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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 Jun 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Strategic Intelligence on the Process of Green Manufacturing An Explorative Study for the Managers Opinions of Sample of Mineral water factories at Dahuk
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         The studying trying to determine the role of  Strategic Intelligence on the Process of Green Manufacturing  of  Sample of Mineral water factories at Dahuk city.  The study submit a theoretical frame of Strategic Intelligence and Green Manufacturing, a supposed sample, had been set to reverye   the nature of the relations and effect in the study  Varity, the study  depend on group of the main and branch concurring with the relations and effect between the Strategic Intelligence and Green Manufacturing to answer the following questions about research to problems:

 What are the relationships and effects between stra

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Publication Date
Sun Mar 13 2011
Journal Name
Baghdad Science Journal
Distribution Of Some Heavy Metals In Water,Sediment & Fish Cyprinus carpio in Euphrates River Near Al- Nassiriya City Center South Iraq .
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The heavy metals Cd, Cu, Fe, pb, and Zn were determined in dissolved and particulate phases of the water,in addition to exchangeable and residual phases of the sediment and in the selected organs of the fish Cyprinus carpio collected from the Euphrates River near Al-Nassiriya city center south of Iraq during the summer period / 2009 .Also sediment texture and total organic carbon(TOC) were measured. Analysis emploing a flam Atomic Absorption Spectrophotometers . The mean regional concentrations of the heavy metals in dissolved (µg/l) and particulate phases (µg/gm) dry weight were Cd (0.15,16.13) ,Cu (0.59,24.48) ,Fe (726,909.4) ,Pb (0.20, 49.95) and Zn (2.5,35.62) respectively,and those for exchangeable and residual phases of the

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Publication Date
Thu Sep 30 2010
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
USING ALUMINUM REFUSE AS A COAGULANT IN THE COAGULATION AND FLIOCCULATION PROCESSES
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The present work aims to study the efficiency of using aluminum refuse, which is available locally (after dissolving it in sodium hydroxide), with different coagulants like alum [Al2 (SO4)3.18H2O], Ferric chloride FeCl3 and polyaluminum chloride (PACl) to improve the quality of water. The results showed that using this coagulant in the flocculation process gave high results in the removal of turbidity as well as improving the quality of water by precipitating a great deal of ions causing hardness. From the experimental results of the Jar test, the optimum alum dosages are (25, 50 and 70 ppm), ferric chloride dosages are (15, 40 and 60 ppm) and polyaluminum chloride dosages were (10, 35 and 55 ppm) for initial water turbidity (100, 500 an

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Publication Date
Wed Oct 09 2019
Journal Name
Journal Of The College Of Education For Women
Naber and toning in the modern Arab poetry Mahmoud Darwish, a model
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Naber and toning in the modern Arab poetry Mahmoud Darwish, a model

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Publication Date
Tue Jan 20 2026
Journal Name
Al-fatih Journal
The impact of the use of mirrors in the level of performance of some skills epeeEmpirical researchStudents on the third stage in the Faculty of Physical Education for Girls
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يهدف البحث الى أعداد بعض تمرينات الاساسية لسلاح الشيش بأستخدام المرايا في تطوير قدرة مستوى تعلم الطالبات في المبارزة ومعرفة الفروق بين المجموعتين التجريبي والضابطة بتأثير استخدام المرايا في مستوى اداء بعض مهارات سلاح الشيش لطالبات المرحلة الثالثة , وقد أستخدمت الباحثتان المنهج التجريبي على عينة من طالبات المرحلة الثالثة , وقد بلغ عددهم (45) طالبة , وقد خرجت الباحثتين بعدة أستنتاجات وهي:- - أن المنهاج التعليمي

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Knowledge Management in Small Project Management Afield Study in Oxygen Ahli Plant in Iraq
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       Most of the literature on the management and application terkzat waved the last period on large organizations was the negligence  of  knowledge management in small organizations where research aims to find out knowleddge management, small projects  In oxygen Ahli plant in Iraq, and the fact the role of knowledge management in small projects from the standpoint of employees in order to achieve this used production method results.  The results showed that knowledge management has a role in the high level of productivity during the years 2010-2013. The results showed that knowledge management has a role in the high level of productivity during the years 2

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Publication Date
Wed Dec 20 2023
Journal Name
Migration Letters
Women's Image in Arabic Songs (An Analytical Study of how Women Appear in the Most Viewed Songs on YouTube for the Year 2021)
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Publication Date
Sun May 02 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The level of Trends banking leaders towards organizational confidence and its and reflection on the dimensions of the strategic position: An applied research in Egypt in Al-mansour Investment and the Business Bay
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The aim of this research is to show the level of banking leadership trends in the importance of  organizational  confidence and its reflection in the dimensions of the strategic position the research was applied in a bank (Al- Mansour Investment, Business Bay), and the Questionnaire Was adopted as a tool to collect data and information from the number of the sample (15) who are in allocation (Department Manager, Department Manager Department Manager, Division Officer, Unit Officer) and he used the statistical program (spss) to calculate (standard deviation, arithmetic mean, percentages, regression, analysis,F-test coefficient of determination R2, Coefficieent, square Kay and the research reached a number of conclusions, the mos

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Publication Date
Sat Sep 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Studying and analysis effect level of the Government expenditure and Gross Domestic product in size of the expenditure on the higher education in Iraq (1995 – 2009)
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The education, especially higher education, is an essentially factor in the progress of any society, if we consider the higher education, represents the top  of  the education`s  pyramid which take part in developing the human  resources and provide the human staff to raise the productive efficiency, and improve the social , economic level                                  

In order to face the increasing importance of higher education, great capabilities and expenditures must be available in a continous way, such expe

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Eye movements, and their psychological significance   In the Holy Quran: (Study in non-verbal language)
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In this research, the researchers attempted to reveal the non-verbal language in the Holy Qur'an through the hurt of the eye, its communicative effect, and its psychological significance in order to demonstrate the importance of this language. Fold the search ..

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