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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
Fri Jun 06 2025
Journal Name
Discover Education
A qualitative study on the beliefs and perceptions of inaugural PharmD program graduates
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Background There is an increasing need for pharmacists to incorporate more patient care targeting. Consequently, the productivity of pharmacy programs can be enhanced by evaluating the advantages and disadvantages of pharmacy curriculum. Objectives To assess the beliefs, perceptions, and challenges of the College of Pharmacy –The University of Baghdad PharmD graduates regarding the PharmD program. Method Qualitative research methodology was implemented. Graduate PharmD candidates were interviewed either inperson or via telephone. The interviews were conducted in a semi-structured format, utilizing a predetermined interview guide that included open-ended questions. Thematic analysis was implemented to analyze the data. Results A total of 2

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Publication Date
Wed Feb 08 2023
Journal Name
Journal Of Educational And Psychological Researches
The Measurement of Academic Stress Level in E-Learning Environment among Postgraduate Students at the College of Education, King Khalid University during Covid-19 Pandemic
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The study aims to measure the level of academic stress in the e-learning environment in three areas, students and their dealing with classmates, dealing with the professor and technical skills, and the nature and content of the curriculum among graduate students in the College of Education at King Khalid University during COVID-19 pandemic. This study was descriptive in nature (survey, comparative). The sample consisted of (512) male and female graduate students in the master's and doctoral programs. The Academic Stress Scale in the E-learning Environment designed by Amer (2021) was used. The results indicated a high level of academic stress among graduate students in the e-learning environment. The study also found that there were stati

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Publication Date
Sat Jul 01 2023
Journal Name
International Journal Of Research In Management
The role of network marketing for the Iraqi cement company in improving entrepreneurial behavior (An exploratory study of the opinions of a sample of company leaders)
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Publication Date
Thu Jun 18 2026
Journal Name
Journal Of Business Economics For Applied Research
The Relationship between Authentic leadership and Knowledge Sharing through the mediating Role of Creative work Behaviors: An applied study on a sample of managers in the Ministry of Labor and Social Affairs in Baghdad
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Publication Date
Tue Dec 30 2014
Journal Name
College Of Islamic Sciences
Investigations in the sanctity of divine texts and their composition: (Comparative study between the Quran and the Torah)
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The research deals with an important issue that many people are working on, namely the sanctification of the texts on which the timings of the time and the different conditions of the place took place. Do not live up to the ranks of perfection and perfection, and every effort has explanations according to the mind machine, which is not protected by infallibility from error. The great downfall is to put these intellectual efforts in the Bible without separating them from the Word of God. The situation and the place on the adherents of a religion and mixed with the trick of the average individual only to be subject to the words of the teachers of Sharia and docility.

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Biodegradation of Diesel Contaminated Soil Using Single Bacterial Strains and a Mixed Bacterial Consortium
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This study was conducted to assess the hydrocarbon degradation abilities of Sphingomonas paucimobilis, Pentoae species, Staphylococcus aureus, and Enterobacter cloacae, which isolated from diesel contaminated soil samples. Single strains and mixed bacterial consortia have been investigated their ability to degrade 1.0 % (v/v) of diesel oil in Bushnell- Haas medium as sole.carbon.and.energy.source. At temperature 30C, the individual.bacterial.isolates exhibited low growth and low degradation.than did the.mixed. bacterial.culture. After 28 days.of incubation the.combination.of four isolates degraded.an upper limit.of diesel  88.4%. This was. continued.by 85.1% by S. paucimobilis, 84 % by Pentoae sp., 79% by S.aureus, and

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Publication Date
Sat Dec 31 2022
Journal Name
Journal Of Economics And Administrative Sciences
An Evaluation of Environmental Performance According to The International Standard (ISO14001: 2015) in a Field East of Baghdad / A Case Study in the Midline Oil Company
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EMS in accordance with ISO 14001: 2015 is considered an entry point to reduce environmental impacts, especially the effects resulting from the oil industry, which is the main source of environmental pollution and waste of natural resources, since the second revision of the standard took place in September 2015. The problem of the research was manifested in the weakness in understanding the correct guidelines that must be followed in order to obtain and maintain the standard. The purpose of this research was to give a general picture of what is behind ISO14001:2015 and how it is possible to create a comprehensive base for understanding its application by seeking the gap between the actually achieved reality, standards requirements

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Publication Date
Sat Jun 25 2022
Journal Name
Al-mağallaẗ Al-šāmilaẗ Li-l-ḥuqūq
The Intent to Harm Others as a Form of Abuse of Rights – A Study in Light of U.S. Law
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In a world of limited space, the owners are always surrounded by others next to them, and, consequently, there is hardly any activity which the owner may exercise on his land which would not affect the other owners. If he builds a building, that building may block the sun's rays or the air from the buildings next to it and owned by other people. And if he runs a business, the lands adjacent to that business may be overburdened with the accompanying noise or traffic. If oil is prospected in a land, the neighboring lands may be deprived of oil or their owners may be exposed to toxic fumes. Hence the importance of researching the intention of harming others, as it is one of the most important forms of abuse in the use of the right (especially

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Publication Date
Tue Mar 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The impact of cognitive processes in the areas of organizational changeApplied Study in the Directorate General of Training and Development / Ministry of Electricity
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Centric study on the interest of the Directorate General of Training and Development / Ministry of Electricity to consolidate the concept of process and enhancement of knowledge in the areas of organizational change، it reached a sample of the study (44) people who are highly heads of departments، technicians and administrators in different sections of the Directorate and by using the correlation coefficient (Spearman) & coefficient of simple regression been tested correlations between variables and the impact of the study، as has been reached to integrate the role of cognitive processes with the areas of organizational change and relationships that were significant at the level of overall dimensions and subsidiary organs.

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
THE USE OF SIMULATION AND LINEAR PROGRAMMING IN THE PLANNING OF AUDIT WORK (An Empirical Study in the Office of Financial Supervision)
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Research includes three axes, the first is the average estimate time of achievement (day) to work oversight, to five supervisory departments in the Office of Financial Supervision Federal and then choose the three control outputs and at the level of each of the five departments above, and after analyzing the data statistically back to us that the distribution of the times of achievement It is the exponential distribution (Exponential Distribution) a parameter (q), and the distribution of normal (Normal Distribution) with two parameters (μ, σ2), and introduced four methods of parameter estimation (q) as well as four modalities parameter to estimate (

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