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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
Sat Dec 01 2018
Journal Name
Acta Facultatis Medicae Naissensis
The Factors Influencing the Risk of Perforation in Patients with Peptic Ulcers: A Cross-Sectional Study from Central Iraq
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Abstract<p>The aim of this study was to evaluate the risk factors that influence the perforation, regardless of the presence of H. pylori infection, in a sample of Iraqi patients with peptic ulcers, admitted to Al-Kindy Teaching Hospital. A total of 90 patients who had perforated peptic ulcer participated in this study. The diagnosis was based on history, clinical examination, laboratory and radiological investigations and was confirmed intraoperatively. A number of probable risk factors for perforation were investigated. Eighty participants were males and 10 were females (male to female ratio 8:1). About 42.2% of patients were in their fifth decade of life. Forty-nine (54.4%) patients were asymptomatic be</p> ... Show More
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Publication Date
Thu Dec 30 2021
Journal Name
Journal Of Legal Sciences
Violation of the rights of sound record producers (piracy) (A Comparative study)
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Piracy is one of the most important problems faced by sound record producers, because it is a problem that technology, evolves with the development of time and and although piracy is not a new problem, it has received great attention in recent years, because of the means by which (the Internet) and its size result from it, even In many of the ruler, describing it as (the crime of nd she participated in the great the electronic age) aharm it causes to all the groups involved in it producing the sound recording, because there are three categories that contribute to the production of the sound recording, which is (the author of the recorded work, the st who performs the work and the producer who artiperforms an operation Performance recording

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
Analytical Study of the Content of Social and National Studies Textbooks of the Middle Stage in Kingdom of Saudi Arabia in the Light of the Values of Social Peace
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This study aimed to reveal the extent to which the values of social peace are included in the content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia. To achieve this goal, the researcher used the descriptive analytical approach. The study sample consisted of all developed social and national studies textbooks of the middle stage in kingdom of Saudi Arabia in first and second semester of student books in edition of 1439-1440. The study tool was the analysis card. The study reached the following results: 1-The content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia as a whole included (38) social peace values of total (40) values, corresponding to the inclusio

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Publication Date
Tue Aug 26 2025
Journal Name
Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte, Issn 1886-8576, Vol. 16, Nº. 3, 2021
The effect of a rehabilitation program using a tens device for the treatment of pain and impaired mobility of the wrist and limbs joint in basketball players
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Autorías: Hadeer Idan Ghanim, Ishraq Mahmood. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 3, 2021. Artículo de Revista en Dialnet.

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Publication Date
Sat Jul 22 2023
Journal Name
Journal Of Engineering
The Characteristics of the Traditional Urban Configuration of ArabIslamic Cities through Form and Moral Values: Al-Kadhimiya as a Case Study
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This paper studies the main characteristics of the traditional urban configuration of Arab cities, as an important built heritage, discussing the approach adopted with such configuration at the local level, and examines its ability to preserve the character of the city, as well as, its responsiveness to the recent  requirements of its society that constantly change; in order to reach the appropriate procedures to deal with the traditional urban configuration of the Iraqi city to achieve a vital cultural communication with the vernacular built heritage, by dealing with the Form-Moral Values structure. Due to its importance within other traditional Iraqi cities, the research chose Al-Kadhimiya as a case study, so it discusses and compares

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Publication Date
Tue Aug 26 2025
Journal Name
Journal Of Legal Sciences
A comparative study between the federal investment law No. 13 of 2006 and the Investment Law Kurdistan No. 4 of 2006
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Publication Date
Tue Jan 01 2019
Journal Name
Ieee Access
Sensing Performance of Modified Single Mode Optical Fiber Coated With Nanomaterials-Based Ammonia Sensors Operated in the C-Band
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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The impact of managing organizational diversity in achieving success Exploratory study in the Ministry of Industry and Minerals
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The aim of the research is to demonstrate the impact of organizational diversity management on achieving success, The problem of research is to create an appropriate work environment that stimulates everyone regardless of each dimension of diversity, So as to reach the best levels of success, The importance of research is to identify how the organization in question can manage organizational diversity effectively and contribute to its success, The research started from two main hypotheses which were derived from sub-hypotheses to identify the correlation and influence between the search variables by analyzing the answers of the research sample which included (81)

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Publication Date
Thu Aug 01 2024
Journal Name
Misan Journal For Physical Education Sciences
A comparative study of the reasons for the reluctance of female physical education teachers in “Baqubah” to participate in refereeing sports competitions according to the variable of years of service
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When searching for an answer to the following question: What are the reasons for the reluctance of female physical education teachers in secondary schools to referee sports competitions according to the variable of years of service? It was found that the research aimed to reveal the differences between the opinions of the research sample of physical education teachers in secondary schools (girls) about refereeing sports competitions according to the variable of years of service. To achieve the research goal, it is assumed that there are significant differences between the average opinions of the research sample of female teachers and their reluctance and the reasons for the differences in the practice of refereeing sports competitions accor

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Publication Date
Sun Mar 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Evolution and set up the maps for solar radiation of Iraq using Data observation and Angstrom model during monthly July2017
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Abstract<p>The development that solar energy will have in the next years needs a reliable estimation of available solar energy resources. Several empirical models have been developed to calculate global solar radiation using various parameters such as extraterrestrial radiation, sunshine hours, albedo, maximum temperature, mean temperature, soil temperature, relative humidity, cloudiness, evaporation, total perceptible water, number of rainy days, and altitude and latitude. In present work i) First part has been calculated solar radiation from the daily values of the hours of sun duration using Angstrom model over the Iraq for at July 2017. The second part has been mapping the distribution of so</p> ... Show More
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