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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
Sun Jun 15 2025
Journal Name
Magazine Aldhakwat Albedh
Ideals and values in the texts of the second century AH - Visit forty examples - Technical objective study
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Values and ideals are two basic pillars in human life, and high societies have been keen throughout their ages to adhere to and establish them so that man can distinguish good and evil, right and wrong, as they are a balance of actions that give man a higher value. Many of the followers of Abbasid literature, poetry and prose – it is noted that many imams and writers have been keen to highlight these values and make them material for their poetry and literature, courage, generosity, chastity and....All meanings of human values and there is no doubt that one of the texts abounding in this field is what was reported from the people of the house of infallibility pure (peace be upon them), including we touch it in the visit of Imam Jaafar al-

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Catalysts for money laundering and control by the banks / analytical study in the province of Arbil measures
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Receive money laundering phenomenon of interest to researchers and scholars on different intellectual orientation of economic or political or other, as this process is gaining paramount importance in light of business and increase the number of banks in the province of Kurdistan of Iraq and Erbil in particular and in the presence of openness developments chaotic economic and there are no factors encourage money laundering operation because of the presence of the hidden economy and the weakness of the banking and legal measures to combat them, and on this basis there is a need to examine money laundering operation in the province of Arbil, to indicate the presence or absence of a money laundering operation in working in the provin

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
The artistic and performing methods of the sass dance in Baghdad "An Analytical Study": أمير علي رضا
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The research study includes shedding light on the sas dance in Iraq, as it is one of the popular legacies that are rich in the Mesopotamian civilization and because of the different practices it has in the different occasions on which these dances are held. Which is one of the kinetic arts widespread among the classes of Iraqi society. The researcher explained its features and artistic content that characterizes Iraqi music. The (methodological framework) reviewed the justification, importance and purpose of the research, and the limits of the research that included the (National Troupe of Folk Art) as a human limit to discover the artistic methods of the Sas dance and then define the terms of the search. The "theoretical framework" cont

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Publication Date
Sat Mar 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The exercise of citizenship behaviors and their impact on customer loyalty: Analytical study from the standpoint of employees in the National Insurance Company
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The exercise of citizenship behaviors and their impact on customer loyalty (An analytical study from the perspective of workers in the National Insurance Company).

The Research aims to find out the degree of customers National Insurance company for customer citizenship behavior and its impact on the level oh loyalty from the perspective of employess in the company, as well as the statement of the differences in the answers of employees according to their personality traits. To achieve the goals of research has been the use of the questionnaire as a tool for the collection and distribution of data on a sample of (90) individuals, as was the use of statistical program (SPSS) in the process of statistical analysis methods (mean, sta

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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Achieve the internal and external dimensions of corporate social responsibility through the human resources management strategies / case study in the Municipality of Ramadi.
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The main focus of research is on how to achieve the internal and external dimensions of corporate social responsibility through human resources management strategies, which is a major of research aimed. The main problem of this research was confirmed, which confirms that there is an unclear role for social responsibility, lack of human resources management strategies, and ambiguity of roles in the municipality under study. The diagnose of the problem and determining the gap between the internal and external dimensions of social responsibility and human resources management was identified, which attacked the researcher's attention to navigate in this subject, look for the reasons for the gaps and try to reduce them. The case study

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Publication Date
Thu Feb 17 2022
Journal Name
Teikyo Medical Journal
Study the Effect of different doses of Rapamycin on the liver development in the Swiss Albino Mice Embryos
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The current study, which extended from February 2020 to June 2021 at the University of Thi- Qar\ College of Education for Pure Sciences, aimed to follow the changes in external morphological features at different Embryonic Developmental stages in pregnant mice treated with different doses of Rapamycin (Rapa). Use In this study, 32 pregnant mice were divided randomly into four groups, each of which had eight pregnant mice. Each group received different dose of Rapa via intraperitoneally injection at different gestation days until the end of the specified periods, whereas the control group received a DMSO. Mice were administered under the same circumstances and dosages were determined based on body weight, as specified in pharmaceutical const

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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Economics And Administrative Sciences
Determining the sources of growth of the cement industry in Iraq (analytical study for the period 1990-2014)
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The objective of this study is to determine the sources of growth of the cement industry in Iraq for the period 1990-2014 and to indicate the nature of the technological progress used in it. To achieve this objective we have built an econometric model, by adapting the production function constant elasticity for substitution, using multiple regression, and enforcement, SPSS program, and using the ordinary least squares method (OLS). The results showed that quantitative factors (labour and capital) are the main sources of growth the cement industry in Iraq, and the qualitative factors (technological progress) did not contribute effectively to achieve this growth. And that the production techniques adopted in the cement industry in

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Publication Date
Wed Feb 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Possibility of applying international AACSB accreditation standards in the faculties of business and Economics- case study in the college of management and Economics-University of Baghdad
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Attention increased to the topic of academic accreditation by the university as a modern philosophy by which to improve its performance and provide high-quality education. Universities and colleges in general and Iraqi universities and colleges in particular have begun interest in accreditation and desire to get it. So starting from the pursuit of the Administration and Economics College / Baghdad University in obtaining accreditation of Association to Advance Collegiate Schools of Business (AACSB) The research is present which aims to determine the level of application (AACSB) International standards at the College of Administration and Economics / Baghdad University in preparation to get its accreditation in the future. Researc

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The extent of the contribution of internal marketing in the management of human talent survey study of the views of some administrative leaders at the University of Mosul
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 Abstract

Investment in the human resource has become an important part of the strategies of educational organizations so that they can be competitive, so that the access of academics in universities to the international awards as a result of their research excellence indicates the effectiveness of this human talent so the interest has emerged in the implementation of a strategy to manage these human talent in organizations in general and educational ones In particular as one of the power sources  that can not be imitated. The focus of the organization on the interaction between the working people has increased attention to the human element in order to achieve the desired quality levels, which called for organi

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Publication Date
Thu Jun 01 2023
Journal Name
2023 Ieee 36th International Symposium On Computer-based Medical Systems (cbms)
Toward a Minimal sEMG Setup for Knee and Ankle Kinematic Estimation during Gait
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