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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
Fri Oct 31 2025
Journal Name
Mathematical Modelling Of Engineering Problems
Heterogeneous Traffic Management in SDN-Enabled Data Center Network Using Machine Learning-SPIKE Model
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Software-Defined Networking (SDN) has evolved network management by detaching the control plane from the data forwarding plane, resulting in unparalleled flexibility and efficiency in network administration. However, the heterogeneity of traffic in SDN presents issues in achieving Quality of Service (QoS) demands and efficiently managing network resources. SDN traffic flows are often divided into elephant flows (EFs) and mice flows (MFs). EFs, which are distinguished by their huge packet sizes and long durations, account for a small amount of total traffic but require disproportionate network resources, thus causing congestion and delays for smaller MFs. MFs, on the other hand, have a short lifetime and are latency-sensitive, but they accou

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Publication Date
Wed Apr 01 2015
Journal Name
Al–bahith Al–a'alami
The Educational Role of Children's Programs in Libyan TV An Analytical -Field Study of "Flowers of Life" Program
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Television contributes children the acquisition of knowledge, moral and social values through programs that are offered to them and the extent of the focus on the effective aspects of life in the age of the target stage. The subject of this research aims to know the children programs in Libya television through a comprehensive analytical study of the program entitled “zihur al-hayat” within the broadcast season from April 1, 2004 to June 30, 2004. It also focuses on trying to identify the Libyan television policy in broadcast educational content through the children's programs in the prevailing political and social conditions during the period of study as well as knowing the opinions of the children's sample under study in Al-Baidhaa

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Diagnosis of factors affecting the strategic implementation of sewage projects ( Case study in General Directorate of sewage projects )
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  This  Research aim to identify the factors affecting the strategic implementation of sewage projects and to seek to activate the real follow-up of projects to identify the factors that accompany their implementation, The study included a sample of the projects of the investment plan implemented for the Directorate General of sewage in the governorates of Iraq, which was completed during the six years period (2010-2016). The sample of the research was four projects: The project of implementation and processing of the treatment plant and the lifting station and the conveyor line for the project of IMARA/The third stage/Al-Sanaf marshland , The project of the processing and implementation of the treatment plant with the

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
The Effect of Duration of Stress Urinary Incontinence on developing Signs of Bladder Outlet Obstruction in Urodynamic Study
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Background: Stress urinary incontinence is a frequent urological disease in women; it has a great influence on an individual’s wellbeing and places a significant economic strain on any health service. The placement of urodynamic diagnostic tests in the evaluation route is an important clinical research concern in this field.

Objective: to find out whether the duration of stress urinary incontinence is associated with the finding of bladder outlet obstruction in urodynamic study or not.

Subjects and Methods: A descriptive study. With enrolled female patients had symptomatic Stress urinary incontinence as their primary complain. All the included patients w

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Publication Date
Sat Aug 13 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of the information of the supporting bodies on the tax inventory: An Applied research in the General Commission of Taxes
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The research aims to show the impact that the information of the supporting bodies can have and its dimensions represented by (information credibility, efficiency and effectiveness of information, cooperation with the tax administration, obligating the taxpayer, accuracy and completeness of information and the appropriate time) in tax inventory, as well as clarifying the moral differences in  The response of the surveyed sample according to the personal variables represented by (gender, educational attainment, scientific specialization, job title, years of service), and the descriptive analytical approach was adopted and in light of it, the questionnaire was designed as a main tool in collecting data from the sample of (80)

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
Explanation of the correct jurisprudence for calculating the value of the selling price, not the purchase, in the zakat of trade offers
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 After completing the research, with the help and success of God  Almighty , I will summarize what has been mentioned in a concise and understandable form, without boring prolongation or abbreviation .

    The subject, in general, was clarified, clarified and corrected, as I mentioned, for an incorrect concept, about paying zakat on trade goods.

    It has known trade offers parts and combination of language and idiomatic .

   The rule of zakat on trade goods, and evidence from the Qur'an, Sunnah and consensus .

    As well as the conditions of its zakat according to the jurists and their differences in it .

    It

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Physics: Conference Series
Measurement the Concentrations of Radon and Thoron and Their Progeny in the Air Samples of Al-Haswaa City in Babylon province
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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Internal control and its role in the reform of the tax work: Applied research in the General Commission for Taxes
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That internal control is particularly important in improvingperformance and tax reform، they play an important role in the regularity ofwork and development and the anti corruption and activating the decisionsand tax legislation، as contained in the organizational plan and the means،procedures and components designed from which to ensure a policy andimplementation plans The research aims to review the reality of the internalcontrol in the General Commission for Taxes and stand on the deficiencies init, with the strengthening of the role of internal control in the GeneralAuthority for taxes based on the laws and regulations and by using modernmeans to work as well as developing the performance of employees in thebody، including helpin

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Publication Date
Tue Jan 01 2019
Journal Name
Iraqi Journal Of Agricultural Sciences
Role of calcium-regulating hormones, adipocytokines and renal function test in the progress of type 2 diabetes mellitus in a sample of Iraqi patients
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A cross-sectional study was conducted on 80 type 2 diabetic patients aged 20-60 years in Baghdad and 20 non diabetic persons as controls. Laboratory assessment of glucose related parameters; Fasting blood sugar (FBS), Glycated hemoglobin (HbA1c), Insulin and Insulin resistance (IR), renal function test; Blood urea, serum creatinine, Calcium (Ca) and Phosphorus (P), Calcium regulating hormones; Parathyroid hormone (PTH), calcitonin and vitamin D, cytokines, Adiponectin and Tumor necrosis factor (TNF-α) and comparison these parameters between patients and controls. The results: a high significant (p˂0.01) increase in FBG level in the patients (211.34 ± 11.20 mg/dl) as compared with control (85.89 ± 3.07 mg/dl). A high significant (p˂0.01

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Publication Date
Mon Dec 03 2018
Journal Name
The Iraqi Postgraduate Medical Journal
Operative Treatment by Plate and Screws Versus Conservative Treatment of Closed Displaced Fracture of the Mid Third of Clavicle in Adults: Comparative Study
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BACKGROUND: Clavicle fractures are common injuries in young active individuals, the mid third of the clavicle is most commonly fractured part(80% of clavicle fracture) OBJECTIVE: To compare the outcomes of operative and non operative management of displaced and or comminuted closed fracture of the mid third of clavicle in young adults PATIENTS AND METHODS: This prospective observational study of 24 patients of fracture of the mid third of the clavicle was conducted in Alkindy teaching hospital from July 2015 to January 2017 and divided into two groups; one managed by operative treatment with plate and screws and the other by non operative sling immobilization after taking the consent and the patients were seen at 2, 4, 6 weeks,3, 6, and 9 m

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