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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
Sat Jan 31 2026
Journal Name
Al-nahrain Journal For Engineering Sciences
The Effect of Magnetic Abrasive Finishing on the Flat Surface for Ferromagnetic and non-Ferromagnetic materials
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Magnetic Abrasive Finishing (MAF) is an advanced finishing method, which improves the quality of surfaces and performance of the products. The finishing technology for flat surfaces by MAF method is very economical in manufacturing fields an electromagnetic inductor was designed and manufactured for flat surface finishing formed in vertical milling machine. Magnetic abrasive powder was also produced under controlled condition. There are various parameters, such as the coil current, working gap, the volume of powder portion and feed rate, that are known to have a large impact on surface quality. This paper describes how Taguchi design of experiments is applied to find out important parameters influencing the surface quality generated during

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Publication Date
Tue Jun 30 2015
Journal Name
College Of Islamic Sciences
Forced State Fair Workers "Trades and professions" To work from the perspective of the Islamic economy
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The origin of occupations and trades producing goods and services necessary for the members of society
When people are designated to perform this task, in which case the state of change is included in the imposition of adequate labor rights, and may change from imposing sufficient to imposing the eye
Does the state have the right to compel "tradesmen and professions" to do their jobs?
Therefore, this research came to address the legitimacy of this from the perspective of the Islamic economy.

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Relationship between Fiscal Policy and Human Development Analytical Studay Of Iraq Using The (ARDL)Model
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Fiscal policy is one of the important economic tools that affect economic development in general and human development in particular through its tools (public revenues, public expenditures, and the general budget).

It was hoped that the effects of fiscal policy during the study period (2004-2007) will positively reflect on human development indicators (health, education, income) by raising these indicators on the ground. After 2003, public revenues in Iraq increased due to increased revenues. However, despite this increase in public budgets, the actual impact on human development and its indicators was not equivalent to this increase in financial revenues. QR The value of the general budget allocations ha

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The causal relationship between debt size and Economic value added With contrast of the Frim Size
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Abstract

       The research aims to identify  the  nature of  the relationship between the level of debt used  and economic  value  added  of companies listed on the Iraq Stock Exchange under the Contrast sizes of these companies , The research addressed the theoretical concepts associated with each of the debt financing , economic added value and Organization size With the use of financial techniques in the practical side to measure these variables, The research community Represent of  the shareholding companies listed on the Iraq Stock Exchange with a choice of intentionally sample of 24 joint stock companies representing&nbsp

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Publication Date
Mon Jan 01 2024
Journal Name
المجلة العربية للعلوم الإنسانية والاجتماعية
The impact of digital transformation on the relationship between commercial bank customers’ empowerment and competitive advantage
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The impact of digital transformation on the relationship between commercial bank customers’ empowerment and competitive advantage

Publication Date
Sun Jan 14 2018
Journal Name
Journal Of Engineering
The effect of Laser Shock Peening on Fatigue Life Using Pure Water and Hydrofluoric Acid As a Confining Layer of Al – Alloy 7075-T6
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Laser shock peening (LSP) is deemed as a deep-rooted technology for stimulating compressive residual stresses below the surface of metallic elements. As a result, fatigue lifespan is improved, and the substance properties become further resistant to wear and corrosion. The LSP provides more unfailing surface treatment and a potential decrease in microstructural damage. Laser shock peening is a well-organized method measured up to the mechanical shoot peening. This kind of surface handling can be fulfilled via an intense laser pulse focused on a substantial surface in extremely shorter intervals. In this work, Hydrofluoric Acid (HF) and pure water as a coating layer were utilized as a new technique to improve the properti

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of voluntary accounting disclosure in enhancing information confidence in
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ABSTRACT:

The study aimed to identify the impact of the role of voluntary accounting disclosure in enhancing confidence in the informational content of financial reports. Correlation - Spearman to measure the degree of correlation, as well as the method of simple linear regression analysis, and the study reached several results, including: The level of enhancing the information content in the annual financial reports of the Palestinian banks listed on the Palestine Exchange under study reached the overall average (total) (94.1%), and also Voluntary Accounting Disclosure in Enhancing Confidence in the Informational Content of the List of Change in Ownership Equity of Listed

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Publication Date
Mon Apr 01 2024
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
Applied the Indicators of Green Building in Educational Hospitals in Iraq
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Publication Date
Mon Aug 02 2021
Journal Name
Al Ustath
Normalizing Society in George Lamming’s In the Castle of My Skin
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This study examines the effect of colonialism on Caribbean society during the colonial period. Through normalization, the British colonial power diminished Caribbean identity and planted a new hybrid identity. Discipline institutions and surveillance techniques had a vital role in normalizing Caribbean society. Caribbean authors have adopted this notion of normalization to represent the reality of colonialism and its consequences. George Lamming, one of the Caribbean political activist and influential novelist in his novel In the Castle of My Skin (1953), reflects normalization as theorized by Michael Foucault. Lamming depicts the story of villagers and their life under colonial domination. Through discipline institution, like school, colo

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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
Standarized Basics in Depicting Walis in the Early Age of Islam
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Despite the simplicity that characterized the administration in the era of the Prophet
(peace be upon him), but it put the Muslim community nucleus Administrative Organization
who walked Garret Caliphs (RIP) and came after them, who added to this organization what
they found necessary and dictated by their conditions of life has begun regulation Managing
this appoint leaders and armies of workers on the state and various tribes to spread the Islamic
religion and to teach people the provisions of the Koran and Altfvh in religion and establish
prayer and collect Zakat money so you do not appoint leaders and workers and governors
followed random, but it is in an objective manner takes reasons to meet expectations.

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