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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 Sep 01 2021
Journal Name
Review Of International Geographical Education
A New Approach in Determining the Criteria of Equations for Morphometric Characteristics of River Basins - Applied Morphometric Study of The Mamaran Basin
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This study aimed at some of the criteria used to determine the form of the river basins, and exposed the need to modify some of its limitations. In which, the generalization of the elongation and roundness ratio coefficient criterion was modified, which was set in a range between (0-1). This range goes beyond determining the form of the basin, which gives it an elongated or rounded feature, and the ratio has been modified by making it more detailed and accurate in giving the basin a specific form, not only a general characteristic. So, we reached a standard for each of the basins' forms regarding the results of the elongation and circularity ratios. Thus, circular is (1-0.8), and square is (between 0.8-0.6), the blade or oval form is (0.6-0

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
(Determine the Impact of Public Relations Ethics in Strategic Decisions) Descriptive Analytical Study of a Sample of Administrative Leadership in the Ministry of Higher Education
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Role of public relations (PR) and from one community to another, depending on the different cultures of these societies in General, and different ethical values established by their practitioners in these communities organizations  , public relations in developed societies, and in  some developing countries have taken great strides to contribute to the strategic planning and decision-making, in the framework of their commitment to the values and ethical standards for practitioners, In contrast, we find that applied in Iraq still skips phase coordinate with different communication means with the aim of advertising and publicity for the organization. As a result of the limited recognition of the strategic and vital 

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Publication Date
Tue Oct 24 2017
Journal Name
International Journal Of Science And Research
Incidence Rate of Infectious Diseases in Hospitalized Children
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Objective: The incidence of infectious diseases among hospitalized children remains high. This study describes the environmental health indicator diseases and differences between gender and age of the affected children. Patients & Methods: A review of hospitalization and death causes among children admitted to the Child Teaching Hospital for Pediatrics in Baghdad, Iraq was performed. Medical records of children admitted throughout three years period were collected for demographics data and statistical analysis using Chi-square test. Results: A total of 4,272 admissions and 309 deaths were recorded. Infectious diseases remain the primary cause of hospitalization among children and frequently lead to death; which recorded (56%) followed by ac

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Publication Date
Sat Dec 20 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Study of salivary IgA concentrations, salivary flow rate in patients with β –thalassemia major in Missan Governorate
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Background: Beta-thalassemia major is the most common monogenic known disorder in the Middle East, characterized by anomalies in the synthesis of the beta chains of hemoglobin resulting in variable phenotypes ranging from severe anemia to clinically asymptomatic Individuals. This study aimed to evaluate salivary flow rate and salivary IgA in β-thalassemia major patients. Since many oral and systemic conditions manifest themselves as changes in the flow and composition of saliva the dental practitioner is advised to remain up-to-date with this issue. Materials and methods: The study samples consist of (60) subjects, patients group composed of (30) patients with β –thalassemia major, age rang (5-23) years and (30) healthy locking

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Publication Date
Mon Jan 01 2018
Journal Name
African Journal Of Hospitality, Tourism And Leisure
An analytical study of the strategic flexibility variation as a function of the dynamic capabilities based on supply chain management (Case study: The General Petroleum Products Distribution Company in Baghdad)
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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Research In Social Sciences &amp; Humanities
The Impact of Strategic Improvisation on Organizational Health: An Analytical Study of the Opinions of a Sample of the Leaders of the Dhi Qar Health Department
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The current research aims to identify the level of impact of strategic improvisation as an independent variable on organizational health. The dependent variable in the Department of Health of Dhi Qar to reach appropriate mechanisms in order to reach appropriate mechanisms and recommendations proposed to contribute to the achievement of organizational health in the Department of Health of Dhi Qar (the research department) and based on the importance of the subject of research in government institutions and the important and service role of the Department of Health of Dhi Qar in the Iraqi society. The descriptive analytical approach was adopted in the completion of the research based on the opinions of the leaders in the surveyed depa

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Publication Date
Sat Apr 25 2020
Journal Name
International Journal Of Research In Social Sciences And Humanities
THE EFFECT OF CAPITAL ADEQUACY AND ASSET QUALITY ON THE VALUE OF THE BANK AN APPLIED STUDY ON A SAMPLE OF IRAQI BANKS LISTED ON THE IRAQ STOCK EXCHANGE
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As the banking sector is a strong influence on the country's economic growth,The solid financial well-being of anybank does not mean only a guarantee for its investors, It is also important for both owners and workers and for theeconomy in all its joints.The elements of capital adequacy and quality of assets are important to the functioning of thebanking business.In this study, the research sample included four private banks. Quarterly data were used for the period(2011 - 2018).Moreover, data is also collected from articles, papers, the World Wide Web (the Internet) and specializedinternational journals.In this research, an effort was made to try to find out the effect of (the ratio of the capital owned todeposits on the value of the bank),

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Advanced Research In Fluid Mechanics And Thermal Sciences
Aerodynamics of a Formula One car front cascade wing during cornering
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Publication Date
Mon Jun 14 2021
Journal Name
Turkish Journal Of Physiotherapy And Rehabilitation
A STUDY OF THE DIMENSIONS OF COMPETITION ANXIETY AND ITS RELATIONSHIP TO THE DIMENSIONS OF SPORTING ACHIEVEMENT MOTIVATION FOR YOUNG TENNIS PLAYERS
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One of the most important phenomena facing the athlete is the anxiety of sports competition, as he faces many psychological problems during training and in competitions of psychological tension, fear and anxiety that accompany him sometimes, which leads to affecting his level, and sports competition anxiety is a special type of anxiety that occurs in the athlete It is related to the attitudes of sports competitions and that participation in sports competitions and the associated emotional experiences are among the important factors that motivate the practice of sports activity and try to advance and develop his sports level. It is assumed that when the individual begins to practice any activity, he aims to reach a level or degree of achie

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Publication Date
Thu Oct 20 2022
Journal Name
Iraqi Journal Of Industrial Research
Study of the Effect of Epipremnum Aureum Extracts and Tribulus Terrestris L. as a Natural Alternative for the use of Industrial Antioxidants
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In this study, two types of local plants were chosen, the first is the plant golden pothos Epipremnum aureum and the second is the Iraqi Sheikh's chin plant Tribulus terrestris L, for the purpose of making a comparison between them in terms of their possession of chemical groups with antioxidant activity in order to use them as a natural alternative to using antioxidants Industrial that cause negative effects on human health, the samples were prepared using the method of water and alcohol extraction (ethanol 70%) for both plants. It revealed the presence of a number of chemical groups (tannins, carbohydrates, phenols, flavonoids, alkaloids) for both plants, the aqueous and alcoholic extracts. Coumarins are only found in the sheikh's chin pl

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