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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 Feb 21 2026
Journal Name
Al–bahith Al–a'alami
Verses of Monks in the Holy Quran Study and Analysis
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Tafsir, ‘interpretation’ is one of the most important sciences the Muslims need. Because Allah, Almighty, revealed the Qur’an to be a way of life for the Muslims in which the healing of what is in the chest, including their goodness and their peasant. Allah says:
“O people, an admonition has indeed come to you from your Lord and a healing for what is in the hearts; and a guidance and a mercy for the believers.”
In order to achieve the goal for which God revealed the Quran must be understood and managed verses:” This is a Book that We have revealed to you abounding in good, that they may ponder over its verses, and that those who have understanding may be mindful.”
The Prophet (PBUH) and his companions understood t

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
Analytical Study of the Content of Social and National Studies Textbooks of the Middle Stage in Kingdom of Saudi Arabia in the Light of the Values of Social Peace
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This study aimed to reveal the extent to which the values of social peace are included in the content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia. To achieve this goal, the researcher used the descriptive analytical approach. The study sample consisted of all developed social and national studies textbooks of the middle stage in kingdom of Saudi Arabia in first and second semester of student books in edition of 1439-1440. The study tool was the analysis card. The study reached the following results: 1-The content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia as a whole included (38) social peace values of total (40) values, corresponding to the inclusio

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of The College Of Education For Women
Alternative Sanctions and their Impact on Societal Security: A Field Study in the Directorate of Juveniles Reformatory in Baghdad
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Crime is one of the most severe challenges facing States, and strives to find preventive measures, reduce its seriousness, and prevent them; due to developments, crimes have increased, and emerging new patterns of crimes, there is an urgent need to prevent crimes and reduce their effects. Modernizing its punitive system and diverting it to correctional rehabilitative justice to redress the prejudice caused by the crime and rehabilitate the convicted person by using alternative measures to short-term imprisonment. This research emphasizes alternative sanctions' value to minimizing short-term imprisonment penalties and their impact on societal security through several goals like, the negative consequences, justifications, and alternatives

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Publication Date
Mon Jun 14 2021
Journal Name
Turkish Journal Of Physiotherapy And Rehabilitation
A STUDY OF THE DIMENSIONS OF COMPETITION ANXIETY AND ITS RELATIONSHIP TO THE DIMENSIONS OF SPORTING ACHIEVEMENT MOTIVATION FOR YOUNG TENNIS PLAYERS
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One of the most important phenomena facing the athlete is the anxiety of sports competition, as he faces many psychological problems during training and in competitions of psychological tension, fear and anxiety that accompany him sometimes, which leads to affecting his level, and sports competition anxiety is a special type of anxiety that occurs in the athlete It is related to the attitudes of sports competitions and that participation in sports competitions and the associated emotional experiences are among the important factors that motivate the practice of sports activity and try to advance and develop his sports level. It is assumed that when the individual begins to practice any activity, he aims to reach a level or degree of achie

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Publication Date
Thu Oct 20 2022
Journal Name
Iraqi Journal Of Industrial Research
Study of the Effect of Epipremnum Aureum Extracts and Tribulus Terrestris L. as a Natural Alternative for the use of Industrial Antioxidants
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In this study, two types of local plants were chosen, the first is the plant golden pothos Epipremnum aureum and the second is the Iraqi Sheikh's chin plant Tribulus terrestris L, for the purpose of making a comparison between them in terms of their possession of chemical groups with antioxidant activity in order to use them as a natural alternative to using antioxidants Industrial that cause negative effects on human health, the samples were prepared using the method of water and alcohol extraction (ethanol 70%) for both plants. It revealed the presence of a number of chemical groups (tannins, carbohydrates, phenols, flavonoids, alkaloids) for both plants, the aqueous and alcoholic extracts. Coumarins are only found in the sheikh's chin pl

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Strategic orientation and its reflection on the Learning organization: Survey study of a sample of Makers decision the Iraqi Ministry of Communications
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The current research focuses on the extent to which the strategic orientation(entrepreneurial orientation, customer orientation, technology orientation, learning orientation, and investment orientation) affects the learning organization (building common vision, systemic thinking, personal dominance, mental models, team learning)The first hypothesis to test the connection relation between research variables and The second hypothesis was to test the relationship between these variables. In order to ascertain the validity of the hypotheses, the research was based on a questionnaire questionnaire prepared according to a number of In addition to building a fifth sub-variable for the strategic orientation (investment orientation) based

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Publication Date
Sat Nov 12 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The possibility of adopting a market approach to measure the fair value of biological assets in Iraq: (Applied study in Middle East Fish Production and Marketing Company)
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The research aims to show the possibility of adopting the market approach to measure the fair value of biological assets in Iraq, by applying to a sample of the company listed on the Iraq Stock Exchange, where the Middle East Fish Production and Marketing Company was selected from among 7 companies representing the agricultural sector in Iraq, and according to the availability of data and for five years, the financial statements were presented of the measurement and disclosure of  biological assets at fair value according to the market approach, One of the most important conclusions reached by the researcher is the The possibility of measuring and disclosing biological assets at fair value according to the market approach in the Ira

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Publication Date
Sat Apr 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Estimation & Analysis Relationship between Growth rate GDP and Unemployment Rate In Iraqi Economic in Period (1990-2014)
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It reflects the gross domestic product in any country total output of goods and services by the size of the country's citizens and foreign residents during the period of the year and reflect the contribution of the commodity sectors of the economy and the distribution and service in the composition of output. And gross domestic product in Iraq as an indicator dominated in the composition of oil output, along with the contribution of the service sector, as the gross domestic product is the output of a yield lien   and subjected GDP in Iraq to a series of declines succession due to vibrations of the oil market during the economic blockade on the one hand and stop imported production inputs, lack of arriving in commodity s

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Publication Date
Mon Dec 14 2020
Journal Name
Plos One
Healthy lifestyle behaviors are major predictors of mental wellbeing during COVID-19 pandemic confinement: A study on adult Arabs in higher educational institutions
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Background

In the past infectious diseases affected the quality of lifestyle during home confinement. The study conducted examines the influence of home confinement during the COVID-19 pandemic outbreak on lifestyle, mental wellbeing, nutritional status, and sleeping pattern.

Method

An online multicategorical questionnaire was distributed to collect demographic information combined with the following tools: Food Frequency Questionnaire (FFQ), International Physical Activity Questionnaire (IPAQ), WHO-5 wellbeing score, and Pittsburgh Sleep Quality Index (PSQI). A snowball non-discriminate sampling procedure was

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Publication Date
Sat Sep 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Effect of strategic thinking in human resource management strategies “Analytical field study of the views of a sample of managers in the Iraqi Ministry of Health”
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The researcher attempts to diagnose the level of the effect  of strategic thinking skills (intuition, meditation, creativity) of the managers in the Ministry of Health in Iraq and some of its institutions in the formulation of human resources management: (selection, training, incentivence , performance appraisal (Recognizing the importance of the subjects studied, and because of the importance of the expected results of th

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