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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 Mar 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Study of direct marketing methods and identificationThe suitability of each of them for application in the Iraqi marketAn analytical study of the views of a sample of wholesalers in Baghdad
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Study of Direct Marketing techniques and determining the scope of the suitability of each of them in the application in the Iraqi market - An analytical and explorative study for sample of views for wholesaler in Baghdad. The essential idea of the research is to go into the most important concepts which have been mentioned in the direct marketing and determining its current and most important techniques and knowing the scope of applying these techniques in Baghdad main markets (Karrada, Jamilah, shorja, Baya area, zeyouna and new Baghdad) and which of those techniques most applicable in these markets. The research took a sample of (100) wholesalers who practice the activities of selling nutritional items, auto and outs spare part

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Publication Date
Thu Nov 18 2021
Journal Name
Eureka: Physics And Engineering
Experimental implementation of Raman scattering spectroscopy, photoluminescence and some optical properties of silver nanoparticles created by eco-friendly technique
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The object of research is studying Raman scattering technique, photoluminescence and some optical properties of silver nanoparticles created by eco-friendly technique which independent on a long time, effort, energy and high temperatures, and with the highest adsorption capacity in order to achieve a high inhibition to paralyze the activity of the bacterial wall, by achieving the highest surface plasmon resonance (SRR). Silver nanoparticles were prepared using Matricaria Flower extract. Characterization of silver nanoparticles and detection of their effectiveness against microbial using two types of bacteria (Escherichia Coli and Staphylococcus aureus ), these nanoparticles were measured using a number of measurements, X-ray diffrac

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
The Difficulties which Face Public Basic School Principals in Jarash Governorate in Editing Formal Letters and Correspondence and Means of Dealing With These Problems as Perceived by Them
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This study aimed at identity baying the difficulties which face public basic school
principals in jar ash governorate in editing formal letters and correspondence and means of
debating with these problems to collect data the researchers developed a question air were
established the population of the study which represents its sample consisted of 129 principals
65 males and 64 females
The results of the study revealed that the principals face difficulties in office and file
management in preparing plans and reports and writing formal letters and answering them
saved recommendations were presented among which were organizing training sessions and
workshops to train the principals on how to dead with there problems.<

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Publication Date
Mon Jun 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of dental enamel color after fixed orthodontic therapy using two types of protectors to prevent white spot lesions (A prospective clinical study)
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Background: The aim of this study is to evaluate the color change ∆E of the dental enamel following treatment with 2 kinds of protector (icon infiltrant, clinpro varnish) before fixed orthodontic treatment to avoid the possible white spot lesions. Materials and Methods: Fifty four subjects treated with fixed appliances were divided into 3 groups: the 1st group was control, while the 2nd and 3rd groups were treated with icon infiltrant and clinpro varnish before bonding procedure, respectively. Color parameters (L,a,b) were recorded for the middle and gingival thirds before and after bonding procedure to get the ∆E of each group. Results: One-way ANOVA test showed a non-significant difference in ∆E between the 3 groups a

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the forensic accounting philosophy in the transparency and quality of financial statements: : An applied study on a sample of workers at the Trade bank of Iraq and the Gulf Commercial Bank in Babylon
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This research aims to identify the role that forensic accounting plays on the transparency and quality of the financial statements in trade bank of Iraq and the Gulf Commercial Bank in Babylon. This research came to address the problem that most financial institutions suffer from, which is represented by the lack of transparency and the quality of the financial statements issued in a manner. Annual also the manipulation and fraud in the financial data, which causes a big gap between that institutions and organizational stakeholders. According to the implementation of the research hypothesis and the objectives of the research, a questionnaire was prepared consisting of three axes, the first axis dealing with the demographic distri

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Publication Date
Sun Dec 30 2012
Journal Name
Al-kindy College Medical Journal
Incidence of Renal Injuries in Abdominal Trauma at Al-Kindi Teaching Hospital
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Background : The kidneys may be injured in abdominal trauma, both blunt & penetrating. Renal trauma may manifest in a dramatic fashion for both the patient and the clinician. Objectives: To evaluate the incidence, management, morbidity &mortality of renal injury in blunt & penetrating abdominal trauma.
Results:The majority o f patients were males (35= 77.8%), the rest were females (10= 22.2%). The average age was 37 years (range= 18-56 years). The most common grades were grade1, grade2 and grade3 (40=88.9%), while 5 patients (11.1%) were grades 4 and 5.The most common associated injuries were liver, spleen, small & large bowels and diaphragm. The mortality was 20% (9 patients). The most common cause of death was multip

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Publication Date
Sat Jun 10 2023
Journal Name
الجمعية العراقية للعلوم السياسية
Ethnofideralism: A Study in the Belgian Experience
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Belgium is one of the countries that headed towards federalism through a peaceful transition, and over a few decades the country has witnessed deep transformations in its institutions, from a unified and central state in the early nineteenth century to a federal union, regional operations began since 1970 up and constitutionally established its diversity Linguistic and regional, the so -called "state reforms" have been implemented, which led to the emergence of political repercussions. The country has suffered about two decades ago, which caused many national governments that are considered to be among the Luxor in the modern political history of Belgium, However, institutional reforms to achieve the stability of the political system began,

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Publication Date
Sat Jul 27 2024
Journal Name
International Journal Of Economic Perspectives
The impact of strategic leadership on the building of intelligent organizations: A field study of a group of economic institutions in Algeria
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This study aims to highlight the role of strategic leadership in adopting the intelligent organization model. The study was conducted on 7 economic organizations in Algeria. The study population consisted of 354 leaders, of whom a random sample of 176 leaders (managers, department heads, division heads, engineers) was selected. The researcher used a questionnaire as the main tool of the study. Statistical analysis and hypothesis testing were conducted using SEM (Structural Equation Modeling) with the aid of SPSS.v26 and AMOS.v24 software. The study concluded with a set of results, most notably: there is a statistically significant direct positive effect between strategic leadership and building intelligent organizations at a significance le

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Publication Date
Fri Jun 12 2026
Journal Name
Al–bahith Al–a'alami
Consumer attitudes towards the integrated marketing communications of the UAE Etisalat company: A study of a sample of its subscribers in the emirate of Abu Dhabi
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The continuous technical development in the means of communication and information technologies has led to an increase in competition in the provision of service and product on the part of the organizations, as this competition does not know silence and stability on specific methods, but rather it is a world that is constantly moving and renewed in approaches, methods and approaches, and the focus of attention of integrated marketing communications practitioners are Customers, for them, organizations sell their goods, products, services, and ideas, and with them, they become stronger in competition.
This scientific study aimed to identify the trends of the initiators towards the integrated marketing communications of (the Emirates Tel

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Publication Date
Tue Jul 11 2023
Journal Name
Journal Of Educational And Psychological Researches
Domestic Violence and Extremism among the Young: A Field Study in the Madain Region
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Young people represent the power and cornerstone of societies and their superiority is linked to their well-being. Their empowerment is as essential as the heart to the body, if it is corrupt, then the whole body is corrupt, and vice versa. The exposure to extremism and pressure from their families leads to violent acts and crimes for obtaining money through unknown organized bodies. This will drive them to fail in their life in an attempt to fulfill their most basic needs, which they have been deprived of by their families, the government, and other institutions. Therefore, governments should provide job opportunities for young people and provide entertainment centers, sports clubs, and family education centers that raise awareness of s

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