monetary environments, such as the window for buying and selling foreign currency, open market operations and deposit facilities. And lending existing. Because any in crease in the monetary base resulting from the accumulation of foreign reserves will affect price stability directly due to the consumer nature of the

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Publication Date
Sun Aug 24 2025
Journal Name
Journal Of Economics And Administrative Sciences
The role of knowledge management in achieving strategic excellence Field research in some Iraqi private banks
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الغرض من البحث دراسة تأثير ادارة المعرفة (استراتيجية الشخصنة والترميز) في تحقيق التفوق الاستراتيجي في بيئة المصارف الاهلية العراقية ، وتم اعتماد منهج البحث الوصفي والتحليلي ، لذا اعتمد الباحث الفلسفة الوضعية وفق المنهج الاستنباطي لغرض اشتقاق فرضية البحث الاولى من الجانب النظري وتوصل البحث الى مجموعة من النتائج اهمها ان استراتيجية الشخصنة حققت تقدماً كبيراً في قدرتها على التأثير في التفوق الاستراتيجي بوصف

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Publication Date
Sat Jun 15 2019
Journal Name
Drug Invention Today
Mucoadhesive oral in situ gel of itraconazole using pH-sensitive polymers: Preparation, and in vitro characterization, release and rheology study
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Publication Date
Mon Dec 21 2020
Journal Name
International Journal Of Environmental Analytical Chemistry
Comparative study of embedded functionalised MWCNTs and GO in Ultrafiltration (UF) PVC membrane: interaction mechanisms and performance
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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Polar structure in the international system
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Conclusion The observation of the phenomenon of structural evolution of the international system and its instability on a particular situation, by its transition from unipolar to polarity to bipolarism and then to unilateralism in the early 1990s led by the United States, and to the present moment, To say that the structure by which the hierarchy of superpowers or the regime is directed in terms of its various capacities that qualify it, and with the consent of the rest of the States directing the regime to lead and lead the world's first place, has no direct relation to the stability of this system, I hope other more influential in its stability. The structure of the new international order will be completely different in terms of the r

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Publication Date
Wed Oct 06 2021
Journal Name
College Of Islamic Sciences
Linguistic deposits in the Arabic language
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Abstract of the research:

     This research sheds light on an important phenomenon in our Arabic language, which is linguistic sediments, and by which we mean a group of vocabulary that falls out of use and that native speakers no longer use it, and at the same time it happens that few individuals preserve the phenomenon and use it in their lives, and it is one of the most important phenomena that  It should be undertaken and studied by researchers;  Because it is at the heart of our huge linguistic heritage, as colloquial Arabic dialects retain a lot of linguistic sediments, and we usually find them at all levels of language: phonetic, banking, grammatical and semantic.  In the

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Publication Date
Thu Apr 04 2024
Journal Name
مجلة مركز بابل للدراسات الانسانية
The Rhetorical methods in Hebrew advertisements
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Advertisement is one of the Media most efficient persuasive communicative activities designed to marketing different ideas and products with the aim of influencing consumers' perception of goods and services. The present study sheds light on the most prominent rhetorical devices that constitute the persuasive structure of the Hebrew advertisements published in various media outlet. The study is conducted by means of analyzing the linguistic structure of the advertising texts and according to the analytic and descriptive approach to know the characteristics and the functions of the oratorical devices used in the advertising industry. The research elucidates that most of the advertisements are written in slang language, and this is due to th

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of The College Of Education For Women
Presupposition in Fitzgerald the Rough Crossing
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Presupposition in Fitzgerald the Rough Crossing

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Publication Date
Fri Dec 15 2023
Journal Name
مجلة آداب المستنصرية
(Semantic expansion in the Arabic system)
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The principle in the language is that each word has one meaning. This is because the purpose of language development is for understanding, understanding, and communication between people. The language is sounds with which each people expresses their Arabic language did not stop at this point, but rather needed another next stage or to convey additional features or characteristics that would qualify it. To be the language of the Qur’an and revelation, and capable of carrying this heavy burden.

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of Planner And Development
The Transitions in Contemporary Urban Space
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It is the dynamic tension between the relatively fixed built environment and the constantly changing in social life that determines the nature of urban spaces belonging to different historical periods, and considered as a tool for diagnosing transformations in urban spaces, that’s why, the characteristics of urban space became unclear between positive spaces and negative spaces, so emerged the need to study contemporary urban space belonging to the current period of time and show the most important transformations that have occurred in contemporary urban space to reach urban spaces that meet the current  life requirements. Therefore, the research dealt with a study of the characteristics of contemporary urban space and the most pr

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