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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 15 2021
Journal Name
Al-academy
Shorthand the representative performance in the theatrical festival performances of the education teams for teachers in primary schools , in secondary schools and artistic supervisors 2019 AD: خضر عبد خضير
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Arts acts to reduce and exclude everything that is not necessary in the delivery of meaning, especially representative performance, which is based on the intensification of the physical and vocal actions, and in drawing the dimensions of the character. And because that, the artistic staff, among others in the ministry of education, are considered the cornerstone, in the development of theatrical activities in schools, this research came to find out the extent to which teachers in primary schools, in secondary schools and artistic supervisors rely on shorthand mechanisms in the representative performance.
The current research relied on the descriptive approach, in analyzing his sample, which was deliberately chosen, Among the most imp

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Publication Date
Sat Nov 30 2024
Journal Name
Iraqi Journal Of Science
Utilizing the Gravity Method to Detect the Potential Effect of the Salt Dome in the Nahr Omar Oilfield, Southern Iraq
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Geophysics is one of the branches of Earth sciences and deals with studying the Earth's interior by studying the variation of physical properties within rock layers. Applied geophysics depends on procedures that involve the measurements of potential fields, such as the gravitational method. One of the significant oil fields in southern Iraq is represented by the Nahr Omar structure. A power spectrum analysis (SPA) technique was used to collect gravity data within the chosen oil field area in order to confirm the salt dome in the subsurface layers. The analysis of SPA resulted from six surfaces representing the gravity variation values of the depths (m)14300, 3780, 3290, 2170, 810, and 93.5. Gravity surfaces have been converted to de

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Publication Date
Tue Jul 15 2025
Journal Name
Smart Innovation, Systems And Technologies
The Role of the European Economic Security Strategy in Managing Economic Risks
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Publication Date
Tue Jan 14 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the Internal Audit Department in detecting corruption through accountability
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Internal Audit  is one of the most important backers of corporate governance, the researcher expanded his interest in this subject to examine the efficiency of Internal Auditors at the Arab Bank and its branches in Jordan to achieve Accountability which enhances the Corporate Governance and to identify the effect of the International Internal Audit  Standards in strengthening the role of Internal Auditors in Accountability, and the effect of Attribute and Performance Standards in Accountability. The researcher applied descriptive analysis method to define the role of Internal Audit in the Arab Bank in achieving one of the basic principles of Corporate Governance assimilated in Accountability. The researcher’s sources include

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Publication Date
Fri Dec 01 2023
Journal Name
Civil And Environmental Engineering
Managing the Utilization of Preventive Measures for Fire Resistance in the Hospitals
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Abstract<p>The study analyzed the current situation of public hospitals in the capital of Baghdad exclusively and diagnosed the resources available; especially after the high demand for these hospitals as a result of the citizen’s need to review the hospital to take care of them, especially after the Corona pandemic. Eight major hospitals in Baghdad were selected to determine the current reality of providing fire safety tools or equipment and what are the preventive measures needed to reduce it. The results after practical study showed many defects and weaknesses in the current situation due to their reliance on the traditional management to manage and provide all preventive measures and safet</p> ... Show More
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Publication Date
Tue Jun 14 2016
Journal Name
Al-academy
Space Treatment in the Ceramic Sculpture of the Potter "Shinyar Abdua – Allah"
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Space is considered as an important element in constructing artwork, it can be a dominant and fulfilled part that adds new existence to the content. Each artwork must have a space artistically or analytically. The internal and eternal space of artwork have associated with each other in order to be ann important connected unit that establishes the work epressions and helps the audience to understand it. Such kind of works can be represented by the works of the potter (Sheinyor Abdu Allah) which have uarious expressions of space which this study is based on.The study aims at finding out the treatment of apace in the ceramic sculpture works of the potter (Sheinyar Abdu Allah).The second chapter has many sections. T

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Publication Date
Wed Jul 02 2025
Journal Name
International Journal Of Environmental Sciences
The Embryonic Development Of The Heart In Sailfin Molly Fish (Poecelia Latipinn)
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This included the study of embryonic development of the heart in different lengths of embryos of Sailfin molly (Poecelia latipinna) fish, which is one of the invasive fish species in Iraq and is spread acrosswater bodies, especially in the marshes that are located in the south of Iraq. The fish samples were collected from the AGhazl market in Baghdad province, and dissected to remove the ovary that containing embryos at different lengths using fine forceps. All the samples were fixed using formalin after making a hole in the gas sac, especially in advanced embryos stage. In a 3 mm embryo, the heart was completely formed and the blood vessels and optic cup were clear, while the lens of the eye was beginning to form. In 4-5 mm embryo, it was

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Publication Date
Mon May 21 2007
Journal Name
Journal Of Planner And Development
The Efficiency of the Distribution for Educational Services in Al-Athamiyah area
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The educational service one of activities which have great effect in the city life and it's community which considered as an affective instrument for the social and civilized construction and its role in the development of culture and determining the general features of the society. Therefore planning for educational service is considered as a necessary for economical, social and cultural conditions in the Arab community lives in general and the Iraqi community in special. The educational service buildings and distribution forms an insurmountable obstacle in the urban areas. So the balance distribution in Baghdad presents an indication to ensure the equality of educational opportunities besides the correlation of these institutes with th

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Estimate the risk of runoff for six basins in the western plateau
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The research risk of flooding on six water basins located in the eastern part of the western plateau, reached total area of the basin (22,998.9 km 2), has reached all the Basin area (basin to time 7056.1 km2 basin by 3585 km 2, Bath Alheiazi 6404 km 2, Abu beasts 544.1 km2 basin Abu Shannan 144.6 km 2, Bath Valley Faraj 5265.1 km 2), where it was specifically spatial degree of this risk by studying some of the hydrological basin transactions directly related to operations spate runoff study area and the occurrence of flood risks on the surface of ponds.

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Information Technology Management
Measuring the performance of the virtual teams in global software development projects
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