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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 Sep 30 2019
Journal Name
College Of Islamic Sciences
Show fate to the people of Badr By Ibrahim ibn Hasan al-Kurani (1025-1101 AH): Study, investigate and comment
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It is the grace of God and his grace that he accepts repentance for his slaves, forgives their bad deeds in return for their misfortune, or offers them a good deed, but pardons many of them for free. Therefore, it is not long for God Almighty to forgive His mercy for many of His slaves and bring them to Paradise with no punishment or punishment, even if they have committed some sins, because of the multitude of their favorable navigational disadvantages, or even without gratitude thanks to him and him. With all this, some have overlooked the old and new on these things and amazed at the hadeeth ((God may have seen the people of the full moon and said do what you want, I have forgiven you)). Therefore, the scholars tried to answer some of

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Publication Date
Sun Jan 08 2023
Journal Name
International Journal Of Research In Social Sciences And Humanities
Evaluating Banking Performance According to the European Model of Institutional Excellence: Case Study at United Bank for Investment and Finance1
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The aim of the research is to identify the impact of the dimensions of the European Excellence Model in evaluating the performance of the bank of the research sample, as well as to interpret which dimensions are more important to the banks of the research sample. Based on the dimensions of this model, the United Bank for Investment and Finance has chosen a research community, and has met with officials of the United Bank for Investment and Finance at various administrative levels to measure the practices of excellence management in the European model, and the analytical approach has been the case study and the construction of the checklist as a tool to collect information. The research has reached the most important results There is a discr

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Publication Date
Fri Jan 01 2021
Journal Name
Int. J. Agricult.
FORECASTING THE EXCHANGE RATES OF THE US DOLLAR AGAINST THE IRAQI DINAR USING THE BOX-JENKINS METHODOLOGY IN TIME SERIES WITH PRACTICAL APPLICATION
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The goal of the study is to discover the best model for forecasting the exchange rate of the US dollar against the Iraqi dinar by analyzing time series using the Box Jenkis approach, which is one of the most significant subjects in the statistical sciences employed in the analysis. The exchange rate of the dollar is considered one of the most important determinants of the relative level of the health of the country's economy. It is considered the most watched, analyzed and manipulated measure by the government. There are factors affecting in determining the exchange rate, the most important of which are the amount of money, interest rate and local inflation global balance of payments. The data for the research that represents the exchange r

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Publication Date
Tue Jul 11 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Daniel's Model on the Achievement of Chemistry Among Fifth Grade Student
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The aim of this research is to find out the influence of Daniel's model on the skills of the twenty-first century among the students of the scientific-fifth grade at the secondary and preparatory government morning schools for the academic year 2022- 2023. Two groups were chosen out of five groups for the fifth-scientific grade, one of which represents the experimental group that is taught by the Daniel model, and the other is the control group that is taught in the traditional method. The equivalence of the two research groups was verified with a set of variables. As for the research tool, a scale was developed by the researchers for the skills of the twenty-first century, in which they adopted the framework of the Partnership Organizat

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Publication Date
Mon Jan 01 2024
Journal Name
Pakistan Journal Of Life And Social Sciences (pjlss)
Antibacterial and Antibiofilm Activity of Phenolic Compounds Extracted From Camellia Sinensis And Evaluate The Effect On The Gene Expression (Clfa) In Staphylococcus Aureus
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Publication Date
Thu Oct 12 2017
Journal Name
Iraqi Journal Of Agricultural Sciences
THE BIOLOGICAL EFFECTIVENESS OF GIBBERELLIC ACID SEEDS SOAKING AND FOLIAR TO ABSCISIC ACID IN THE GROWTH , ANISE OIL YIELD AND ITS CHEMICAL CONTENT
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A field experiment was carried out during two winter season 2013, 2014 at the field of the Department of Field Crops, College of Agriculture, University of Baghdad, to study the effect of seeds soaking with Gibberellic acid and foliar with Abscisic Acid on the growth, yield, and content of Anise oil seeds using factorial experiment within RCBD design with three replicates. The seeds was treated within GA3 were soaked with two concentrations of  30, and 60 mg. litter-1 in addition to without soaking and the code has been B0 , B1 , B2 overlapped these transactions with two concentrations of Abscisic Acid  3, and 6 mg. litter-1 in addition to without foliar A0 , A1 , A2The seeds to be treated  with GA3 are soaked for 24 hours prior

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Publication Date
Sat Jan 10 2026
Journal Name
Proximus Journal Of Sports Science And Physical Education
ORGANIZATIONAL TRUST AND ITS EFFECT ON THE DECENTRALIZED WORK OF OFFICIALS IN ORGANIZING AND MANAGING LOCAL CHAMPIONSHIPS AFFILIATED WITH THE IRAQI ATHLETICS FEDERATION
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The aim of the study is to identify the stage of both decentralized performance and organizational confidence with through those responsible the decentralized work of officials in organizing and managing local championships affiliated with the Iraqi Athletics Federation from their perspective. The study employed a descriptive approach using a correlational method on a sample of those managing local championships of the Iraqi Athletics Federation, including members , coaches, referees, and the president of the central administrative board, as well as the members and presidents of the subfederations for the sports (2020/2021).

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Publication Date
Fri Jan 01 2010
Journal Name
Bn Al-haitham Journal For Pure And Applied Sciences
Effects of Different Levels of Urea and Superphosphate Fertilizer in Some Growth Characters and the Yield of Fenugreek plant
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جريت التجربة في اصص فخارية سعة كل اصيص 4 كغم تربة في البيت الزجاجي التابع لقسم علوم الحياة/كلية التربية ابن الهيثـــــــــم/جـامعــة بـغداد لموســم النمـو 2008-2009 لدراســة تأثيــر اربعـــة مستويـــــات من سمــــاد اليوريـــا وهي (0, 0.1, 0.2, 0.4) غم/اصيص والتي تعادل (0, 100, 200, 400) كغم/هكتار وثلاث مستويات من سماد السوبر فوسفات وهي (0, 0.1, 0.2) غم/اصيص والتي تعادل (0, 100, 200) كغم/هكتارفي مكونـات الحاصـــل لنبــات الحلبـــة Trigonella foe

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Publication Date
Wed Apr 13 2022
Journal Name
International Journal Of Medical Sciences
Evaluation of the Levels of Erythropoietin and Some Haehematological Parameters in Patients with History of Haemodialysis and Non- haemodialysis
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Publication Date
Fri Sep 01 2023
Journal Name
Iranian Journal Of Veterinary Science And Technology
Investigation of bacterial contamination with Klebsilla and E. coli in the prepucal cavity of pubertal and adult age in caprine
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