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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 Aug 24 2025
Journal Name
Basrah Journal Of Agricultural Sciences
Histological Study of the Stomach of the North African Catfish Clariasgariepinus (Burchell, 1822) (Siluriformes, Clariidae) from the Tigris River, Iraq
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This study investigates the stomach morphology and histochemistry of Clarias gariepinus. Grossly, the stomach is a J-shaped organ with three distinct regions: cardiac, fundic, and pyloric. Histologically, its wall comprises four layers: mucosa, submucosa, muscularis externa, and serosa. The mucosa exhibits broad longitudinal folds lined by high columnar cells with basal oval nuclei. These cells contain apical mucosubstances that react positively with Periodic Acid Schiff (PAS) stain and negatively with Alcian Blue (AB). Gastric pits result from mucosal invaginations. Glands are present in the fundic and cardiac regions but absent in the pyloric. Oxynticopeptic cells exclusively line the fundic glands. Enteroendocrine cells are distr

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Publication Date
Sun Aug 24 2025
Journal Name
Basrah Journal Of Agricultural Sciences
Histological Study of the Stomach of the North African Catfish Clariasgariepinus (Burchell, 1822) (Siluriformes, Clariidae) from the Tigris River, Iraq
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This study investigates the stomach morphology and histochemistry of Clarias gariepinus. Grossly, the stomach is a J-shaped organ with three distinct regions: cardiac, fundic, and pyloric. Histologically, its wall comprises four layers: mucosa, submucosa, muscularis externa, and serosa. The mucosa exhibits broad longitudinal folds lined by high columnar cells with basal oval nuclei. These cells contain apical mucosubstances that react positively with Periodic Acid Schiff (PAS) stain and negatively with Alcian Blue (AB). Gastric pits result from mucosal invaginations. Glands are present in the fundic and cardiac regions but absent in the pyloric. Oxynticopeptic cells exclusively line the fundic glands. Enteroendocrine cells are distr

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Determination of the lot size using the Wagner-Whitin algorithm under the Constraint Theory / Case Study of Diyala Public Company
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         International companies are striving to reduce their costs and increase their profits, and these trends have produced many methods and techniques to achieve these goals. these methods is heuristic and the other Optimization.. The research includes an attempt to adapt some of these techniques in the Iraqi companies, and these techniques are to determine the optimal lot size using the algorithms Wagner-Whitin under the theory of constraints. The research adopted the case study methodology to objectively identify the problem of research, namely determining lot size optimal for each of the products of electronic measurement laboratory in Diyala and in light of the bottlenecks in w

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Concept Maps in Academic Achievement among Family Education Students in the Subject of the Art of Elegance and Fashion
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Abstract

The current research aims to identify the effectiveness of concept maps in the academic achievement of the art of elegance and fashion for third vocational students. The current research is a quasi-experimental one. The research sample consisted of (74) female students in Al-Saydiyah secondary school for girls, they were divided into two groups: the experimental group and the control group. The following hypothesis was developed: There are no statistically significant differences at the level (0.05) between the average scores of the students who studied the subject using concept maps and the average scores of the students who studied the subject in the traditional method in the post-achievement test. The

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Publication Date
Sun Jan 04 2015
Journal Name
Journal Of Educational And Psychological Researches
Effectiveness of the self-questioning strategy in the achievement of the third stage Institutes of teacher preparation and decision - making in Chemistry
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This research aims to find out "the effectiveness of the self-questioning strategy in the achievement of students Phase III institutes of teacher preparation and decision-making in chemistry." The researcher follows approach quasi-experimental with a post-test, and the sample consisted of (27) from " Teachers Training Institute-AL-Byaa "in Directorate of Education Baghdad Karkh / 2 students divided into two unequal groups: experimental its number (14) students studied using reciprocal teaching strategy and control its number (13) students have studied in the usual way.The two groups were equivalent extraneous variables.

The researcher was prepare achievement test consist of 40 items was the adoption of a measure of decision-makin

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Use of Remote Sensing in the assessment and classification of land degradation in the district of Mahmudiya for the period 1990-2007
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The study consisted in the development and use of a practical method to detect and
monitor, analyze and produce maps of changes in land use and land cover in the district of
Mahmudiya in Baghdad during the period 1990-2007 using the applications of remote sensing
techniques and with the assisstant of geographic information systems (GIS),as a valuable
contribution to land degradation studies.
This study is based maiuly on the processing on two subsets of landsat5 TM images picked up
in August 1990 and 2007 respectively in order to facilitate comparision and were thengeometrically and radiometrcally calibrated ,to used for digital classification purposes using
maximum liklihoods classification or six spectral bands of

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Publication Date
Wed Sep 15 2021
Journal Name
Al-academy
Design and implementation of a glove theater of cardboard materials for the students of the Kindergarten Department: قيس هاشم احمد النعيمي
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The current research aims to develop the skills of the kindergarten students in designing and implementing a theater for gauntlets made of cardboard materials. To study this, the researcher determined to build teaching plans for design and implementation skills according to (Kolb model).
The results of this research showed the effectiveness of teaching plans according to (Kolb's model) in developing skills of design and implementation (theater for gauntlets made of cardboard materials) for the students of the Kindergarten Department - the experimental group. Which had a positive effect to reach the desired results in the design and implementation of the gauntlet theater and dealing with cardboard materials

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Enhancing audit procedures in accordance with the international assurance standard through the implementation of a proposed program
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Abstract:             

                  The research seeks to identify the role of the International Assurance Standard (3402) in the auditor's procedures, as the importance of the research stems from providing assurance services for control tools through reports that are prepared according to this standard, which contribute to strengthening audit procedures through a proposed assurance program. Many conclusions were reached, the most important of which The assurance operations are considered among the operations with a special assignme

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
Features of the actor's performance in the ritual theater (Iraqi theater as a model): علي شخير نفل
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The features of the actor's performance in the ritual theater are of great importance and chief in theatrical work since the first emergence of the theater, as the features of the performance were embodied in all Iraqi theatrical performances, but they took personal privacy in some ritual performances because of their differences and similarities between the ritual theatrical performance and the ritual show Al-Khalis, who wanted the researcher to know the similarities and differences in the features of the ritual performance and in the theatrical performance, despite the many transformations that occurred in the theater and affected the features of the performance, but it remained an important and attractive link between the recipient, t

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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The Efficiency Of Physics Forceps In Comparison To The Conventional Dental Extraction Forceps: A randomized Clinical Trial
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Background: Tooth extraction is one of the most commonly performed procedures in dentistry. It is usually a traumatic process often resulting in immediate destruction and loss of alveolar bone and surrounding soft tissues. Various instruments have been described to perform atraumatic extractions which can prevent damage to the paradental structures. The physics forceps is one of those innovations in dental extraction technologies that claim to provide an efficient means for atraumatic dental extractions. Materials and method: A randomized clinical trial was conducted to compare the physics forceps with the conventional forceps for the removal of 28 mandibular single rooted teeth under the following parameters: incidence of crown, root, b

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