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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 19 2026
Journal Name
Al–bahith Al–a'alami
CARTOON SEMIOTIC ABOUT MARCH OF RETURN IN THE PALESTINIAN NEWSPAPERS: : (A Comparative Analytical Study)
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This study aims to reveal the semiotic of “March of Return” cartoon in the Palestinian journalism, topics, Symbols and semantics that were covered.
This study is descriptive. It uses the survey method. Content analysis, and methodological comparison was also used.

The researcher chose an intentional sample of Palestine and Al-Hayat Al-Jadida newspapers for one year from March 30, 2018 to March 31, 2019, through a comprehensive inventory of all cartoons of the return marches during this period, which amounted to 59 cartoons.

The study has reached the following findings:

Newspapers cartoons focused on the topics of durability of the protester

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Strategic orientation and its reflection on the Learning organization: Survey study of a sample of Makers decision the Iraqi Ministry of Communications
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The current research focuses on the extent to which the strategic orientation(entrepreneurial orientation, customer orientation, technology orientation, learning orientation, and investment orientation) affects the learning organization (building common vision, systemic thinking, personal dominance, mental models, team learning)The first hypothesis to test the connection relation between research variables and The second hypothesis was to test the relationship between these variables. In order to ascertain the validity of the hypotheses, the research was based on a questionnaire questionnaire prepared according to a number of In addition to building a fifth sub-variable for the strategic orientation (investment orientation) based

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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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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
Sun Jun 30 2019
Journal Name
Journal Of The College Of Law /al-nahrain University
The Content of the Contract – A Study in Light of French Legislative Decree No. 131-2016 Issued on 10 February 2016
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Of the new concepts introduced by the decree of the amendment of the French Civil Code No. 131-2016 issued on 10 February 2016, which raised a debate in jurisprudence both at the level of French jurisprudence or the Arab, the concept of (the content of the contract), which seems to have emerged from the appearance of new legal articles ( 1162-1171) is the cornerstone of the contract and the contract in the contract, the two pillars which, over the course of 200 years and a half, have been one of the main pillars of the codification of Napoleon. Is that the decree of amendment has already abandoned these two pillars, or most of what he did is a change in terminology while preserving the content of these two pillars implicitly, this is what w

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Publication Date
Thu Oct 01 2009
Journal Name
Journal Of The College Of Languages (jcl)
A RAISIN IN THE SUN: the dream of RECOGNITION
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Lorraine Hansberry’s A Raisin in the Sun (1959) appeared at the beginning of renewed political activity on the part of the blacks; it is a pamphlet about the dream of recognition of black people and the confusion of purposes and means to reach such recognition. It embodies ideas that have been uncommon on the Broadway stage in any period. Situations such as a black family moving into an all-white neighborhood were not familiar before this time; they were just beginning to emerge. In depicting this so realistically, Hansberry depends more on her personal experience as an African American embittered by social prejudices and discrimination. 

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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of The College Of Education For Women
protect the environment from destruction in light of the verses of the Quran (Subjective Study)
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Environment suffered in recent years a large corrupting by human; and because of his ignorance of the dimensions of Caliphate in the ground and ignore what it means gearing. The gearing is that the son of Adam, which will benefit the board of Allah Almighty to him in the land of the causes of life, without exaggeration or negligence and without prejudice to the cosmic Balnoames enacted by the Almighty Creator, has urged verses of the Quran Muslim to preserve and protect the environment which is a religious duty, as it showed a great verses he is the author and the splendor and beauty of workmanship and manufacturer greatness of the Almighty, who created all things beautiful.
Koran played a major role in the consolidation of environmen

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Publication Date
Tue Oct 30 2001
Journal Name
3rd. Jordanian Civil Engineering Conference ,29-31 Oct.2001. 2001
The Use of the F.E.M. to Study the Performance of Stone Columns in Soft Soil
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In this paper, the penetration of the stone column was investigated in order to get the minimum length of the stone column above which the increase in length has little advantage. The effect of using different materials in column are also studied. The material used is granular of different angle of internal friction (). The results of the investigation indicated that the effect of stone column remains constant when the ratio of the thickness of the soft clay layer to the stone column’s diameter is more than 15. The results also indicated that a pronounced effect is obtained when the angle of internal friction of the stone column material is increased.

Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The role of intellectual capital in promoting financial performance an applied study on a sample of the companies listed in Iraq stock exchange
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The interest in the intellectual capital and its development is a civilized necessity imposed by the requirements of the times and cannot imagine an advanced society in its potential productivity in poor efficiency of human capital, and features the work environment change permanently, putting the management of financial companies against a constant challenge toward coping with new developments in this changing environment and this is not taken unless owned by these companies qualified human resources and the provision of Culture organizers have, which manifested itself with the research problem by the following two questions:

  1. Did the intellectual capital value specific financial and

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Publication Date
Wed May 10 2023
Journal Name
Journal Of Planner And Development
The impact of population density in sustainable housing - An applied study in the city of Baghdad (Mahalla 817), Al-Bayaa as a model
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Population density represents an important indicator for determining the growth of the size of urban areas. Population density has a direct impact on the quality of life, and its excessive rise may lead to the deterioration of basic service facilities. The problem of the research is that the increase in the total population densities of the residential neighborhood may reflect negatively on the nature of the services provided to the residents in these shops, and thus the failure to achieve sustainability in the residential locality. The research assumes that the increase in population densities negatively affects the achievement of sustainability in the residential neighborhood.

 

      

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