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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
Fri Nov 21 2025
Journal Name
Journal Of Physical Education
The Effect of Special Exercises Using Handball R.T On Motor Response Development and Some Goalkeeping Skills For Handball Players from the National Center for Gifted In Handball Aged (15 – 16) Years Old
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Publication Date
Wed Mar 16 2022
Journal Name
Journal Of Educational And Psychological Researches
The Extent to Which Future Skills are Employed During Teaching from the Viewpoint of Students of Islamic Studies and their Relationship to Students' Attitude towards Future Profession
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The research aims to identify the relationship between employing future skills during teaching from the viewpoint of students of Islamic studies at the Northern Border University, as well as their attitudes towards future professions. The researcher employed the correlational descriptive approach. The tools were a questionnaire for employing future skills, and a scale for the attitude towards the future profession. The two research tools were applied to a random sample of (242) male and female students from the department of Islamic Studies, College of Education and Arts. The findings showed that the total level of employing future skills and their three axes during teaching was average. It was also found that the attitude towards future

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Publication Date
Fri Jan 01 2021
Journal Name
Webology
The role of change management in achieving competetive advantage a case study in diyala state company
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The research aims to test the correlation relationships between wise leadership, and the business model, and to demonstrate its influence (wise leadership) on the business model. Therefore, two main hypotheses were put forward. The research was applied to a sample consisting of (87) managers and deputy managers, some of them are members on the board of directors of the researched company. The questionnaire was adopted as a basic tool for collecting data, in addition to personal interviews. A number of statistical methods were used to analyze the data and obtain results. The researcher showed a set of results, including: There is a significant correlation between wise leadership and business model. There is an influence of wise leadership on

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The quality of higher education requirements and its impacts in achieving organizational excellence: The case study of the Universities of Baghdad and AL-Nahrain
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Abstract

This research aims to determine the role of the quality of higher education in achieving organizational excellence at the universities of Baghdad and Al-Nahren, was based on research on the main hypothesis is:First:- There is correlation and between the quality of higher education dimensions (continuous improvement, measurement and analysis, the culture of the organization, optimal use of resources , customer satisfaction) and organizational excellence dimensions (strategic planning, focusing on the market and the customer, information and analysis, the effectiveness of operations, processes and resources), Second:- Second, there is the impact of relationship sig

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The mechanisms of generation of Unemployment in Iraq and its types and calculating the Disguised of it: Analytical Study for the period 2003-2015
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     The objective of this study is to attempt to provide a quantitative analysis to the causes of unemployment  in Iraq and its mechanisms of generation, as well as a review of the most important  types of both visible and invisible unemployment, and an attempt to measure the disguised  unemployment  and analyze the causes. The problem of the research lies in the fact that the Iraqi Economy has been suffered  for  a long time although its characterized by abundant  physical and natural  resources, from the existence of the  phenomenon of unemployment  in the previous two types. Causing a lot of economic problems, represented by the great waste of resources and

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Publication Date
Fri Dec 31 2021
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY OF THE EFFECT OF CHITOSAN EXTRACTED FROM THE MUSHROOM ON THE EXPERIMENTALLY INDUCED HYPERLIPIDEMIA IN MALE RABBITS: STUDY OF THE EFFECT OF CHITOSAN EXTRACTED FROM THE MUSHROOM ON THE EXPERIMENTALLY INDUCED HYPERLIPIDEMIA IN MALE RABBITS
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The present study aimed to identify the therapeutic evaluation of chitosan extracted from the fungus cushroom and pure chitosan on glucose and lipid profile in the blood of 35 male rabbits with hyperlipidemia induced experimentally by cholesterol. The tests included estimation of glucose levels, total cholesterol, triglycerides, high-density lipoproteins, low-density lipoproteins, and very low-density lipoproteins. hyperlipidemia was induced in the male rabbits used in the study which was administered orally with cholesterol 150mg/kg body weight for a week. rabbits were divided into seven groups: control, cholesterol, pure chitosan, mushroom chitosan, cholesterol and pure chitosan, cholesterol and mushroom chitosan and cholestero

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Publication Date
Tue Dec 22 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of insider trading in accounting information on the investors decisions: An Applied Study In a sample of corporation listed in Iraq Securities Exchange
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This research aims to discuss an important issue because of its role in increasing the efficiency of financial markets and boost investor confidence by a insider trading, which arises as a result of leaking secret information to some investors and reliable in the process of trading shares in the Iraq Stock Exchange And thus obtain abnormal profits at the expense of other investors. Research was based on the assumption that " Where shortcomings in local regulations relating to disclosure and insider trading in accounting information leads to the activate the phenomenon of insider trading in accounting information in the Iraq Stock Exchange and including a negative impact on investors' decisions ". and Because of the difficulty the discove

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Cyber security technology and the reflection of its application on the quality of financial reports: An exploratory study of a sample of internal and external auditors
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Abstract

                 This research aims to define the roles of auditors by clarifying the concept and risks of cyber security in protecting information and financial data in economic units. Najaf, Babylon and Karbala, then the results were analyzed and the results were presented and analyzed to show that adopting cyber security improves the quality of reports Finance through what it achieves in displaying information with credibility and transparency, in a way that suits the needs of users, and cyber security has a role in managing economic resources more effectively to obtain benefits that would have been lost in the event of an

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Publication Date
Fri Nov 21 2025
Journal Name
Journal Mustansiriyah Of Sports Science
A comparative study of mental abilities and athletic achievement motivation among students of the College of Physical Education and Sports Sciences at the University of Baghdad
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Publication Date
Fri Nov 21 2025
Journal Name
Adab Al Rafidayn
The State of the Practical Application by Students at Department of Information and Technology and Libraries/ Institute of Administration-Al-Rusafa: A Developmental Evaluative Study
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Practical application is an effective tool for preparing qualified scientific and technical cadres if applied correctly and efficiently. In addition to being the complementary part of everything that has been studied in the years of study, it is a scientific linking tool between theory and application. Here lies the importance of this research in clarifying the central and important role that practical application plays in general in raising the scientific level of the student, and the extent of the suitability of the curriculum and means of practical application and the extent and needs of the students applying at the Institute of Administration - Rusafa - Department of Information Technology and Libraries. This research attempted to answe

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