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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 Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The use of water resources in light of the challenges of water security in Iraq
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Iraq suffers from lack of water resources supply because the headwaters of the rivers located outside its borders and the influence of upstream countries on the quantities of flowing water, in addition to the increase of pressure on available water as a result of population increase and not adopting the principle of rationalization where misuse and wastage and lack of strategic vision to treat and manage water use in accordance with the economic implications fall.  This is reflected fallout on water security and subsequently on national and food security, while the issue of using water resources is development top priority in different countries in the world because of the importance of water effect on the security of indivi

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Publication Date
Mon Jan 26 2026
Journal Name
University Of Anbar Sport And Physical Education Sciences
The Impact of the Concept Maps Strategy in the Guided Discovery Method at Learning the Skill of Layup Shooting of Basketball
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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of the Alternative Evaluation Strategy on the Achievement of Fourth-Grade Female Science Students in the Subject of Biology
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Abstract

The aim of the current research is to identify the Effect of the alternative evaluation strategy on the achievement of fourth-grade female students in the subject of biology. The researchers adopted the zero hypothesis to prove the research objectives, which is there is no statistically significant difference at the level (0.05) between the average scores of the experimental group who study according to the alternative evaluation strategy and the average scores of the control group who study in accordance with the traditional method. The researchers selected the experimental partial adjustment design of the experimental and control groups with the post-test. The researchers intentionally selected (Al-fed

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Publication Date
Thu Dec 28 2023
Journal Name
Al–bahith Al–a'alami
Digital Interactive Elements in The Twitter Platform: An Analytical Study
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The primary issue addressed in this research revolves around identifying the interactive elements provided by the Twitter platform and understanding their utilization by digital newspapers with official accounts. These newspapers broadcast content in line with their policies. This study is classified within descriptive research that employed a survey method and content analysis tool. The methodology relies on the "how was it said?" approach to categorize the analysis. The research yielded the following results:
Twitter utilized numerous interactive elements for disseminating tweets, which include "text, branching links, hashtags, digital images, digital videos, digital audio, and digital polls." However, thes

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Publication Date
Thu Dec 15 2022
Journal Name
Bionatura
Comparative morphoanatomical study for the same rodents species in Iraq
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Samples (4th) reviewed are deposited and stored in the Iraqi Natural History Museum (INHM), and there are 4th of them. Sciurus anomalous (Güldenstädt, 1785) species are preserved and mummified. It is a Caucasian squirrel (S. anomalus) that was medium in size, with a grayish-to-chestnut color, a golden gray back, and a golden tail. It is found in the forests of East and Southeast Asia. The variety possessed for the study was previously registered in the vertebrate literature by several authors and was stored by scientific methods in the museum. As a result of the multiplication and growth of these species, and to know the environmental changes that occurred in them, they were compared with models and samples found throughout Iraq

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Publication Date
Tue Sep 19 2017
Journal Name
Al-academy
Aesthetics configuration in the Assyrian winged bull )An analytical study(
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Subjected Find winged bull Assyrian monetary analysis in order to identify the formative relations in terms of percentages, movement and public swab for being aesthetic values ​​upon which the mechanisms of artistic composition, which did not give researchers artistic interest that affects the status of these sculptures and the like of the achievements of the Iraqi civilization in Assyria.

Resulting analysis to a number of the most important results, the percentages approved in the calculation of the parts to do with all when viewed status horizontal with a realistic formulas while in the case of considering frontally clear for Ras stylized proportions and head size larger in length, a ratio confirmed by previous studies, and

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Publication Date
Wed May 02 2012
Journal Name
Journal Of Planner And Development
the population in Iraq up to 2035 an analytical study
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The population studies are one of the difficult tasks facing the world in all periods. most of the researchers and who have relationship to population policies and development plans, may have succumbed to the idea that the population problem is based and confined mainly in the rate of increase in population, or the so – called population explosion, and not the content because of its pressure on resources and there is no problem of population if the resources are available and therefore no need for the development and implementation of population policies in any way . While the population policies here should take a range of general and comprehensive in every respect to population and demographic phenomena distribution, not only

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Standards of creditworthiness of customers and their impact on the liquidity of Iraqi private: Applied research in a sample of Iraqi private commercial banks
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Customers' creditworthiness standards are the key means employed by private commercial banks in assigning a suitable credit assessment for each customer. Accordingly, it had an instrumental role in indicating the degree of solvency of the potential customer before granting the required credit. The research problem reveals the nature of the relationship between the criteria of customer’s creditworthiness and banking liquidity. The most critical objectives of the study shed light on the role of using creditworthiness criteria as a tool for credit analysis of customers by banks that help reducing credit risks and thus increase banking liquidity. The questionnaire that was distributed to bank employees, the research sample, which w

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of forensic accounting in banking stability An applied research on a sample of Iraqi private banks listed on the Iraq Stock Exchange
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                 This study aims to identify the role of forensic accounting in the Iraqi environment, banking stability, and to achieve this goal, we used the field survey method, as it is the most appropriate for studying the phenomenon in question and achieving its objectives.

Where we selected a sample consisting of (50) male and female employees, distributed among five private banks in Baghdad governorate, namely (Ashur International Bank, Development Investment Bank, Iraqi Middle East Investment Bank, Hammurabi Commercial Bank, Khaleej Commercial Bank), and the questionnaire tool was applied to them Designed for this purpose, which consisted of

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Publication Date
Tue Sep 01 2015
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Kick tolerance control during well drilling in southern Iraqi deep wells
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The importance of kick tolerance in well operations has recently increased due to its implications in well design, in drilling and well control. To study a simple method for the application of kick tolerance concept in an effective way on the basis of field data, this research purpose is to improve knowledge about Kick Tolerance and represents a technical basis for the discussion on revision of standard procedure. The objective of this work is to review and to present a methodology of determination the kick tolerance parameters using the circulation kicks tolerance concepts. The proposed method allows to know, to evaluate and to analyze the kick tolerance problem in order to make the drilling execution safer and more economical by reducin

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