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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 Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Ali Al Bazergan and its impact on the intellectual, political and administrative in Iraq 1887-1958 Historical Study
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The historical person study as a personality to the AL- Bazargan, one of the important
studies, is the shed light on the character had an effect of the political life in Iraq, an important
historical era involved many events, coincided with a national and historical by this personal
at the events successive positions that stage of the history of Iraq, especially if we know,
strongly his loyalty to the homeland and the earth, and intense hatred for any occupation or
colonization desecrate the land...
This was evident during his participation and his supervisor in 1920 liberal revolution
against the British occupation, and urged the need for adherence to the principles of
independence, and the emphasis on the nation

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Publication Date
Mon Aug 22 2022
Journal Name
World Bulletin Of Management And Law
THE IMPACT OF OUTSOURCING OF HUMAN RESOURCE ACTIVITIES ON ORGANIZATIONAL WINNING(FIELD RESEARCH IN A SAMPLE OF PREMIUM CLASS HOTELS -IN IRAQ)
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The aim of the research is to test the effect of outsourcing human resources activities (independent variable) with its dimensions (outsourcing of staffing, outsourcing of training and development, outsourcing of wages and compensation, outsourcing of human resources information systems) on organizational winning (dependent variable) with its dimensions (the culture of winning, successful organizational change, continuous improvement, and adoption of risk). The research problem was the questions posed by the researcher, the most important of which is the extent to which the research sample realizes the importance of applying outsourcing to human resources activities and its role in organizational vi

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Publication Date
Mon Jan 01 2018
Journal Name
الأستاذ
Analysis of the content of the chemistry book for the second intermediate grade according to habits of mind In light of the educational reform project (2061)
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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluating the supervision tools of the Central Bank of Iraq to verify the continuity of private banks: An applied research in the Central Bank of Iraq
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The aim of the research to highlight the calendar of the most important tools used by the Central Bank of Iraq, in the implementation of the function of supervisory oversight, to verify the stability of the banking system, and protect the funds of shareholders, and depositors in general and the absence of any raises the risks of default and financial failure in particular, for commercial banks. The most important flaws and weaknesses in these tools, in the early detection of the risks of continuity in a timely manner, The study concluded a set of conclusions, including the weakness of the tools used in the performance of the function of supervisory oversight in detecting cases of default and financial failure in the early time as well as

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Organizational Tactics An Approach to Strategic Agility A field study in a sample of mobile operators in Iraq
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The current research dealt with the issue of organizational skillfulness as an entry point to reach strategic agility. The study has been tested in Iraq's mobile operators - Asia Cell, Zain Iraq and Cork Telecom. The study was applied to a sample of (93) managers distributed at various levels of management (board members, general managers, commissioners, department managers, people managers, unit managers, office managers). The survey used the questionnaire as a key tool for collecting data and information as well as personal interviews. It has sought to test a number of hypotheses related to correlation and influence relationships between the variables of the study, in order to answer the questions related to the problem of stud

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Publication Date
Mon Jun 04 2018
Journal Name
Baghdad Science Journal
Effect the Thickness on the Electrical Properties and (I-V) Character of the (CdTe) Thin Films and Find the Efficiency of Solar Cell CdTe/CdS
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Thin films of CdTe were prepared with thickness (500, 1000) nm on the glass substrate by vacuum evaporation technique at room temperature then treated different annealing temperatures (373,473,and 573)K for one hour. Results of the Hall Effect and the electrical conductivity of (I-V) characteristics were measured in darkness and light.at different annealing temperature results show that the thin films have ability to manufacture solar cells, and found that the efficient equal to (2.18%) for structure solar cell (Algrid / CdS / CdTe /glass/ Al) and the efficient equal to (1.12%) for structure solar cell (Algrid / CdS / CdTe /Si/ Al) with thick ness of (1000) nm with CdTe thin films at RT.

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of knowledge Management Processes in the Tax Performance: AnApplied Research in the General Tax Authority
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The research aims to measure the relationship and impact of the operations of the knowledge of management of the six dimensions (diagnosis knowledge, define knowledge objectives, knowledge generation, knowledge storage, distribution of knowledge, application of knowledge) in the fiscal performance of the General Authority for taxes of the four dimensions (financial, customers (taxpayers), Operations Interior, learn and grow), the research aims also to the use of computerized programs for training and career development of the Authority that helps to add knowledge workers in the Authority, and to reach an appropriate arrangement for knowledge management processes in the Authority, as well as analysis of the reality of the Authority to get

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Publication Date
Fri Oct 28 2022
Journal Name
Political Sciences Journal
The impact of the US military variable in reality Security in the Arab Gulf region after 2003
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The military presence in the Gulf region after the British withdrawal from it in 1971 was one of the most important pillars of the American strategy to climb the ladder of global leadership, as the geostrategic features that the region enjoyed provided factors of controlling energy sources and global trade routes. The United States of America guarantees Western Europe and Japan the process of access to energy sources and the exclusion of its opponents from the region, especially the Soviet Union, and the growing American military presence in the Gulf after the invasion of Iraq in 2003. On the other hand, the region experiences many contradictions, some of which threaten its security, such as the exacerbation of disputes between its count

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Crossref
Publication Date
Mon Feb 02 2026
Journal Name
Journal Of Babylon Center For Humanities Studies
The reflection of the Arab character in Israeli children&#39;s literature in the years 1990 - 2015
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Publication Date
Mon Feb 02 2026
Journal Name
Political Issues
(The Libyan crisis in the Turkish and Iranian perspectives)
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The Turkish intervention in the Libyan crisis in the recent period was a trigger for more tension than a solution - as Turkey claims - as Turkey seeks to quickly set a welcome military footing in Libya to prevent the reconciliation government from falling and planning to start exploration for gas and oil in Libya to solve the Turkish energy crisis, that is, the energy exchange for security and trying to exploit the situation to establish a new gathering of proTurkish political Islam, as for the Iranian position on the Libyan crisis, it does not exceed a logistical role and provide Turkey with expertise in circumventing international sanctions and assisting it in transporting fighters and weapons to Libya, Iran has also deliberately added so

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