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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
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
(Love and Love) in the light of the significance of Quranic
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Thanks allah and peace be upon our prophet muhammed and upon his family and his
followers……
Love means in holy quran what comes to people s mind nowadays and what it inspired its
signi ficence is related with sensual desire and it means adore and passion .by the waythe
word (ishiq) adore wasn’t mentioned in holy quran which means that both of their bases are
farfrom each oiter in m eaning.
The significance of love means virtue while adore means the excess and desire so adore is
dis praised . as al askari said (died 395h )between love and adore.adore is the strain of desire
to get the purpose from lovers if it was ahuman who intended to make love affairs.
Today both of love and adore changed in their meani

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Publication Date
Wed Jun 19 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Effect Wisdom Management in Defferentiation Strategy for Service Operations Exploratory: Search of the Views of A Sample of the Officials in the General Establishment of Civil Aviation
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Today, the success or failure of organizations depends to possess the wisdom of their managers promised that the key to organizational success of the business environment, making the right decisions, and create the ability to work and think towards discrimination of products and services the organization . Seek this research to investigation the relationship between the wisdom management and differentiation strategy for service operations . It was a test of that relationship in light of the results of the analysis of the data collected through the questionnaire distributed on a sample from (98) Director Mangers, head of department and head of division in  the General Establishment of Civil Aviation . The research used descriptive st

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
Rights and duties in the reform project of Imam Ali (peace be upon him) in the footsteps of the Koran and the Sunnah
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The principle of rights and duties is part of the reform project of the Commander of the Faithful Ali ibn Abi Talib, to build a state of institutions whose foundations have been built on Quranic rules, a prophetic biography, and his diligence in doing so in accordance with the requirements of interests and evil, and his certainty in determining the most important and important, and research analytical study of speeches Imam Ali and his career, in this study (the principle of rights and duties) of the ruler and the parish because of their role in the reform process, which depends on the demolition and construction together, as it is the responsibility of the ruler to demolish all constructed corrupt and contrary to the principles of Islam

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Engineering
A Prediction Formula for The Estimation of Sediment Load in The Upper Reach of Al-Gharraf River
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The presence of deposition in the river decreases the river flow capability's efficiency due to the absence of maintenance along the river. In This research, a new formula to evaluate the sediment capacity in the upstream part of Al-Gharraf River will be developed. The current study reach lies in Wasit province with a distance equal to 58 km. The selected reach of the river was divided into thirteen stations. At each station, the suspended load and the bedload were collected from the river during a sampling period extended from February 2019 till July 2019. The samples were examined in the laboratory with a different set of sample tests. The formula was developed using data of ten stations, and the other three s

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The role of compensation system in improving the quality of educational services (Halabja University as a model)
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          This study deals with the role of compensation system in improving the quality of educational services (University of Halabja as a Model) also our problem was the following question ; What is the role of compensation system in its different dimensions in improving the quality of educational services? And what is the relationship and impact of using the dimensions of the compensation system to improve the quality of educational services? The hypothesis of the research included the correlation and the impacts between the compensation system and its combined variables in the quality of educational services. This was proved through a field study and the distribution of questionn

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Publication Date
Tue Mar 22 2022
Journal Name
Journal Of The College Of Basic Education
Directing treatment of the concept of cruelty in the Iraqi theater show (Autumn play as a specimen)
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    رافقت القسوة الانسان منذ القدم  وكثيرا ما تم الخلط بينها وبين العنف لشدة التقارب بينهما , وهنا يحاول البحث  ان يفصل بين كلا المفهومين ويتفرد بمفهوم القسوة, الذي سلط عليه الضوء في المسرح لأول مرة على يد الفرنسي(انطوان ارتو)  في محاولة للكشف عن المعالجة الاخراجية التي قدمها المخرج العراقي(صميم حسب الله) لمفهوم القسوة في مسرحيته الموسومة (خريف) ويتضمن البحث نبذه  (مفهوم القسوة في الفكر الانساني) وكذلك (الق

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Publication Date
Tue Aug 01 2023
Journal Name
Baghdad Science Journal
The Ecological Risk Assessment of Mercury Contamination in a Mangrove Ecosystem of the Segara Anakan Cilacap, Indonesia
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Ecological risk assessment of mercury contaminant has a means to analyze the ecological risk aspect of ecosystem using the potential impact of mercury pollution in soil, water and organism. The ecological risk assessment in a coastal area can be shown by mangrove zonation, clustering and interpolation of mercury accumulation. This research aims to analyze ecological risk assessment of potential mercury (including bioaccumulation and translocation) using indicators of species distribution, clustering, zonation and interpolation of mercury accumulation. The results showed that the Segara Anakan had a high risk of mercury pollution, using indicators like as the potential of mercury contaminant in water body was 0137±0.0137 ppm, substrate a

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Publication Date
Sun Dec 09 2018
Journal Name
Baghdad Science Journal
An Epidemiological, Diagnostic, and Therapeutic Study of the Leishmania tropica Parasite in Iraq’s Anbar Province
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This paper involved the registration of 1,936 cases of infection of the Leishmania tropica parasite observed at hospitals and health centers in Ramadi, Fallujah, Baghdadi, and Hit during 2017. The results revealed that the highest rates of infection were found in Ramadi and Fallujah. The 1-10 years age group recorded the highest rate at 35.5%. There was no significant difference (p ≥ 0.05) between the sexes. December and January saw the highest rate of infection, where the rate in rural townships was found to be 65.5%, higher than in urban regions which saw a rate of 34.4%. Facial lesions were the most prominent area of infection, recorded at a rate of 41.3%. The study also included an examination of 180 rodents (94 mice and 86 black r

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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research &amp; Development
Comparative Study of Hepcidin and Some Inflammatory Parameters in Pregnant Women at the Three Trimesters
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Publication Date
Mon Dec 22 2025
Journal Name
Al Ghary Journal Of Economic And Administrative Sciences
The impact of strategic knowledge on strategic improvisation: an exploratory study of some private hospitals in the city of Baghdad
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