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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
Mon Jul 28 2025
Journal Name
Retos
The effect of the beehive strategy on deliberate thinking and learning the setting skill of volleyball among female students at the College of Physical Education and Sports Sciences for Woman
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Objective: Develop a deliberate thinking scale for the setting skill in volleyball for second-year female students in the College of Physical Education and Sports Sciences for Woman. Research methodology: The researchers used the experimental approach, employing a two-group approach (pre-test and post-test), to suit the nature of the research. The research community comprised (65) second-year female students from the College of Physical Education and Sports Sciences for Woman at the University of Baghdad for the academic year 2024-2025. The research sample was randomly selected, with (15) students in Section A, the experimental group, and (15) students in Section B, the control group. This group represented (46%) of the students. Th

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Publication Date
Mon Jul 28 2025
Journal Name
Retos
The effect of the beehive strategy on deliberate thinking and learning the setting skill of volleyball among female students at the College of Physical Education and Sports Sciences for Woman
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Objective: Develop a deliberate thinking scale for the setting skill in volleyball for second-year female students in the College of Physical Education and Sports Sciences for Woman. Research methodology: The researchers used the experimental approach, employing a two-group approach (pre-test and post-test), to suit the nature of the research. The research community comprised (65) second-year female students from the College of Physical Education and Sports Sciences for Woman at the University of Baghdad for the academic year 2024-2025. The research sample was randomly selected, with (15) students in Section A, the experimental group, and (15) students in Section B, the control group. This group represented (46%) of the students. Th

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Publication Date
Tue Jan 07 2020
Journal Name
Xi,an University Of Architecture &technology
The Effect of Jigsaw strategy on Academic Achievement and Engagement in Learning among the 3rd male graders students in Chemistry
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The research aims to identify the effect of jigsaw strategy in learning achievement and engaging for the third grade intermediate students in chemistry. The research sample consisted of (61) students distributed in two experimental and control groups. The research tools consisted in the achievement test and the measure of engaging learning. The results showed that there are statistically significant differences at the level of (α = 0.05) between the experimental group and the control group in both the achievement test and the measure of learning involvement for the benefit of the experimental group. In this light, the researcher recommended the use of jigsaw strategy for teaching the subject matter. Lamia because of its impact in raising

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Publication Date
Tue Jul 01 2014
Journal Name
Political Sciences Journal
Kurdistan Workers' Party (PKK) and its role in the evolution of the Kurdish issue in Turkey from 1991 to 2013
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حزب العمال الكردستاني ودوره في تطوير القضية الكردية في تركيا من 1991-2013

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Publication Date
Mon Mar 25 2019
Journal Name
Al-academy
Educational -Learning Design in the Achievement and Motivation of Students in the High School towards Art Education: كنعان غضبان حبيب
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  The present study aimed at ((building an educational -learning design based on the theory of Merrill in (CDT) and measuring the effectiveness of this design in the motivation and achievement of the high school fifth grade students to art education in the subject of the history of modern art)). The research community is made of fifth grade preparatory students in the secondary school of Umm Ayman in the Directorate of Education of Baghdad / Ar-Rusafa in a simple random way. The study sample (58 students) was chosen from section (e) to study according to Merrill theory (CDT) and section (d) to study according to the traditional way.
The pilot design of the control and experimental equivalent groups that have partial control in t

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Publication Date
Sun Dec 16 2018
Journal Name
Al-academy
The Formative Truth of the Dramatic Work between Direction and Production
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Most of the theorists and researchers and also those interested in cinema and television attributed the fact of the existence of the dramatic works to the directors may be due to a historical justification. At the same time, the existence of the production world came as a result of the emergence of the production city (Hollywood). This is also a historic fact. The research would tackle all the formative truths to prove the relation and the timeline, i.e., before and after and the synergy that resulted in the existence of the dramatic works that benefited the humanity and those interested in this giving art. The objective of the research is to uncover the formative truth of the dramatic work between direction and production.

The s

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Publication Date
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
The Authority and its impact on the prevention of Sharia rulings
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Praise be to God, Lord of the worlds, and prayers and peace be upon our master Muhammad and upon his family and companions.
And after:

      Muslim scholars have fought in the extent of regard to these interests, each according to his opinion and according to his evaluation, and his consideration of this interest, but it remains important that the legislation in them needs more precaution and caution against the predominance of passions, because the passions often decorate spoilers so they see an interest, so practical application must To realize the spirit of Islamic Sharia in its entirety of its rulings, and the preponderance between the interests and evils that prevail in our societies, which c

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Publication Date
Wed Jan 01 2025
Journal Name
Journal Of Animal Health And Production
The Control and Preventative Measures for the Health Problems of Pets
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Publication Date
Tue Jan 03 2023
Journal Name
College Of Islamic Sciences
The position of the Jews on divinity, lordship, names and attributes
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Judaism followed the approach of monotheism after God Almighty sent Moses (peace be upon him) to convey to them the messages of their Lord, so that they might be on a right guidance and path, but the people did not follow that path.” Love of matter and faith in what is witnessed, so they portrayed the Lord in several images in line with what their souls drew upon them.

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Publication Date
Mon Feb 09 2026
Journal Name
Al–bahith Al–a'alami
THE NATURE OF THE RELATIONSHIP BETWEEN PROPAGANDA DISCOURSE AND POLITICAL DISCOURSE
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The propaganda discourse is the most widely circulated in the media and communication studies, where the interest of scholars and researchers in this field has become clear in the analysis and interpretation of the content of this discourse, to identify the intentions, purposes and objectives of the communicator activity, which exceeded the borders of states in the heated atmosphere of rivalries and political conflicts that characterize The countries of the world as a whole and for many years.

In particular, the economically and militarily developed countries (the Nordic capitalist countries) have exerted special efforts in the production of information and ideas, using advanced methods and means in all details of communication w

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