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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
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The Role Of Intellectual Capital In The Performance Of Small And Medium Enterprises Research filed In Small And Medium Enterprises In Baghdad
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The Research aims to determine role of The Intellectual capital in the performance of small and medium enterprises , to achieve this goal through a researcher from the theoretical literature and studies related to the construction of the scheme shows the hypothetical relationship between the variables, which was adopted by the independent variable intellectual capital, distributed four variable are:( human  capital, structure capital ,customer capital, innovation capital) as well as four variable (the financial perspective, the customer perspective, process perspective ,the learning & growth perspective) The  study were getting to  many results as bellow :the intellectual capital in the small and intermediate p

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Publication Date
Mon Dec 31 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
ELEMENTS OF MARKETING MIX AND THEIR ROLE IN CONSUMER PERCEPTION OF BRAND IMAGE: A SURVEY OF SAMPLE OPINIONS FROM CONSUMERS OF ENIEM BRAND IN THE ALGERIAN MARKET.: ELEMENTS OF MARKETING MIX AND THEIR ROLE IN CONSUMER PERCEPTION OF BRAND IMAGE: A SURVEY OF SAMPLE OPINIONS FROM CONSUMERS OF ENIEM BRAND IN THE ALGERIAN MARKET.
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The current research aimed to analyze the importance, correlation and the effect of independent variables represented by marketing variables on the dependent variable represented by local brand, through taking ENIEM as a model for this study, which represents a sensitive sector for the Algerian consumer. The results of the study evinced that the Algerian consumer has a positive image toward the brand ENIEM given marketing variables which has acquired considerable importance to this consumer. Also, the results of this study showed a statistically significant correlation between marketing variables and good perception toward the brand ENIEM, at the same time, the existence of a statistically significant effect for each of these variables o

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Publication Date
Tue Jan 20 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of different finishing and polishing systems on surface roughness of new low polymerized composite materials (An in vitro study)
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Background: Prophylaxis methods are used to mechanically remove plaque and stain from tooth surfaces; such methods give rise to loss of superficial structure and roughen the surface of composites as a result of their abrasive action. This study was done to assess the effect of three polishing systems on surface texture of new anterior composites after storage in artificial saliva. Materials and methods: A total of 40 Giomer and Tetric®N-Ceram composite discs of 12 mm internal diameter and 3mm height were prepared using a specially designed cylindrical mold and were stored in artificial saliva for one month and then samples were divided into four groups according to surface treatment: Group A (control group):10 specimens received no surfa

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Publication Date
Wed Mar 01 2023
Journal Name
International Journal Of Research In Social Sciences And Humanities
The Role of Value Chain Analysis as well as Programs and Performance Budget in Reducing Waste of Public Money(Applied Study)
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Programs and performance budget represents a sophisticated method of public budget numbers, which includes all allocations to be determined for each job or activity within a government entity, which is analyzed according to their needs and costs, and this method can be applied using one of the cost accounting techniques, which is the technique of analyzing the value chain that reduces costs by avoiding activities that do not add value and enhance activities that add value to the economic entity, the current research aims to develop the budget system in government entity by using the budget of programs and performance as a tool for planning and monitoring events and activities, thereby reducing the waste of public money by reducing unnecessa

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Publication Date
Wed Mar 01 2023
Journal Name
Heliyon
The influence of pulse duration and exposure time of Er,Cr:YSGG laser on lithium disilicate laminate debonding, an in vitro study
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Publication Date
Thu Nov 09 2023
Journal Name
Journal Of Global Scientific Research In Business Management And Economics
The profitability index and its role in evaluating the performance of specialized banks in Iraq.
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Central banks around the world typically use various financial indicators to evaluate performance. In Iraq, the indicators used by central banks to evaluate the performance of banks are of great importance to ensure that the banks operating within the Iraqi banking system comply with the regulatory and legal requirements issued by the Central Bank of Iraq or the Ministry of Finance. Given the need to study the profitability indicator to ensure its ability to evaluate the performance of specialized banks in Iraq, these banks carry out their banking activities and businesses through capital funded by the government. The use of profitability indicators in evaluating the performance of specialized banks provides information about the profitabil

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Publication Date
Wed Jan 09 2019
Journal Name
Преподаватель ХХi век | مجلة الاستاذ في القرن الواحد و العشرين
Arabic borrowings in the Russian language and features of their actualization in the modern period
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Publication Date
Sun Dec 16 2018
Journal Name
Al-academy
The Influence of the Iraqi Maqam in the Recitation of Hafiz Khalil Ismail
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The earthly music has a clear influence on the religious music in the musical culture to read and recite the Holy Quran in the city of Baghdad.   This research deals with this subject in an attempt to reveal the influence of the Iraqi maqam in the recitation of Hafiz Khalil Ismail. The methodological framework of the research included the problem of research and its importance as it is useful to the Iraqi schools concerned with the recitation of the Holy Quran in Iraq. The theoretical framework included three sections that serve the literature of its subject: the first is (Iraqi maqam), the second is (the recitation of the Holy Quran) and the third is (the biography of Hafez Khalil Ismail).

The most important procedures

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
the effect of ethanol on the level of sialic acid in the brain
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The study dosage ethanol in the total content of acid sialic TC and acid sialic associated fat (LBSA) in blood serum and congener brain Dkor Jerd eggs study included dosage 20 animals of male rat Ald ethanol daily for a period of four weeks and concentrations 20% and 30%, 40%, 50% and size of dose 5mlThe results of the study showed that levels of TSA homogeneous in the brain and blood serum significantly reduced Ankhvaza

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Publication Date
Mon Jun 23 2025
Journal Name
Sabir
The importance of teaching the diatopic variety of Spanish in the ELE classroom
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Trends in the teaching of Spanish in terms of diatopic variables have had a significant change around the world, thanks to the evolution of technology, teaching approaches, processes and methods, pan-Hispanic policies and the reason why a person studies this language, which has caught the attention of linguistic researchers who teach Spanish around the world. Hence, the objective of this research is to show the scientific production regarding opinion trends in the teaching-learning processes of diatopic variables in the Ele classroom indexed in Scielo, Dialnet plus, Redalyc.org, Dialnet. unirioja .es, Researchgate.net, and Google Scholar, Thematic analysis was used to analyze the opinions of linguistic researchers. Of the 6 articles analyze

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