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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 Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The extent of the social worker’s use of group discussion technique in professional practice with school activity groups in Tubas Governorate schools
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This study aimed at identifying the extent to which the social worker used the techniques of group discussion in the professional practice with the groups of school activity in the schools of Tubas governorate in light of some variables (gender, years of experience, academic qualification). The analytical descriptive method was used due to its suitability for the objectives of the study.  A questionnaire was designed to collect data that included (30) items, distributed in three areas .The validity and reliability of the tool were verified and then distributed to the study sample.

 

The results of the study showed that the highest averages were in the discussion stage domain, where the pre-discussion stage was m

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Publication Date
Sun Apr 04 2010
Journal Name
Journal Of Educational And Psychological Researches
Teaching Explanation Difficulties in Islamic University from the lecturers Point of View
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This study is about awareness of teaching explanation difficulties in the Islamic university from the lecturers point of view. It discussed the difficulties and the traditional teaching methods of explanation. The study concentrated on teaching Islamic studies in general and teaching explanation in specific and set difficulties so as to be treated.

            The study is of three chapters, the first contains the difficulties in several aspects like the educational goals, text contents, teaching methods and styles, students, educational techniques, educational aids and evaluation, it addition to the lecturers of Islamic university colleges in 2009-2

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Publication Date
Sun Jul 27 2025
Journal Name
Journal Of Studies And Researches Of Sport Education
The most important obstacles facing girls’ clubs in Iraq
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SummaryThe most important obstacles facing girls’ clubs in IraqLamia Hassan Al-Diwan - Fatima Abdel Maleh - Nahida Hamed Thank youResearch SummaryIn the introduction and the importance of the research: We talked about women entering endurance events and relying on the principle of more training will achieve better results in the future. Based on the concepts that call for the equality of men with women in all aspects of sporting and competitive activity and as a result of the decline in women’s participation in sports clubs that include men, we came to The idea of ​​establishing clubs for Iraqi girls in 1992, with a club in every governorate, and the Iraqi National Olympic Committee adopted this idea, the goal of which is to develop

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Publication Date
Wed Sep 09 2020
Journal Name
International Journal Of Innovation, Creativity And Change
Estimation of the Effect of the Government Expenditure Growth Rate on the Rate of Inflation in the Iraqi Economy for the Period (1991- 2015)
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Government expenditure represents one of the controlling financial policies in the economic affairs and management of the economic cycle in order to achieve price stability, raise the rate of output growth and decrease the level of unemployment. The price stability represents one of the macroeconomic goals that all countries seek without exception, regardless of the economic philosophy adopted by each country; in addition to this is raising the productive capacity and reaching the actual output to the level of the expected output, that is, the level of output related to the natural unemployment rate or what is sometimes called the Non-inflationary unemployment rate. The restriction of government expenditure (G=T+∆B/iP+∆M/P) is

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Publication Date
Tue Jan 05 2016
Journal Name
Iraqi Journal Of Science
Local Study of blaCTX-M genes detection in Proteus spp. by using PCR technique
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n this study, 25 clinical isolates of Proteus spp. were collected from urine, wounds and burns specimens from different hospitals in Baghdad city, all isolates were identified by using different bacteriological media, biochemical assays and Vitek-2 system. It was found that 15 (60%) isolates were identifies as Proteus mirabilis and 10 (40 %) isolates were Proteus vulgaris. The susceptibility of P. mirabilis and P. vulgaris isolates towards cefotaxime was (66.6 %) and (44.4 %) respectively; while the susceptibility of P. mirabilis and P. vulgaris isolates towards ceftazidime was (20%). Extended spectrum β-lactamses producing Proteus was (30.7 %). DNA of 10 isolates of P. mirabilis and 4 isolates of P. vulgaris were extracted and de

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Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
Forbidden Montage and the transition Technique in one-snapshot Movies 1917 Film- A model: محمد عبد الجبار كاظم-عذراء محمد حسن
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  Starting from the term (forbidden montage) initiated by the French critic (Andre Bazin) as a method of processing the movies that depend on (mise en scene) achieved by the action of the camera and its ability to photograph and employ the depth of the field, in addition to the possibility of free movement without interruption in the filming environment in order to avoid montage as much as possible (the montage that distorts focus and distracts attention and moves away from realism, which is the most important theoretical pillar of Bazin in photography). The pursuit was behind a cinema that depicts its topics in one integrated snapshot with all its details thus approximating reality without any interference of montage. Our study sta

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Publication Date
Wed Sep 27 2023
Journal Name
Journal Of Optics
Studying the responsivity and detectivity of GO/PSi/n-Si photo detector via drop casting technique
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Publication Date
Wed Sep 27 2023
Journal Name
Journal Of Optics
Studying the responsivity and detectivity of GO/PSi/n-Si photo detector via drop casting technique
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Publication Date
Sat Jul 01 2017
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIRST RECORD OF APOLEPTOMASTIX BICOLORICORNIS (GIRAULT, 1915) (HYMENOPTERA, ENCYRTIDAE), AS PARASITOID OF THE RICE MEALYBUG, BREVENNIA REHI (LINDINGER, 1943) (HEMIPTERA, PSEUDOCOCCIDAE) IN IRAQ
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Here we report for the first time the presence of Apoleptomastix bicoloricornis (Girault, 1915) (Hymenoptera, Encyrtidae), as parasitoid of the rice mealybug, Brevennia rehi (Lindinger, 1943) (Hemiptera, Psedococcidae) in Iraq. Brief notes are provided in distinguishing the parasitoid from other closely allied species.

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Publication Date
Mon Jan 27 2020
Journal Name
Medico-legal Update
Indications and Adverse Outcomes of Emergency Lower Segment Cesarean Section at 1St and 2Nd Stages of Labor at Al-Elwiya Maternity Teaching Hospital
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