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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
Mon Oct 28 2024
Journal Name
Anggaran : Jurnal Publikasi Ekonomi Dan Akuntansi
The Role Of Emotional Intelligence in The Board Of Directors and Its Impact On The Performance and Value Of Institutions and Conservative Practices In Light Of Crises (Applied Research On a Sample Of Banks Listed On ISX)
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This research aims to underscore the significance of women's emotional intelligence in enhancing the effectiveness of the Board of Directors, a crucial component of internal governance, particularly during crises. Despite strides made in recent decades in appointing women to senior roles in government, business, and education, challenges persist in improving women's leadership opportunities, especially in developing countries. The study utilizes statistical methods, including Pearson's correlation, to analyze the relationships between variables within a sample of banks listed on the Iraqi securities market, comparing periods before and during the COVID-19 pandemic (2019 and 2020). The goal is to measure the impact of female emotiona

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Publication Date
Sun Jun 06 2010
Journal Name
J Of Mustansiriya College Of Dentistry
the usefulness of Ramfjord teeth to represent the full-mouth pocket depth in epidemiology study
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Publication Date
Sat Dec 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Importance of Strategic Orientation Dimensions in the Iraqi National Security Service: An Analytical Study
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The current research aims to identify the level of strategic orientation and its dimensions (vision, mission, goals, and values) in the Iraqi National Security Service (INSS). The researchers followed the descriptive analytical approach as one of the forms of analysis and organized scientific interpretation to describe a specific phenomenon or problem, adopting the form questionnaire being the main source in collecting data and preparing for this. Based on the program of the Statistical Package of Social Sciences (SPSS 26) to analyze the data and come up with the final research results to identify the opinions of the intended sample on the subject of research, and the questionnaire of (20) paragraphs included the search variable, and was

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Publication Date
Fri Dec 19 2025
Journal Name
Al–bahith Al–a'alami
The Media Discourse of the Newspaper (El Watan) Towards Social Issues Study in Discourse Analysis
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Journalistic discourse is a fertile through which most of the segments of the society interact in all their platforms: intellectual, cultural, social, and various settings between the vital structures of the state; which makes it the link between the groups and segments of the society.

The role of discourse, moreover, engages in a vital way by establishing a culture of debate on controversial issues that provided a space in the different visions and differing perceptions on how to formulate the discourse and the magnitude of vocabulary for the diagnosis of these issues. Since there is no system of any community empty of the emergence of issues reflecting the public interest which is necessary is reflected in the context discourse

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Publication Date
Mon Oct 19 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
The effect of using the interactive video accompanying the static training in learning some basic skills of a model school in squash
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Lately great interests have emerged to find educational alternatives to teach and improve motor skills according to modern educational methods that take into account individual differences and speed in learning for the learner through individual learning that the learner adopts by teaching himself by passing through various educational situations to acquire skills and information in the way he is The learner is the focus of the educational process and among these alternatives the interactive video, the researchers noted through the educational training units at the Model Squash School of the Central Union, and that most of the methods and methods used in learning basic skills take a lot of time in the educational program and do not involve

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Publication Date
Tue Sep 18 2018
Journal Name
Water
A Systematic Operation Program of a Hydropower Plant Based on Minimizing the Principal Stress: Haditha Dam Case Study
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Dam operation and management have become more complex recently because of the need for considering hydraulic structure sustainability and environmental protect on. An Earthfill dam that includes a powerhouse system is considered as a significant multipurpose hydraulic structure. Understanding the effects of running hydropower plant turbines on the dam body is one of the major safety concerns for earthfill dams. In this research, dynamic analysis of earthfill dam, integrated with a hydropower plant system containing six vertical Kaplan turbines (i.e., Haditha dam), is investigated. In the first stage of the study, ANSYS-CFX was used to represent one vertical Kaplan turbine unit by designing a three-dimensional (3-D) finite element (F

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Electronic trading system and its refletion in the trading of stock market indices –an analytical study of the Iraqi market for securities–
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The research aims at identify the role of the electronic trading system used in the Iraq stock exchange to promote trading activity for the stocks of listed companies in this market.

To prove the hypothesis of research, it was selected the main trading indicators for the market to be a main field in test the research hypothesis.it was selected as the period of time for (9)years span between the years (2005-2013) because they represent the first two articles of equal time periods represent aperiod that preceded the introduction of electronic trading system  while the second represents the period of time that followed 

The research found a number of conclusions but the mo

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Publication Date
Tue Dec 01 2015
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
STUDY ON THE EFFECT OF ROYAL JELLY OF BEES (APIS MELLIFERA) ON THE MORPHOLOGY AND SPERM FUNCTION PARAMETERS IN MICE (SWISS ALBINO)
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    The objective of this study was to investigate the effect of Royal jelly RJ on morphology and motility of mice sperms. Sperms were collected from the cauda region of the  epididymis of each 10 mice from the treatment and control groups. Direct activation techniques and evaluation of sperm morphology were carried out. Dhino microscope was used for sperm measurement. The inspection was carried out in Salamatic laboratory for pathological analysis in 2015.The result revealed that all of the sperm function parameters registered significant activation  in the treatment group. There was a significant increase in both the percentage of the sperm motility grade A and the progressive motility (A+B) of the treatment gr

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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of The College Of Languages (jcl)
The Construction of a National Identification in the Novel of N. Scott Momaday House Made of Dawn
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The United States government allowed Native Americans to abandon their reservations in the 1950s and 1960s. The historical, social, and cultural backgrounds shaped the forms and themes of works by American Indian writers who urged people to refuse their culture's sense of shame. Moreover, their behavior corresponded with the restoration of individuals to their rituals after disappointment, loss of sense of life, and mental illness performed from the influence of mainstream American society. Among these writers, N. Scott Momaday and Leslie Marmon Silko participate in similar interest in portraying characters caught between indigenous beliefs and white mainstream standards.  

      The construction of

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Publication Date
Thu May 12 2022
Journal Name
Journal Of Kerbala For Agricultural Sciences
Response of Bread Wheat Crop to the Spray of Alcoholic Sugars and A balanced Mineral Fertilizer in the Central Region of Iraq
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Two field experiments were conducted during the season 2021-2022 in central Iraq represented by the Al-Muthanna governorate - Al-Majd District and Al-Qadisiyah governorate / Al-Nouriah Research Station to determine the productivity of the Baghdad 3 cultivar from spray foliar fertilization of Macro and Micro elements with alcoholic sugars and half the fertilizer recommendation for addition floor, three treatments were used for fertilization: T1 as the control treatment and T2 with alcoholic sugar fertilization at a concentration of 20 g.L-1 + the fertilizer combination of Macro and Micro elements, and T3 with alcoholic sugar fertilization at a concentration of 40 g.L-1 + the fertilizer combination of Macro and Microelements, at irrigation 55

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