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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
Thu Mar 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Some of Behaviorism Choices that is Availability of Managerial Leaderships an affect of job frustration Management An Opinion Study of Heads Units and Departments In Modern Badoosh Cement Factory
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 Represent choices Behaviorism available to the Managerial leaders one of the prerequisites to run any beginnings of a psychological or dilemmas Managerial barriers to working in the field of work has been varied these options until it had taken several kinds of which contributed to the left different impacts on the alleviation of these problems, which prompted the researcher to raising the problem of study within the framework of questionable content how to contribute to that shown by Choices Behaviorism accredited to the Managerial leaders in the management of frustration

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The role of moral values in the tourism service ,An analytical study
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Business Ethics play a major role in explaining the behavior of those interested in the management of tourism enterprises in the field of management gains, which sometimes turn to manipulation in the specification of the service of tourism and influence in the technical characteristics at the expense of the brand and market share, as well as misleading beneficiaries about the fact that the performance of the service of tourism, may depend activities tourist dramatically when submitting and sharing various services on the types of mutual relations the framework for moral distinct, in interaction or direct contact between producers of tourism services and tourists or their beneficiaries, in order to provide comfort and recreation a

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Publication Date
Mon May 20 2019
Journal Name
Journal Of Planner And Development
Rural Colonization In Iraq Study Of The Rural Colonization To The Kubeisah
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Iraq is considered the origin of civilization first colonies have been cited in its northern parts , when the first attempt in agriculture and animal breeding were began ,and the cave , were taken as houses. That time the first agricultural colony were colonized in Kirkuk and Mussel . There colonies have been developed to be villages which had another activities in addition to the main activity which was agriculture . The distribution without any administrative planning . Lately , the stochastic distribution starting to disappear due to the planning of cities and their to rural surrounding. This study is involved in the analysis of the patterns of the location distribution of the villages , and the form that taken by the village

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Cytological study in the Iraqi speeies of the genus Bromus L. Poaceae)
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This paper is a part of a cytological studies of the genus Bromus L. in Iraq . Cl number for 103 specimens ropro^eming l^species determined . The course of meiosis including an analysis of chromosome configuradon for 27 collections belonging to 8 species were investigated . Meiosis was regular in most species . Tetraploid for B.scoparius L. (new cytotype ) and hexaploid ?'or " Kunth. were re^rted for the first time, cytological findings were supported the view of maintaining the closely related species B.danthoniae Trin. and B.lanceolatus Roth, as distinct species .

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Publication Date
Sun Dec 31 2017
Journal Name
College Of Islamic Sciences
The role of the media in promoting tolerant religious values: intellectual study
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Research summary

Informing means informing and informing, which is conveying information to someone and confirming his narration with it. Accordingly, information is its main content..and it has multiple means, including visual, audio and read, and it has become the dominant role in the process of socialization, and much of what we hear, read, or watch in the media is not devoid of a goal, and expresses that scientifically as “charged with values” ( Value Loaded)..Values that are: the set of beliefs that the individual holds towards things, meanings, and various aspects of activity, which direct his desires and attitudes towards them, and determine for him acceptable and unacceptable behavior, right and wrong, and all of this

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Publication Date
Sun Jan 01 2017
Journal Name
Iraq Journal Of Agricultural Research
THE COMPARATIVE STUDY OF THE TOTAL COSTS AND NET REVENUE OF DIFFERENT TILLAGE SYSTEMS USING TWO TYPES OF SEEDLINGS IN THE PRODUCTION OF BARLEY GREEN VARIETY SAMEER IN THE GYPSUM SOILS
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Publication Date
Tue Sep 10 2024
Journal Name
Journal Of Mathematics And Computer Science
The role of human shield in prey‎, ‎crop-raiders and top predator species in southwestern Ethiopia's coffee forests‎: ‎a modeling study
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In this work, we have developed a model that describes the relationships between top predators (such as tigers, hyenas, and others), crop raiders (such as baboons, warthogs, and deer), and prey (such as deer) in the coffee forests of southwest Ethiopia. Various potential equilibrium points are identified. Additionally, the model's stability in the vicinity of these equilibrium points is examined. An investigation of the model's Hopf bifurcation is conducted concerning several significant parameters. It is found that prey species may be extinct due to a lower growth rate and consumption by top predators in the absence of human interference in the carrying capacity of prey. It is observed that top predators may be extinct due to human interfe

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Publication Date
Tue Jan 01 2008
Journal Name
University Of Baghdad
The use of remote sensing to study the reflection of the ground cover and its relationship to some soil characteristics in the Abi Gharib area
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Publication Date
Sat Sep 01 2007
Journal Name
Al-khwarizmi Engineering Journal
Study the influence of the reinforced material geometrical shape on the internal stresses in the composite materials
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In this paper the reinforced materials manufactured from steel continues fibers are used in Aluminum matrix to build a composite material. Most of researches concentrated on reinforced materials and its position in the matrix according to its size and distribution, and their effects on the magnitude of different kinds of the stresses, so this paper presents and concentrate on the geometrical shape of reinforced material and its effects on the internal stresses and strains on the composite strength using FEM as a method for analysis after loaded by certain force showing the deference magnitudes of stresses according to the different geometrical shapes of reinforced materials.

 

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Publication Date
Fri Nov 21 2025
Journal Name
Iraqi Journal For Administrative Sciences
Using the Statistical Analysis to study the important reasons of the pollution in the Iraqi Marshlands Areas
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The need for detection and investigation of the causes of pollution of the marshes and submit a statistical study evaluated accurately and submitted to the competent authorities and to achieve this goal was used to analyze the factorial analysis and then obtained the results from this analysis from a sample selected from marsh water pollutants which they were: (Electrical Conductivity: EC, Power of Hydrogen: PH, Temperature: T, Turbidity: TU, Total Dissolved Solids: TDS, Dissolved Oxygen: DO). The size of sample (44) sites has been withdrawn and examined in the laboratories of the Iraqi Ministry of Environment. By illustrating SPSS program) the results had been obtained. The most important recommendation was to increase the pumping of addit

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