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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 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The possibility of applying CAPP technology to improve the quality of the product
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     The research deals with A very important two subjects, computer aided process planning (CAPP) and Quality of product with its dimintions which identified by the producer organization, the goal of the research is to Highlight and know the role of the CAPP technology to improve quality of the product of (rotor) in the engines factory in the general company for electrical industries, The research depends case study style by the direct visits of researcher to the work location to apply the operational paths generated by specialized computer program designed by researcher, and research divides into four axes, the first regard to the general structure of the research, the second to the theoretical review, the t

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The Economic Feasibility of the beekeeping project Using the method of mobile promiscuous
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               An update of our research is the first to develop and reform the agricultural sector . and promoting production and productivity of this sector multi-sources , which is the management and beekeeping one source . Been applied to the style of beekeeping mobile promiscuous includes twentieth cell in the Iraqe project of mussiab . in which there exist a variety of crops and trees .

Experiment had proved successful and led to raise the level of npoduction of single Dell of the honey to 49 kg over the previous year and surpassed the average production percell in the province of Babylon , which the amount of 13.945 kg , another

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Publication Date
Mon Feb 16 2026
Journal Name
Al–bahith Al–a'alami
THE MENTAL PICTURE OF THE HOUSE OF REPRESENTATIVES AMONG THE IRAQI PUBLIC : (SectionII)
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This research is considered as the beginning of other studies about the iraqi the public and their relationship with the various state institutions. Recently, such studies used to be almost non-existent. The main characteristic that distinguishes the scientific studies, is the fact that it involves a specific problem that needs to be studied and analysed from multiple aspects, otherwise the definition of problem identification wouldn’t have been narrowing the topic into what the researcher wants to address, also not what the title is referring to as topics which the researcher doesn’t want to address. The problem in this research resides in the lack of well planned scientific programs that aims at building a positive mental picture a

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Global Pharma Technology
Study of the genetic diversity in three species belonging to family: Daphniidae (Crustaceae, Cladocera) collected from different regions in Baghdad Province/Iraq
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Publication Date
Sun Jan 01 2023
Journal Name
Revista Iberoamericana De PsicologÍa Del Ejercicio Y El Deporte Vol. 18 No 1 Pp. 117-121
THE EFFECT OF SPECIAL EXERCISES ACCORDING TO THE DIFFERENTIATED TEACHING METHOD ON MENTAL MOTIVATION AND LEARNING THE SKILLS OF BASKETBALL AND SHOOTING FOR FEMALE STUDENTS
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Publication Date
Mon Sep 01 2025
Journal Name
Chinese Journal Of Analytical Chemistry
Synthesis, characterization, and evaluation of the antioxidant and anticancer activities of metal ion complexes with a novel7-(3-hydroxyphenylazo)-quinolin-8-ol ligand
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Publication Date
Fri Jun 28 2019
Journal Name
Journal Of The College Of Education For Women
The most important ministers of the Abbasid state until the end of the era (198-218 AH)
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The existence of succession system has appeared in Arab Islamic state after the death of the prophet Mohammed (peace be upon God and peace), So there was caliphate, then the Umayyad dynasty in Syria , until 132 AH , the date o the emergence of the Abbasid state adopted a system ministry formally , hafs bin sulaiman ( Abu salamah Khallal ) was the first  minister emerged on the political scene. He was killed at the time of the first  Abbasid caliph , Abu Albbas , incest 132-136 who had put Khalid bin barmak as a minister instead of Hafs bin Sulaiman . During the reign of AL-Mansur 136-158 , there was an importance and a place for the ministry , despite of AL-Mansur strength personality that covered on his ministers personalities

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The use of the genetic algorithm to estimate the parameters function of the hypoexponential distribution by simulation
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In this research, the focus was placed on estimating the parameters of the Hypoexponential distribution function using the maximum likelihood method and genetic algorithm. More than one standard, including MSE, has been adopted for comparison by Using the simulation method

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Publication Date
Tue Jan 14 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The factors effecting the discovery of insurance fraud from the perspective of the National Insurance Company's employees
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This research aims to identify the factors effecting the investigation of insurance fraud from the perspective of the National Insurance Company employees, by analyzing the study variables and make recommendations on how to enhance the company and employees performance, and to achieve the objectives of the study and test hypotheses a questionnaire was designed after referring to the international standards  and the 1969 Iraqi punishment law, and it was answered by 20 employees that were approved for the purposes of  this research and analysis.

      The study found that lack of employee training was a strong factor, while the supervisory staff and operational procedures was a weak one.

G

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Publication Date
Mon Feb 01 2021
Journal Name
Journal Of Physics: Conference Series
The Fear Effect on a Food Chain Prey-Predator Model Incorporating a Prey Refuge and Harvesting
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Abstract<p>In this paper, we investigate the impact of fear on a food chain mathematical model with prey refuge and harvesting. The prey species reproduces by to the law of logistic growth. The model is adapted from version of the Holling type-II prey-first predator and Lotka-Volterra for first predator-second predator model. The conditions, have been examined that assurance the existence of equilibrium points. Uniqueness and boundedness of the solution of the system have been achieve. The local and global dynamical behaviors are discussed and analyzed. In the end, numerical simulations are confirmed the theoretical results that obtained and to display the effectiveness of varying each parameter</p> ... Show More
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