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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 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Affect of learning the bag in the acquisition of historical concepts for students in the fifth grade literary history
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The  adopted method in the teaching of history is conservation and indoctrination in all grades, and this will lead to a lack of students interact with teachers in the course of the lesson, and poor use of teachers to questions that raise students' thinking during the lesson, which leads to a lack of interest in the topic of the lesson and wasting opportunities contribution making it the teacher at the center of the educational process, and to provide arrogating the researcher to contribute to teaching style with the belief that the use of this method of teaching could lead to overcome the difficulties and problems faced by the teaching material.

And there are educational complexes integrated approac

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Publication Date
Sun Oct 19 2025
Journal Name
Lecture Notes In Networks And Systems
The Role of Artificial Intelligence in Studying the Impact of Contemporary Revolutions on Political Systems in the Middle East
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In this study, we tackle the understudied area of Artificial Intelligence (AI) and its role in examining how modern revolutions may affect political systems across the Middle Eastern region. despite hundreds of studies documenting Middle Eastern uprisings over the past three decades, there has been little effort to harness AI to better understand or predict these multifaceted events. This study seeks to address this gap by assessing the performance of AI-intelligence in analyzing (broadly) revolutionary processes and their effects on regional political systems. The research uses a mixedmethod methodology that involves a systematic literature review of contemporary scholarly articles, and an analytics study using AI tools. Our results show t

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Publication Date
Sun Apr 07 2013
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Clare's Plan on Female Students' Achievement in the History Subject in the Institute of Teachers' Preparation
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Teaching through the system of personal learning, known as (Clare's plan) is amongst the most prominent plans which depend on self-education, as it received worldwide recognition. The plan lets the learner achieve learning by depending on himself after being familiar with the educational goals given to him, then he starts to solve the exercises and the drills accompanying the unit. After that, he checks his achievement by answering the self-evaluation tests. This method offers more opportunities for personal interaction than do the traditional systems, and individual leaning is a methodical expression aims at taking care of the learner and making him the locus of the processes of teaching and learning.

Aims of the study

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of international auditing standard (320) of materiality in defining the analytical procedures of the auditor: Applied research in the Iraqi company for seed production
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The study seeks to clarify the role of International Auditing Standard No. (320) of the relative importance in determining responsibility for planning and implementing the process of auditing financial statements and expressing neutral technical opinion through the analytical procedures of the auditor, whose responsibility is to obtain appropriate and reliable audit evidence that helps the auditor to form a general conclusion about whether The financial statements were consistent with the auditor's understanding of the entity. The relative importance contributes to defining the important accounts that help to set priorities for the auditor to set the necessary analytical procedures for these accounts. One of the most important co

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Publication Date
Sat Jan 01 2022
Journal Name
Specialusis Ugdymas
The Effect of the Idea Filtering Strategy in Second Grade Middle School Female Students for the Subject of Science in their productive habits of the mind
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RHS Nasser, NHY Al-Afoun, SPECIALUSIS UGDYMAS, 2022

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Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
The Constant and the Variable in the Kurdish Singing between the Past and Present: كونا قادر محمد
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  This research is interested in studying the constant and the variable within the signing reality in Iraqi Kurdistan region, and the researcher tries to tackle the importance of this topic within a search that serves the Kurdish culture, and contribute to its intellectual settlement, and introducing it to centers concerned with studying singing and music science in any civilized environment, whether inside or outside the territory of Kurdistan region. We see that this research which dealt with the topic (the constant and the variable in the Kurdish signing between the past and the present) deserves research and investigation for all its causes, being one of the academic necessities that contribute in identifying the historic artist

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Publication Date
Wed Jan 29 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Benchmarking in Developing the Curricula of Accounting Departments in Iraqi Universities
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             The economical units in the world face great and rapid challenges in all aspects, a matter that requires facing these challenges throughout continuous improving and developing in their performance to keep their competitive position "place".

       The Benchmarking Technique is one of the modern managerial tools that are proved to be successful in application throughout making continuous comparisons between products or services and the best – performance levels the compete with it . This is achieved to develop its performance and give it the competitive criterion with which it faces its competitors.

  

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Role of Woman In Improving Society: The Role of Woman In Improving Society
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Abstract:
One of the most prominent historical stage feature that is well- known
nowadays in the world is democracy issue. This issue gives man the right to
reflect his concept and notions . It,s the world of freedom , human right and
liberation of women. This leads to the principle of equality between women
and men which is put in the top of liberty and Improvement lists .
Improvement can be defined as a group of means and ways that is
used to direct human work to improve their level of life economically and
socially .
This study contains three sections, the first presents the social state of
women in pre-history period . And the second section presents the theory of
improvement as an important social ph

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Publication Date
Tue Jan 31 2017
Journal Name
Journal Of Engineering
The Impact of Legislative Factor in the Identity of Modern Residential Urban in Iraq
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 The Urban Residential has developed and changed in different periods of time with successive and gradual shifts, as it cast a shadow over the characterization of modern urbanism in Iraq. The semi-total absence of the governing legislation of urbanization as well as the weakness of the State's role of supervisory in addition to neglecting urban heritage contributed in offering a strange environment  in relation to its traditional identity.  That was increased by the pressure of the using urban environment as a result of the increasing of population as well as the growth of people’s needs. The research aims to provide an objective view for a mechanism of the application of urban legislation to monitor the implementation o

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Publication Date
Wed Dec 11 2019
Journal Name
Journal Of The College Of Education For Women
Process in the Acquisition of Rhetorical Concepts of Students in The Fifth Grade Literary
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   To investigate the research objectives, the researchers put the following hypothesis:

There was no statistically significant difference at the level of (0.05) between the average score of the students of the experimental group who studied the language of rhetoric according to model of learning method, and the average score of the students of the control group who studied the same article in the traditional way acquiring rhetorical concept.    The researchers relied on the experimental design with the partial setting of the post-test, which depends on the experimental group that is taught using the model of the learning method, and the control group taught using the traditional method.   

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