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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
Wed May 01 2013
Journal Name
Chemical And Process Engineering Research
Synthesis and Characterization of Polycyclicacetal Derived from PEG & Erythro-Ascorbic Acid Derivative and Study Its Effect on the Activity of ACh Enzyme (In Vitro)
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Polycyclicacetal was prepared from the reaction of PEG with aldehyde derived from Erythro-ascorbic acid (pentulosono-ɣ-lactone-2,3-enedianisoate).All these compounds were characterized by Thin Layer Chromatography (TLC) and FTIR spectra and aldehyde was also characterized by (U.V-Vis), 1HNMR, 13CNMR, and mass spectra.The inhibitory effect of prepared polymer on the activity of human serum AcetylCholinesterase has been studied in vitro. The polymer showed a remarkable activity at low concentration (4.7x10-3 – 4.7x10-8M).

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Analysis of the performance of the stock market in light of inflation : empirical research in the Iraqi Stock Exchange
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Abstract:

                The aim of this research to try to determine the type of expected relationship between inflation as the explanatory variable and market performance as a dependent variable, for that used data issued and published by the Central Bank of Iraq and the Iraqi Stock Exchange for a sample consisting of (159) observations using the intentional or intentional sampling method for the period extending between the months (January 2010 to March 2023), in the light of each of the Consumer Price Index (CPI), the Iraqi Stock Exchange Index, the number of traded shares and the number of market capital shares to ex

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Publication Date
Sun Apr 04 2010
Journal Name
Journal Of Educational And Psychological Researches
Effective an instructional in program in the development of some of the moral values on the children of kindergarten
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The research aims to
1 – The discloser  of the level of moral values in the children of
kindergarten.
2 - Building an educational program designed to develop moral values on the children of
kindergarten.

3 - Knowing the impact of the program in the development of moral values in children
Purposive sample was selected consisted of 40 children and a child aged 5-6 years and to achieve objectives of the research promising measure of the moral  values
kindergarten has been applied to the children of the two groups was based on  pre and post test

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Strategic Flexibility in Achieving Organization Effectiveness: Analytical Research in the Directorates of the Ministry of Education
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This research aims to know the role of strategic flexibility in achieving organizational effectiveness by studying the dimensions of strategic flexibility (capacity flexibility, resource flexibility, information flexibility, and coordination flexibility) on the dimensions of organization effectiveness (environmental adaptation, productivity and achieving goals) through an analytical study conducted in six directorates in the office of the Iraqi Ministry of Education.

The research problem was represented in the form of questions, the most prominent of which was "What is the role of strategic flexibility in achieving organization effectiveness?" The descriptive analytical approach was relied on in applying

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Publication Date
Fri Jan 23 2026
Journal Name
Journal Of The Iraqi University
The experience of providing selective broadcasting of information in the library of the Institute of Management / Rusafa
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The selective information broadcasting service is one of the important services in libraries and information centers, as it is the link between the source and the beneficiary and between related sources, as it links similar sources through keywords and then sends them to beneficiaries, which contributes to reducing the time and effort spent by beneficiaries in obtaining sources or information. Therefore, the application of this service is an important matter and gives a positive indicator in the progress of the library towards the integration of its services. From this standpoint, this research came to answer some questions, including: 1. What are the outlets for beneficiaries (the research community) in obtaining information sources? 2. Wh

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Publication Date
Thu Oct 01 2015
Journal Name
Al–bahith Al–a'alami
The Mental Image of the Iraqi Policeman in the Anbar Province
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The study of images in the cognitive field receives considerable attention by researchers, whether in the field of media and public relations or in other humanities. Due to the great importance in shaping trends of public opinion, especially trends that individuals and the behaviors of people, institutions or ideas are determined by forming images that they hold in their minds towards these persons or institutions. Modern enterprises have realized, whether they are governmental ministries and official departments or non-governmental organizations as civil society organizations, the importance of studying the dominant image in the minds of the masses and make decisions and draw plans to configure this image as these institutions wishes.&n

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Publication Date
Tue Mar 15 2022
Journal Name
Al-academy
The operations of the hypertext in the contemporary Iraqi theatrical show
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The theater benefited from the concept of (hypertext) to create different virtual worlds. The four chapters of the research included the first (methodological framework), the second (theoretical framework) came in two sections (hypertext, its concepts and applications) and (hypertextual space in theatrical performance), and the investigations resulted in indicators, including:
1- Hypertext is interacting interactively, but it is organized by correlation as a basic feature that defines it with different manifestations.
2- The hypertext combines the word with other formative elements that reduce a set of tagged information (word, image, light, shadow, color, number).
In the third chapter (research procedures) (Lord play) was

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Publication Date
Tue Jan 29 2019
Journal Name
Journal Of The College Of Education For Women
The vocal inspiration of expressing the complaints in the Qur'anic script
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Thanks and gratefulness be to Allah , the most merciful , and prayers be on his messenger and our prophet mohammed and his descendants.The voices have great influence on the diversity of methods of complaints and implication in the Qur'anic expression through
their inspiration , forms and notes. They also have influence on performing semantic and psychological condition of the emitter . that is because of the connection between the complaints and human behavior and emotions , since it is considered as the outlet by which the human expresses his repressed desired and instincts . he resorted to it " when he is helpless physically and mentally i.e. he cannot reach his goals or satisfy his needs." Complaints come from deprivation , social

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of The College Of Education For Women
The Sound of the letter (ق) in the Contemporary Arabic Dialects
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The Sound of the letter (ق) in the Contemporary Arabic Dialects

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Publication Date
Sun Dec 01 2013
Journal Name
Political Sciences Journal
The role of the Zionist lobby in the US policy-making
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دور اللوبي الصهيوني في صنع السياسة الأمريكية

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