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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 Jul 19 2025
Journal Name
Annals Of Applied Sport Science
A Comparative Study of the Average Motor Response Time for the Arms and Legs of Handball, Basketball, and Volleyball Players Aged 14-16 Years
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Background. The motor response is a fundamental ability that is evident during any physical or motor activity. However, the need for this ability varies from one sport to another and depends on the specific skills required in each sport. Objectives. This study aims to compare the average motor reaction times of the arm and leg among handball, basketball, and volleyball players aged 14 to 16 years. Methods. The sample included 30 players aged 14-16 years from the sports talent care center, evenly distributed on handball, basketball, and volleyball. Standardized tests were used to measure the speed of motor response, including the Batak Micro test for hands, which records the number of responses to light stimuli in 30 seconds, and the Saqer t

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Publication Date
Sat Feb 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Study the reality of vocational education in the province of Basra Applied statistical study for the period 2004/2005 – 2010/2011
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         Vocational education is the basis of contemporary educational movement that aims at satisfying human needs. Societies can develop their human resources via setting programs for the working class as an aspect of the comprehensive national development. Vocational education is the main source of technical cadres the Iraqi labor market requires of the vocational preparatory schools to provide after three years of schooling.

        The vocational schools of the governorate of Basra have a number of problems that lead to the lack of proficiency of their graduates. This study is an attempt to identify these problems or obstacles

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
The causes of fear in the world An original Quranic study
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The subject of fear is one of the most important tasks that one should seek to find out the reasons behind it, and push it up with all its sound mental concepts.
     The main reason for the lack of security and fear and disturbance in the world is to commit the legitimate violations that God warned us in his Holy Book as well as in the Sunnah of His Prophet (peace be upon him).
    The talk about the causes of fear in the Koran is not limited to the word (fear) Fakk but came in different and varied methods such as (horror) and (awe) and (shares) and (narrow).

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Publication Date
Wed Sep 21 2022
Journal Name
Journal Of Planner And Development
"An analytical study of The New Urbanism in the urban suburbs
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                 The research deals with the concept of a New Urbanism as an urban development strategy in the suburbs of cities or in its centers that are affected by pedestrian-oriented design and the possibility of walking, as well as integrating economic classes through the diversity of housing and its costs, and this works to facilitate access to jobs and services while providing more diverse neighborhoods and reducing the use of cars , As designing separate houses in the suburbs and increasing car trips poses a threat to the environment and the quality of urban life, and thus the new urban provides a good strategy for developing

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
Study the positive effects of “Whatsup” application in the educational process
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Limited importance of research in a stand on the most important difficulties faced by both faculty and parents to communicate with each process to follow up on their children, and the analysis and inventory of the obstacles that hinder the educational process, and work to develop a vision of how to address these constraints and the important role of technology in the treatment of problems of the society so as to develop frameworks future to minimize the errors and the problems they face, and the development outlook for future generations in order to promote the educational level, especially that Iraq is going through a change in conditions in all sectors. Through the questionnaire, which includes questions set that was made on a sample o

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Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Rising Rate of Cesarean Section
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Cesarean section, which was introduced into clinical practice as a lifesaving procedure for both the mother and the baby, is one of the most common surgeries performed in modern obstetrics. Formerly it was performed in interest of the mother; currently it is frequently done for fetal indication. As other procedures of some complexity, its use follows the health care inequity pattern of the world; underuse in low income setting, and adequate or even unnecessary use in middle and high income setting (1).
The first modern cesarean section was performed by German gynecologist Ferdinand Adolf Kehrer in 1881. Cesarean section is often performed when a vaginal delivery would put the baby's or mother's life or health at risk. Many are also pe

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Publication Date
Mon Jun 26 2023
Journal Name
International Conference On Scientific Research &amp; Innovation (icsri 2022)
Age and gender profile of coronavirus disease 2019 (COVID 19) in Quarantine Center in Baghdad, Iraq
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Publication Date
Mon Jun 26 2023
Journal Name
International Conference On Scientific Research &amp; Innovation (icsri 2022)
Age and gender profile of coronavirus disease 2019 (COVID 19) in Quarantine Center in Baghdad, Iraq
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Publication Date
Sun Jan 19 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Effect flexibility of the Strategic human resources in improvement operational performance: "Survey study of views of a sample of managers, engineers and technicians in the Baghdad south 2/Station directorate of Electricity"
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The research attempts to diagnose the level of the effect of human resources flexibility (employees skills flexibility, employees behaviors flexibility, and human resource practice flexibility) in the south al-rusafa directorate of a power  station one of the formations and the Ministry of Electricity, and impact of a range of variables related to the performance operational, namely, (efficiency, effectiveness)recognizing the importance of the subjects studied,& because of the importance of expected results of the field under consideration,researcher selected a sample of size (121) engineers and technicians of workers in the directorate. Was my hypotheses the major search of a relationship and impact between human resources flex

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Development and democracy in the Republic of Korea study in dialectic relationship
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After its 35-year occupation of Japan and the US occupation, Korea has set its sights on a long-term goal of building its country and establishing its foundations, unobtrusive and unchecked by the problems and wars that have stood in the way of its goal, surpassing all odds and achieving the best results. The most powerful Asian and global economies, which gained the respect of the world and its appreciation of the experience has become referred to as boys

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