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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 Jan 01 2019
Journal Name
Journal Of The College Of Languages (jcl)
The article deals with the marked vocabulary of Russian and Arabic language, extrapolated to the phraseological: Маркировка арабского и русского языков: На примере фразеологии
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  The paper deals with the marked vocabulary of Russian and Arabic language, and the extrapolated to the phraseological layer of the mentioned language systems. Specificity of the functioning of this process is presented against the backdrop of the peculiarities of the existence of Russian and Arabic languages. Attention is focused on the fact that linguistic markers should be considered as a kind of keys that represent the specificity of the experience of being experienced by an individual in ontological reality. It is asserted that marking can be revealed practically at all levels of the language polysystem, but it is especially productive on its lexical layer, in particular, on the basis of lexicology and ph

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Publication Date
Thu Jan 01 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An Evaluation of Olive Oil as a Separating Medium and Its Effect on Some Mechanical Properties of Processed Acrylic Resin Denture Base (A Comparative Study). Part Two
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Background: During acrylic resin processing, the mold must be separated from the surface of the gypsum to prevent liquid resin from penetrating into the gypsum, and water from the gypsum seeping into the acrylic resin. For many years, tin foil was the most acceptable separating medium, and because it's difficult to apply, a tin-foil substitute is used. In this study, olive oil is used as an alternative to tin foil separating medium for first time, and evaluating its effect as a separating medium on some mechanical properties such as (indentation hardness and transverse strength) of acrylic resins denture base comparing it with those processed using tin-foil and tin foil substitute such as (cold mold seal) separating medium. Materials and M

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of The College Of Education For Women
The Warning Messages of Jeanne DuPrau’sThe City of Ember to the World with Reference to Gil Kenan’s Film Adaptation: The Theory of Conspiracy
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The City of Ember is a very interesting novel that is although intended for young readers, have so many layers and messages that are misunderstood. In this research, both the novel and the film adaptation are studied with the intent to decode the warning messages that the novelist and the director tried to introduce to the audience. The research studies four vital messages; the first message is that history repeats itself for the novel has many allusions to the history of Jews and their painful holocaust and even goes back in history the days of Moses and the Exodus, the second message tackles the conspiracy theory that states nothing happens by accident and that everything is planned and connected hence comes the third message

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
The current research aims to identify the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham
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  • Identifying the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham.
  • Identifying the statistically significant differences in the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham according to the gender variable.
  • And the descriptive approach was used, due to its relevance to the nature of the research objective.

    To verify this, the visual culture skills test consisted of (22) items of the multiple choice type, where the (Koder Richardson 20) equation was applied to calculate the stability of the visual culture skills test. For the skill of writing

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Effect of IFRS 16 on the quality of financial reporting For the Iraqi economic units Applied to the General Company of Iraqi Airways
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The rental activity receives "significant" interest from accounting organizations interested in issuing accounting standards worldwide, such as the Financial Accounting Standards Board (FASB), the International Accounting Standards Board (IASB). As leases represents an important source of finance for economic units as an alternative to financing assets through purchase or borrowing. Professional organizations have focused on addressing the situation of extra-budgetary funding through which the lessee hides many leases that are classified as financing without It shows in the budget, which gives an incorrect picture of the reality of the financial situation of economic unity, IASB has issued IFRS 16, which terminates off- Balance s

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Publication Date
Sat Aug 30 2025
Journal Name
Iraqi Journal Of Science
The role of Matrix metalloproteinase (MMP-9) and its tissue inhibitor (TIMP1) in Cutaneous Leishmaniasis patients and their role in prognosis
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Cutaneous leishmaniasis (CL) is a widespread, yet often overlooked, parasitic disease caused by the Leishmania protozoan, which is prevalent in numerous countries, including Iraq. This condition is marked by the appearance of skin lesions on various exposed areas of the body. In most old-world regions, sodium stibogluconate (SSG) is the classical widely used drug to treat CL. The progression of skin ulceration is controlled by different inflammatory modulators including cytokines and enzymes. In this study, the possible role of the enzyme Matrix metalloproteinase9 (MMP-9) and its inhibitor Metallopeptidase inhibitor-1 (TIMP-1) as immunological markers was evaluated in CL patients suffering from cutaneous leishmaniasis before and aft

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Empowerment administrative Factors and its impact on Performance of the service organization An analytic Research at the Ministry of Interior – General Directorate of Traffic
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Abstract

The research study about the empowerment as an independent variable, in which details include (training and improvement, incentives, information sharing, trust, and delegation), has also focused on the performance of the service organization as a dependent variable in all dimensions which include (improve work efficiency, building the core competencies, focus on the beneficiary of the service, increasing the feeling of satisfaction of the employees, and the organizational support commitment). The research has been based on the opinions of a chosen sample of 75 service officers of the Ministry of Interior who work at the General Directorate of Traffic. The research problem has been identified by t

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Publication Date
Wed Apr 06 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Management using the Six Sigma approach to cost rationalization of activities : Application in the Iraqi mechanical carpet factory
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The textile industries play a prominent role in reviving the national economy, but they are currently suffering from several problems, including the high costs of their activities, the low quality of their production processes, and accordingly, the hexagonal diffraction approach came to help analyze production activities to determine which of them are the most expensive and do not have a benefit or cost greater than Its benefit as a result of waste and losses that accompany its implementation. And by applying to the Iraqi mechanical carpet factory, the research reached several conclusions, the most important of which is the presence of several sources of waste and loss, such as activities and operations that do not add value, whi

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Publication Date
Wed Jun 20 2018
Journal Name
Al-academy
The effect of CORT educational program on creative thinking for the secondary school students in art education subject
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The current research aims to identify (the effect of CORT program on creative thinking for middle school students in the art education history of ancient art subject).

     The research society continue of the5th of scientific students in ALsadreen secondary school of excellence which related of the Directorate of Education al-sader city, for the academic year (2015/2016), The sample was (35) students for each of the two groups (experimental and control). The equivalence between the research groups was carried out in the IQ variable, the age and the level of the father and mother.

     The researcher used the experimental method of partial control and the post-test. If the course of

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Publication Date
Thu Jan 01 2026
Journal Name
Journal Of Physical Education
The effect of the Perkins-Blyth model on learning some compound skills in soccer for second intermediate students
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