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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
Mon May 02 2022
Journal Name
International Journal Of Research In Social Sciences & Humanities
The Linguistic Study of Grammatical Metaphor
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Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
The martial rights and duties (Rights and duties of a woman and a man)
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This research addresses the relevance of men and women and the consequent provisions
such as dowry and alimony ... Of the like, marriage is to organize links masculinity and
femininity any sexual meeting between men and women a special system that must be
produces reproduction him and alone, which gets its reproduction in human kind, and has no
family and on the basis of private life is being organized.
The importance of the topic see Islam has urged marriage and forbade celibacy, and ensure
that the Lord of Glory Almighty married subsidy nor the origin of the differences between
men and women in money or workmanship or blue-chip Every Muslim inept any Muslim and
every Muslim efficient for any Muslim.
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Mon Oct 28 2024
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The Role Of Emotional Intelligence in The Board Of Directors and Its Impact On The Performance and Value Of Institutions and Conservative Practices In Light Of Crises (Applied Research On a Sample Of Banks Listed On ISX)
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This research aims to underscore the significance of women's emotional intelligence in enhancing the effectiveness of the Board of Directors, a crucial component of internal governance, particularly during crises. Despite strides made in recent decades in appointing women to senior roles in government, business, and education, challenges persist in improving women's leadership opportunities, especially in developing countries. The study utilizes statistical methods, including Pearson's correlation, to analyze the relationships between variables within a sample of banks listed on the Iraqi securities market, comparing periods before and during the COVID-19 pandemic (2019 and 2020). The goal is to measure the impact of female emotiona

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Publication Date
Sat Feb 01 2020
Journal Name
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Effect of applying the CAMEL model to profitability of banks )An applied study on a number of Iraqi banks for the period 2010-2016(
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The evaluation of banks plays an important role in maintaining the interests of customers with the bank as well as providing continuous supervision and control by the Central Bank. The Central Bank of Iraq conducted an assessment of the Iraqi banks through the implementation of the CAMEL model during a certain period. This evaluation did not continue. The research provides continuity to the Central Bank's assessment and as a step to continue the evaluation process for all banks through the use of the CAMEL model. ROA and ROE by using the regression model for four Iraqi banks registered in the Iraqi market for securities during the period 2010-2016. The results showed that the capital and profitability indicators have a significan

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Publication Date
Sun Feb 26 2012
Journal Name
Ibn Al-haitham Journal For Pure And Applied Science
Study the Effect of Annealing Temperature on the Structural, Optical and Electrical Properties of ZnS Thin Films
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The structural, optical and electrical properties of ZnS films prepared by vacuum evaporation technique on glass substrate at room temperature and treated at different annealing temperatures (323, 373, 423)K of thickness (0.5)µm have been studied. The structure of these films is determined by X-ray diffraction (XRD). The X-ray diffraction studies show that the structure is polycrystalline with cubic structure, and there are strong peaks at the direction (111). The optical properties investigated which include the absorbance and transmittance spectra, energy band gab, absorption coefficient, and other optical constants. The results showed that films have direct optical transition. The optical band gab was found to be in the range t

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Physics: Conference Series
Study of the matter density distributions of halo nuclei 6He and 16C using the binary cluster model
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The harmonic oscillator (HO) and Gaussian (GS) wave functions within the binary cluster model (BCM) have been employ to investigate the ground state neutron, proton and matter densities as well as the elastic form factors of two- neutron 6He and 16C halo nuclei. The long tail is a property that is clearly revealed in the density of the neutrons since it is found in halo orbits. The existence of a long tail in the neutron density distributions of 6He and 16C indicating that these nuclei have a neutron halo structure. Moreover, the matter rms radii and the reaction cross section (𝜎𝑅 ) of these nuclei have been calculated using the Glauber model.

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Publication Date
Thu May 12 2022
Journal Name
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Response of Bread Wheat Crop to the Spray of Alcoholic Sugars and A balanced Mineral Fertilizer in the Central Region of Iraq
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Two field experiments were conducted during the season 2021-2022 in central Iraq represented by the Al-Muthanna governorate - Al-Majd District and Al-Qadisiyah governorate / Al-Nouriah Research Station to determine the productivity of the Baghdad 3 cultivar from spray foliar fertilization of Macro and Micro elements with alcoholic sugars and half the fertilizer recommendation for addition floor, three treatments were used for fertilization: T1 as the control treatment and T2 with alcoholic sugar fertilization at a concentration of 20 g.L-1 + the fertilizer combination of Macro and Micro elements, and T3 with alcoholic sugar fertilization at a concentration of 40 g.L-1 + the fertilizer combination of Macro and Microelements, at irrigation 55

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Publication Date
Sat Jun 30 2018
Journal Name
College Of Islamic Sciences
What he finishes and what he does not leave Between Sibawayh and the cooler A descriptive study of their methodologies
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It was rumored in the grammatical circles that the (short) refrigerant is only a copy of (book) Sibweh, except some of the views that violated it, or some of the evidence that increased it; On the (brief) or not, the researcher has chosen the subject (what is going away and not leave) a field of study of the budget, has come on three demands, the first devoted to the study of the term, and the second to explain the methodology of scientists in the presentation of the topic, and the third was limited to the study of the evidence they invoked .
God grants success

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Publication Date
Mon Oct 01 2012
Journal Name
Al–bahith Al–a'alami
Dealing of the Providers of Sport Media Content with Crises : (The Department of Media of the Ministry of Youth and Sports a Model)
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In a report by Transparency Organization in 2010, Iraq has 200 newspapers, magazines, sixty-seven radio stations and 45 satellite TV channels. The increase in these figures is measured in days or weeks and not months and years. This fact confirms the importance of studying content providers, especially youth sports content, for two reasons: the first is that young people constitute the highest percentage in Iraqi society, with all the potential involved in shaping the future aspects; the second reason is that for years sport has become an important pillar in people's lives not only in the entertainment aspect as it was seen in the past; Rather, sport has an influential presence in politi

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Publication Date
Sun Jan 01 2023
Journal Name
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HRM Management Approaches, With a Focus on Employee Centric Approach: A Case Study In The Rafidain Bank In Iraq
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This research attempts to shed light on a topic that is considered one of the most important topics of HRMs management, which is the Employee centric approach by examining its philosophy and understanding . To achieve the goal, the research relied on the philosophical analytical method, which is one of the approaches used in theoretical studies. The research reached a set of conclusions, the most important of which are the theoretical studies that addressed this entry in the English language and the lack of it in the Arabic language, according to the researcher's knowledge. The research reached a set of recommendations, the most important of which was that this approach needs more research, analysis and study at the practical and th

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