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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 Sep 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Continuous Improvement Strategy (Kaizen) in organizational innovation: An analytical research in the General Company of Electrical and Electronic Industries /The Ministry of Industry and Minerals
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This paper aims at the fact that most organizations today suffer from a waste of time, effort, and cost, and they have difficulty in achieving the best performance situations and compete strongly. The researcher distributed 108 questionnaires as a statistical analyzable sample society where the sample intentionally consists of general managers, department head, and division head. The questionnaire was formulated according to the Likert scale. The use of personal interviews and observations are additional tools for data collection and a number of statistical methods is used for data analysis such as simple regression and correlation coefficient (Pearson). One of the most prominent conclusions is that the company has adequate and c

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Publication Date
Wed Oct 31 2018
Journal Name
International Journal Of Research In Pharmaceutical Sciences
The impact of systemic hypertension-related heart remodeling on right ventricle mechanics: A two-dimensional echocardiographic speckle tracking study
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Publication Date
Sat Apr 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Risk Analysis of Projects Accordance with the Professional Project Management System: A case- Study Mansur Construction Contracting Company here
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The research aims to identify the risks faced by projects and work on the administration, such as those risks by using professional Project Management System (Project Management Professional) by identifying those risks and their impact on the objectives of the project, if they occur and to provide appropriate responses to Ha.autam search application on the draft Law Faculty port by the General Mansour Construction Contracting company has been using a method personal interview with the heads of departments and project managers in the Al-Mansour and tools descriptive and quantitative analysis as was used (likelihood and impact of risk analysis, Ai_kaoa scheme Sbb- effect, analysis of probability and impact, risk matrix (probability

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Publication Date
Sun Jan 01 2012
Journal Name
Journal Of Educational And Psychological Researches
The Psychological status of and the feeling of loneliness of the trainees (newly released Detainees) participating the training and rehabilitation courses
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The research aims to understand the psychological status of and the feeling of loneliness of the trainees (recently released detainees) participating in the training and rehabilitation courses held in the Technical College - Baghdad. The study was conducted on a specimen of (23) trainees. An open questionnaire was adopted which included one question that was ( What was your feeling psychologically and socially before taking part in the training course?) , also the feeling of  loneliness Scale , designed by ( Russel,Peplau, Cutrona /University of California Los Angeles ) was implemented after the courses .

 

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Publication Date
Mon Jan 19 2026
Journal Name
Iklīl For Humanities Studies
The directions of the Federal Supreme Court in determining the parliamentary bloc with the largest number in the Iraqi constitution of 2005
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Publication Date
Mon Jan 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The Mathematical construct and its relationship with effective mathematical operations in both sides of the brain among students of the Department of Mathematics at the Colleges of Education and Basic Education
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The current research aims to identify: 1. The level of mathematical construct among the Department of Mathematics students in the colleges of education and basic education. 2. The level of effective mathematical operations in both sides of the brain at the Department of Mathematics students in the colleges of education and basic education. 3. The strength and direction of the correlation between the mathematical construct and effective mathematical operations on both sides of the brain at the Department of Mathematics students in the colleges of Education and Basic Education. To investigate the research objectives, the researcher formulated zero-main hypothesis for each aim and from the same hypothesis, three sub-zero hypotheses are deri

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Study the Effects of Polyphenolic Cocoa beans Extracts (CE) in Streptozotocin-induced diabetic mice.
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Diabetes Mellitus is a group of metabolic diseases characterized by increasing of glucose level in plasma compared with normal value (hyperglycemia). This disease also causes elevation of lipid profile levels except HDL (High density lipoproteins) which increased relatively. The effects of the polyphenolic mixture (catechins, epicatechins, procyanidin B1, procyanidin B2 and procyanidin C1) on total cholesterol (TC), triacylglycerol (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were studied in (30) streptozotocin-induced diabetic mice with (20-25)gm weight. Mice were given (30 mg/mL) of Polyphenolic Cocoa beans Extracts (CE) once daily for (7) days before Streptozotocin STZ injection and for (21 day) there after. A

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of green strategy formulation in green behavior for municipal corporations – Analytical study
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The research shows the importance of orientation towards the formulation of the green strategy and its effect in determining the behavior of the green municipal institution in Babel governorate. The research highlighted the formulation of the green strategy as an important variable, especially today, the trend towards protecting the environment and minimizing the damage resulting from the delivery of services, and through it also the type of green behavior or performance adopted by the municipal institution and the emergence of the need for a strategy that is not harmful to the environment. The research took the sample intentionally comprehensive size of 222 personnel of municipal institutions and some formations concerned with t

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Publication Date
Wed Jun 30 2010
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study on Vanadium Recovery from Spent Catalyst Used in the Manufacture of Sulfuric Acid
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Spent catalysts for sulfuric acid production have large amount of vanadium and due to environmental authority it is required to reduce the vanadium contain of the spent catalyst. Experimental investigation was conducted to study the vanadium recovery from spent catalyst via leaching process using sodium hydroxide to study the effect of process variables (temperatures, sodium hydroxide molarities, leaching time and particle size) on vanadium recovery. The effect of process variables (temperature, particle size,molarities of sodium hydroxide and leaching time) on the percentages of vanadium recovery were investigated and discussed .It was found that the percentage of vanadium recovery increased with increasing temperature up to 100 , incre

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Human Capital on Stratigic agility " Field Study in Jordan tourist companies"
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The research aims to identify the degree of the availability of knowledge, skill and ability as components of human capital, in addition to stand at the level of strategic agility upon tourism and travel agencies company of Jordan, the impact of human capital on strategic agility has been tested through distribution of a questionnaire on a Randomly Sample from Workers in Jordan tourist Companies of (349),a number of statistics techinces have been used simple liner Regrision and Multiplayer regession, it has shown that the degree of knowledge, ability and skill availability was high, and the same applies on strategic agility components, and shown out that there is a statistically significant impact between human capital and strate

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