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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 Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Impact of climatic fluctuations in the production of citrus in the province of Karbala
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The relationship between the elements of the climate and the productivity of citrus (kg
/ tree) in the province of Karbala has been determined through the use of simple correlation
coefficient of Pearson (rp) and (t) test. The result for each of oranges, limes and tangerine had
all shown moral and relevant statistical indications; except for relative humidity, which were
not linked to a moral relationship with productivity of tangerine, oranges and limes.As for the
relationship between climatic factors and yield of bitter orange were all not significant
statistically and very weak.
In order to determine the strength of the correlation between fluctuations in the
climatic elements and fluctuations in the productivi

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
The effectiveness of prediction and clairvoyance and its functions in the inner space
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The research dealt with the effectiveness of prediction and foresight in design as a phenomenon that plays a role in the recipient's engagement with the design, as it shows the interaction between the recipient and the interior space. The designer is keen to diversify his formal vocabulary in a way that secures visual values that call for aesthetic integration, as well as securing mental and kinetic behavioral understanding in the interior space.
As the designer deals with a three-dimensional space that carries many visual scenes, the designer should not leave anything from it without standing on it with study and investigation, and puts the user as a basic goal as he provides interpretive data through prediction and foresight that le

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Publication Date
Sun Sep 27 2020
Journal Name
Journal Of The College Of Education For Women
The Term Delay and its Jurisprudences in the Section of Punishments and Felonies
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Different Arabic and Islamic societies are free of evil instincts. Therefore, certain provisions of legitimacy came to stress the importance of the intentions of sharia to achieve the interests of all people that involve several aspects, including the five fundamental things: religion, oneself, offspring, mind and money. Almighty Allah has specified certain punishments on those who violate these things by imposing punishments on the part of the criminal to preserve souls. He imposes the penalty of theft to preserve property, the Hadd punishment for adultery to preserve the symptoms, the punishment on the drunk to preserve the mind, and the Hadd punishment for the apostate to preserve the religion. By the adherence to these punishments li

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The role of the learning organization in the behavior of the work teams \ exploratory research in the Rasheed Bank
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This research aims to examine the relationship between learning organization and behavior of work teams. The variable of the learning organization took four dimensions depending on the study (sudhartna & Li, 2004): Common cultural values ​​, communication, knowledge transfer and the characteristics of workers. The behavior of teams was identified on the basis of realizing of the respondents of their organization to work as a team where the research relied concepts applied in the study (Hakim , 2005) , and chose to research the case of a service organization for the study and relied on four dimensions of coordination , cooperation , sharing of information , the performance of the team, and was a curriculum approach and des

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Role of the evaluation process of the staff in determining the training programs Field research in the Office of the Inspector General of the Ministry of Health / Iraq
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         The objective of this research is to determine the relationship between the performance evaluation process and the training programs for the employees, to identify the extent of the organization's commitment to perform the performance evaluation process for its employees and to use the results of this process in determining the appropriate training programs. Performance evaluation, functional analysis, evaluation method used, dependent variable (training programs) and its dimensions, type of programs, program objectives, program curriculum, And the application of the field research methodology and the questionnaire, which included 146 individuals to know their views and analyz

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Publication Date
Tue Dec 30 2025
Journal Name
Adab Al Rafidayn
Measuring the quality of office services using (LibQUAL + ®): the central library of the University of Baghdad as a model
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Libraries, information centers, and everything related to organizing and preparing information need to be periodically re-evaluated in order to stand on the level of quality, which means improving the general reality of these institutions to ensure sufficient satisfaction from beneficiaries of the services provided. This is what was worked on in this research, as one of the most important quality standards in libraries and information centers, LibQUAL+®, was applied in one of the most important and oldest central university libraries, namely the Central Library of the University of Baghdad at its two locations, Al-Jadriya and Al-Waziriya. The sample of beneficiaries to whom the questionnaire was distributed reached 75 beneficiaries distrib

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Publication Date
Sun Dec 10 2023
Journal Name
Journal Of Applied Engineering And Technological Science (jaets)
The Role of Artificial Intelligence in Diagnosing Heart Disease in Humans: A Review
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The electrical activity of the heart and the electrocardiogram (ECG) signal are fundamentally related. In the study that has been published, the ECG signal has been examined and used for a number of applications. The monitoring of heart rate and the analysis of heart rhythm patterns, the detection and diagnosis of cardiac diseases, the identification of emotional states, and the use of biometric identification methods are a few examples of applications in the field. Several various phases may be involved in the analysis of electrocardiogram (ECG) data, depending on the type of study being done. Preprocessing, feature extraction, feature selection, feature modification, and classification are frequently included in these stages. Ever

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Publication Date
Thu Dec 01 2022
Journal Name
Environmental Nanotechnology, Monitoring & Management
Challenges in the implementation of bioremediation processes in petroleum-contaminated soils: A review
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Environmental pollution is regarded as a major problem, and traditional strategies such as chemical or physical remediation are not sufficient to overcome the problems of pollution. Petroleum-contaminated soil results in ecological problems, representing a danger to human health. Bioremediation has received remarkable attention, and it is a procedure that uses a biological agent to remove toxic waste from contaminated soil. This approach is easy to handle, inexpensive, and environmentally friendly; its results are highly satisfactory. Bioremediation is a biodegradation process in which the organic contaminants are completely mineralized to inorganic compounds, carbon dioxide, and water. This review discusses the bioremediation of petroleum-

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
Internal music in the poetry of guidance In the era of Islam and its effects Artistic and semantic
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In this research entitled "Internal music in the poetry of guidance in the era of Islam and its artistic and semantic implications" dealt with the following:
 Preface, which addressed the importance of internal music in poetry, and its close association with poetry, and the poet himself, to reveal what is touring himself and revolves in his imagination.
 Repetition of all kinds: repetition of letters, repetition of words, and repetition of phrases: It showed what this repetition of strengthening the melody, and linking parts of words within the same house, or the poem, and create a special musical atmosphere to spread a certain significance and to confirm the meanings and accompanied by musical accommodation.
 Anaphysic

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Economics And Administrative Sciences
Crisis management according to the strategic leadership - the interactive role of decision support systems. (An exploratory study at the Ministry of Industry and Minerals / the State Company for Steel Industries)
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The researcher aims to Diagnose the reality of research variables, strategic leadership and decision support systems, and their impact on crisis management in the General Company for Steel Industries because of their important role in preventing crises and reducing their occurrence for the research company in particular and other companies in general affiliated with the Ministry of Industry and Minerals, as well as clarifying theoretical concepts of research variables As it included the answer to questions related to the research problem, including (Is there an impact of the strategic leadership in managing crises if decision support systems are used), and the researcher adopted the descriptive and analytical approach in its comp

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