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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
Tue Jun 30 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
MEASURING THE EFFECTOF VISUAL MEDIA IN THE DEVELOPMENT OF TOURISM SERVICE SECTOR: MEASURING THE EFFECTOF VISUAL MEDIA IN THE DEVELOPMENT OF TOURISM SERVICE SECTOR
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The research aims at measuring the impact of visual media on the development of the tourism services sector, which is a field study for the public. It aims at determining the impact of visual media on tourism sector development, clarifying the concept of visual media and its functions and studying the role of media in the development of tourism culture among the public. For a sample of the employees of the University of Baghdad, consisting of (120) male and female. A questionnaire was prepared for this purpose consisting of (21) questions distributed to the sample. The data were analyzed and the hypotheses were tested using the statistical program spss to unload the results and calculate the frequencies, percentages and correlati

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Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of business incubators represented by the banking system in financing small and medium enterprises in Iraq for the period 2000-2010
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The process of transformation from the central economy to a free economy requires restructuring the economy according to a new economic philosophy that relies on activating the role of private economic activity in which private and medium-sized institutions occupy an essential axis for their active role in the economies of all countries, especially those countries that have directed towards the market mechanism and sector leadership. The special process of economic development and the role that commercial banks can play in advancing the financing of these projects by establishing specialized business incubators for financing.

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Thu Jan 29 2026
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The impact of proposed approach for flexibility and agility in learning some basic skills on the table land movements in the artistic gymnastics
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Sun Sep 01 2019
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The causal relationship between leadership integrity and organizational conflict: An applied research in the State Real Estate Department in the province of Najaf
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This research aims to know the impact of leadership integrity as explanatory variable including its dimensions (courage, asceticism, justice, rationality, and humanity) on organizational conflict as responding variable. This research depended on the descriptive- constructive approach through the responses of a sample of (79) employees from (Real Estate Office of The State) in Al-Najaf province. The analyzing of the study done by using (Smart PLS) program to calculate (R2, t, p). Many results concluded and one of them, there is significant impact correlation of the leadership integrity on organizational conflict. There are many suggestions have been reached depending on the results reached and one of them is the necessity of de

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Investigating the use of lean manufacturing techniques in liquid batteries production: A field research in Babylon plants
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Tue Feb 01 2022
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Lithofacies types, mineralogical assemblages and depositional model of the Maastrichtian–Danian successions in the Western Desert of Iraq and eastern Jordan
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An integrated lithofacies and mineralogical assemblage was used to describe a depositional model and sequence stratigraphic framework of the Maastrichtian–Danian succession in the Western Desert of Iraq and eastern Jordan. Fifteen lithofacies types were grouped into three associations recognized in a distally steepened ramp characterized by an apparent, distinct increase in a gradient paleobathymetric deepening westward. The clay and nonclay minerals are dominated by smectite and palygorskite, with trace amounts of kaolinite, sepiolite, illite and chlorite. Meanwhile, quartz, calcite, dolomite, opal CT (Cristobalite - Tridymite), and apatite are the main nonclay minerals. The widely dominated smectite in the Western Phosphatic Basin of Ir

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The Time-Cost Trade-off to Manage A Project in a Fuzzy Environment
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Evaluating the Students’ Performance in the College of Education for Women in Using the Digital Transformation
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This study aims at evaluating the performance of MA students in the College of Education for Women in using the digital transformation and identifying the significant difference in performance evaluation according to the variable of academic qualification (Master or PHD). In order to achieve the aim of the research the researcher prepared a questionnaire of 20 items, and this happens after the researcher's getting acquaintance of the literature of previous studies related to the variable of the research. The apparent validity of the items was examined by exposing them to 10 juries specialized in education, psychology and evaluation and measurement. The stability of the items was examined via two methods, the test-repetition and half-divisio

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Fri Dec 31 2021
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The application of smart power in the regional power struggle in the Middle East after 2011
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Receipt date:12/7/2020 accepted date:24/1/2021 Publication date:31/12/2021

 Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

The constant characteristic of international relations is the constant change due to political, economic and military developments in addition to technology, and this in turn has led to many transformations in the concept of power, its uses, and the elements that form power and its distribution, and according to those variables, the concept of power has shifted from hard to soft, up to smart powe

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Sun Dec 01 2019
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Unemployment Rates in Iraq and the Extent of the Contribution of Loans Granted by Banks to Finance Small and Medium Enterprises in Reducing Them
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This study examined the phenomenon of unemployment in Iraq and the extent of the contribution of these loans granted by banks to finance small and medium enterprises in reducing their rates. The temporal boundaries of the study included the period between (2012-2018). The spatial boundaries consisted of random sampling of six Iraqi banks) Where the government banks included (Rafidain, Rasheed and industrial), private banks included (the Iraqi Islamic Bank and the Gulf Commercial Bank and the Bank of the Middle East). In order to achieve the objective of the research in the light of the hypotheses drawn up, the research divided into three topics, the first section highlighting the reality of small and medium enterprises in Iraq and the lo

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