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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 Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Governance and role in increasing the tax outlet in Iraq
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The goal of the research is to highlight the role of the governance and its characteristics in increasing the tax outcome by implementing the laws, regulations and annual controls issued annually from the general authority for taxation for the financing of the general treasury of the state, Additional development and economic capacity, As the search shares a view of the governance and its characteristics and its ideas from increasing tax output. The analytical transparent approach was used by adopting the practice of practicalities of the general authority for tax For quotations in the senior cabinet section ,the revealing of the ongoing operations was relied on the revenue for each financial year, The tools adopted in the process of ana

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Publication Date
Sat Jul 29 2023
Journal Name
International Journal Of Professional Studies
MULTIMODALITY IN THE COURTROOM IN AMERICAN AND BRITISH CRIMINAL CASES
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PDBN Rashid, International Journal of Professional Studies, 2023

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Publication Date
Tue Jun 14 2016
Journal Name
Al-academy
Figure role in highlighting and content in the technical poster
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The poster is one of the means which can be communicate with others through it, to transfer ideas that the designer want to focus on, for its importance to accomplish the poster. It’s a visual mean contact aim to submit an idea to the audience to get a clear idea, and that would be through the shapes and subject to submit the idea. Depend on that our goal in this study is to find out, what follows:1-Finding the relationship between the shape and the idea.And the study comes up with several results, like:1-The drawings that contain themes connected with what the designer want to achieve, through the clearness of idea and to make those elements clear by putting more elements to surround the main shape.2-To assure that the strong connecti

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Publication Date
Sun May 02 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of applying lean construction tools to improving the results of the earned value management model: Applied research in Al-Rasheed General Company for Construction Contracting
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Contracting companies play a prominent role today in economic activity, due to their contribution to the implementation of major construction projects which together constitute the infrastructure of society. Most construction projects also suffer from exceeding the time and cost specified and planned for the completion of the project, and this comes for several reasons, including the work environment, country conditions, The method of managing project costs and the techniques used in its implementation Accordingly, the concepts of lean construction came, which help in addressing the causes of waste, both in time and cost, in addition to the fact that project management needs techniques that are useful in controlling the control and manag

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Publication Date
Tue Jan 27 2026
Journal Name
Journal Of Baghdad College Of Dentistry
A Salivary α-Amylase Level in Relation to the Oral Health Parameters among Children in Baghdad City
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Background: Saliva is a specific bio-fluid with important biomarkers. Analyzing any alternation in these markers could give valuable information, in relation to oral health status parameters. The aim of this study was to investigate the level of α -amylase in unstimulated whole saliva of healthy, primary school children in relation to some oral health parameters. Materials and Methods: A questionnaires consisted of demography and medical histories of participants were filled by children families. Saliva samples were collected for 5- minutes between 9:00 -11:00 AM from 114 healthy students aged 6-13 years, divided into four age groups. Flow- rate, Plaque and Gingival Index were assessed and dentition status was investigated by DMFT/dmft

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Publication Date
Wed May 02 2012
Journal Name
Journal Of Planner And Development
the planning and design characteristics of Iraqs mud building and settlement
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The Mesopotamian soil is muddy and fertile, and so from ancient eras Iraqis used mud in their building, settlements and architecture in different methodologies according to the nature and the function of the building that was either in its pure form or by mixing it with other materials such as straw . also as raw bricks in different ways either for the whale building or parts of it, or for the finishing parts such as roofing for instance. In this research these different forms and methodologies will permeate through out a chosen examples of historical building, rural buildings and settlements and ancient buildings as well as some current uses of mud in the structures and building in standing cities, this in order to conclude some

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Publication Date
Tue Jan 27 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The Clinical Approach and Treatment of Benign and Malignant Parotid Masses
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Background: Parotid gland tumors account for 80% of all salivary gland neoplasms, 20% of these are malignant, but in daily clinical practice most parotid masses are operated on before obtaining the final histological diagnosis. This clinical setting further complicates the critical point of parotid surgery, which is the management of the facial nerve. Materials and methods: 45 patients underwent parotidectomy for benign and malignant neoplasms. A complete history is collected from the patients with the duration and the site of the tumor, the facial nerve examined and its associations, a medical consultation done for opinion and management. Clinical examination with facial nerve was mandatory to avoid any mistakes that may occur. The most si

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Publication Date
Tue Jan 27 2026
Journal Name
Sciences Journal Of Physical Education
The Contribution of Certain Physical Abilities to the Selection of Athletes for the 110m Hurdle Race (Youth Class)
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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Degree of the E-Leadership Practice at Princess Nora Bint Abdul Rahman University of the Corona Pandemic
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The study aimed to identify the E-leadership practice at Princess Nora Bint Abdul Rahman University and to explore the obstacles that are facing the leaders in the implementation of E-leadership, in addition to find mechanisms to improve the practice of electronic driving at the university in light of the Corona pandemic. A descriptive analytical approach was used by depending on a questionnaire to collect the needed data. The study sample consisted of (139) heads of departments, attorneys' colleges and support Deanships universities. The study results showed that E-leadership employment recorded a medium to high degree. Especially at university, that publishing decisions electronically and uses technical means in providing its services.

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Publication Date
Sat Nov 01 2025
Journal Name
Iop Conference Series: Earth And Environmental Science
The effect of large-scale engineered roughness elements on the hydraulics of the Shatt al-Arab estuary: Methodology
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Abstract<p>Erosion and deposition are natural phenomena in the river estuaries that could be presented as a dynamic process involving removing materials from one location and accumulating these materials at other locations. These two phenomena may cause changes in waterways and affect offshore structures. The Shatt Al-Arab River Estuary, Iraq was greatly affected by these two phenomena, and topography changes occurred. Velocity profiles and bed shear stress can be used as indicators to identify the erosion and deposition locations. Large-scale roughness elements proved to make beneficial changes in the hydraulic properties of open channels. They can create desirable effects to control erosion</p> ... Show More
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