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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
Wed May 17 2023
Journal Name
College Of Islamic Sciences
Except that of wishing between Sibawayh and grammarians
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The scholars of Arabic - may God reward them with the reward of the doers of good - laid down the rules of this language, the cycle of which never ceases to dazzle minds, so they adopted principles according to which they judged the denomination of this word, and the accusative of that, and determined in its light the worker and the done, until they reached us the rules and foundations of our dear language, and it is obvious that they differ. The origins of grammarians from one school of thought to another, or from one world to another, especially with regard to the subsidiary rules, and this difference was clearly reflected in what we have received from the rules, as we find a difference in the rulings that they restricted to the one fa

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Zankoy Sulaimani - Part A
A Comparison Study on the Formation of Administrative and Leadership Policies for the Team and Individual Olympic Games in the Iraqi National Olympic Committee
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The planning for the formation of administrative policies and guidance through leadership are important things for managing administrative processes and sporting activities. As both contribute in the stability of the administrative conditions, and their development in the sport federations, whether they both were attentive about team and individual Olympic Games. The two researchers observe that, there is a variation in the correct way of application. Particularly in the formulation of administrative policies and leadership describing it as, modern management standards for both team and individual Olympic Games in the Iraqi National Olympic Committee. That led to cause a misconception and lack of clarity for some administrators of those uni

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Publication Date
Thu Nov 20 2025
Journal Name
Al-rafidain University College For Sciences
“Simple Regression Analysis by using Linear Programming Technique and illustration of Absolute Residuals method with another Estimation Techniques”
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This research deals with unusual approach for analyzing the Simple Linear Regression via Linear Programming by Two - phase method, which is known in Operations Research: “O.R.”. The estimation here is found by solving optimization problem when adding artificial variables: Ri. Another method to analyze the Simple Linear Regression is introduced in this research, where the conditional Median of (y) was taken under consideration by minimizing the Sum of Absolute Residuals instead of finding the conditional Mean of (y) which depends on minimizing the Sum of Squared Residuals, that is called: “Median Regression”. Also, an Iterative Reweighted Least Squared based on the Absolute Residuals as weights is performed here as another method to

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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
Structure properties of cobalt dioxide (CoO2) thin films effected by violet and red lasers irradiation using (SCSP) technique
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Publication Date
Sat Aug 19 2023
Journal Name
Silicon
Structural and Hardness Characteristics of Silicon Nitride Thin Films Deposited on Metallic Substrates by DC Reactive Sputtering Technique
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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
‘There is no place like home’: A Comparative Study of the Meaning of Home in The Wonderful Wizard of Oz and Peter and Wendy
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The Wonderful Wizard of Oz and Peter and Wendy present universal ideas that exist in all times, despite being written in the beginning of the 20th century. Among the most significant ones is the concept of “home”. The article discusses the essentiality of the idea of “home” where the identity of an individual shapes, and where one’s spiritual, psychological, and physical being develop. It also studies the attitudes of each protagonist towards the concept of ‘home’ based on their understanding of it and according to their gender differences. The characters in both stories tread on the path of perplexity between leaving their homes and returning to them. Peter’s world is the world of imagination while Doro

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Publication Date
Thu Dec 30 2021
Journal Name
College Of Islamic Sciences
The Trilogy of Punishment - The Great, Painful and Humiliating in the Holy Quran An objective study: The Trilogy of Punishment - The Great, Painful and Humiliating in the Holy Quran An objective study
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The study of triples seeks to deal with the comprehensive nature of the Qur’an texts, and the choice fell on the trilogy of great torment, pain, and humiliation in the Noble Qur’an - an objective study, the title of this research, in which I tried to shed light on these terms, and the nuances between them, and in particular torment The eschatological terminology varied, which can be summed up in three terms, namely the great, the painful, and the offensive. The types of torment, the pain is the painful one that is described by the severity of pain and its horror, as for the humiliating punishment, it is that which humiliates the one who has fallen on it, and the diversity of torment is due to the diversity of sins.

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Publication Date
Wed Aug 03 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The pioneering trend in managing health institutions and its impact on improving the quality of services : A case study in some institutions of the Iraqi Ministry of Health
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This study seeks to identify the role that the leadership trend plays in the management of health institutions in Iraq and its impact on improving the quality of the health service provided by analyzing some opinions of affiliates working in the Iraqi health sector where a survey list was used as a main tool for collecting primary data, as it was subjected to this analysis ( 60) of the medical staff, of whom (40) are doctors and (20) are affiliated with the rank of assistant physician, and (60) members of the administrative cadre have undergone their various job ranks and administrative specializations (department manager, auditor, observer, accountant, statistician, secretary). Reliance on statistical software (spss) in data ana

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of Techno strategy of Information management in achieving administrative innovation : A case study in the college of Management and Economics / University of Kirkuk
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The present research aims to identify and define the basic dimensions of the information management strategy and the administrative creativity in the Faculty of Management and Economics / the University of Kirkuk, as well as the role played by the dimensions of the information technology management strategy in achieving the administrative innovation in the college and the research problem was formulated in several questions. The research problem was formulated in several questions centered on the correlation between the research variables, and the research was based on a major hypothesis and five sub-hypotheses emerged from which it was subjected to several tests to ensure its validity. The researcher used the descriptive-analyti

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Publication Date
Sat Apr 01 2017
Journal Name
Al–bahith Al–a'alami
Digital Communication: The Future of Identity in Arab TV Drama: A Field Study on a Sample of Arab Society in the UAE in 2017
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The digital communication of a product of communication and information revolution. It is characterized by accurate and comprehensive in its services and its effects, which brought changes in the structure of many communities and their organizational structures. They have significant impacts on the social systems and social relations, especially in the Arab societies, which are the focus of the globalized Western media, for many reasons: economical, political , cultural and social.
According to this perception, the Arab identity has become in an encounter with big challenges by the globalized media of trade and the media, which aims to achieve greater profits because of identity and its importance to the communities. This occurs par

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