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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 Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
A reflection of organizational citizenship behaviors in the performance of employees A prospective study of a sample of the teaching staff working in the Degla University College
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Abstract
        This research aims to identify the relationship and the impact of the behavior of organizational citizenship in the performance of employees, as practiced behaviors organizational citizenship substantial role in achieving the objectives of both the organization and its staff at the same time, so it affects a large extent on the characteristics and performance of individuals employees and thus influence the success of the organization as a whole, problem of the research has indicated that there is a clear failure in the study of the impact of the behavior of organizational citizenship in the performance of employees, was chosen

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Mackenzie role model dimensions in the quality of service, "a Prospective study of the views of a sample of Iraqi banks managers
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The organizational integration forms a necessity according to McKinsey model, especially for service organizations. In the context of various service sector developments, importance adoption of compact mechanisms by these organizations to upgrade their services has increased and senior management must be more aware of environmental, competitive and developmental requirements. It gets more important when it shows in an organization seeking at excellence of making services within its policies and strategies. Subject organizational integration dimensions (strategy, structure, systems, style, staff, shared values, and skills) are effective components in directing behaviors of employees and organization. This motivated both researcher

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Publication Date
Fri Dec 23 2022
Journal Name
F1000research
Association between polymorphisms within the gene coding for tumor necrosis factor (TNF)-alpha with outcomes of treatment in a sample of Iraqi patients with ankylosing spondylitis taking etanercept: an observational study
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Background:Ankylosing spondylitis (AS) is a progressive, chronic inflammatory illness with an unclear etiology that explicitly targets the vertebral column, peripheral joints, and extraarticular tissues. The purpose of this research was to investigate if the existence of single nucleotide polymorphisms (SNPs) in the promoter region of the tumor necrosis factor-alpha (TNF-α) gene at positions -1031T/C (rs199964), -857C/T (rs1799724) and -806C/T (rs4248158) in a sample of Iraqi AS patients could influence the patients' outcomes with etanercept.

Methods:Sixty patients with established AS receiving only etanercept were selected to enroll in this study, with a mean age of 40.75±8.6

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Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
The Effect of a Training Program on the Diabetic Patients Utilizing Skills of Insulin Injection Technique
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Objectives: The study aims to evaluate patients’ performance toward insulin injection after training program to
identify the variation in skill of patients in insulin injection technique with regard to some variable (i.e.
educational level and duration of insulin injection.
Methodology: A quasi experimental study has been conducted on diabetic patients.
An observational checklist had been prepared which consisted of 4 main areas with 37 sub-items, which are
syringe preparation for injection, insulin drawing; skin preparation for injection and insulin injection. Each of the
sub-items has 2 options yes or no. One score for positive answer and zero for no.
The sample of the study consisted of (n =30) males and females

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Publication Date
Wed Nov 12 2025
Journal Name
Journal Of Physical Education
The Effect Of Psychological Counselling On The Development Of Psychological Skills and the Level Of First Class Soccer Referees (Baghdad governorate)
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Publication Date
Fri Sep 17 2021
Journal Name
Al-kindy College Medical Journal
Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study
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Background: The main objective was to compare the outcome of single layer interrupted extra-mucosal sutures with that of double layer suturing in the closure of colostomies.

Subjects and Methods: Sixty-seven patients with closure colostomy were assigned in a prospective randomized fashion into either single layer extra-mucosal anastomosis (Group A) or double layer anastomosis (Group B). Primary outcome measures included mean time taken for anastomosis, immediate postoperative complications, and mean duration of hospital stay. Secondary outcome measures assessed the postoperative return of bowel function, and the overall mean cost. Chi-square test and student t-test did the statistical analysis..

Resu

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Publication Date
Sat Oct 09 2021
Journal Name
Turkish Journal Of Computer And Mathematics Education
An Analysis of the Mathematics Book for the First Intermediate Grade According to the Dimensions of Mathematical Power
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The current research aims to analyze the mathematics book for the first intermediate grade according to the dimensions of mathematical power by answering the following question: What is the percentage of the availability of the dimensions of mathematical power included in the content of the mathematics textbook for first-grade students, average, in its first, and second parts for the academic year 2020-2021, approved by the Iraqi Ministry of Education / General Directorate of Curricula? The research community was determined by middle school mathematics books, and middle school students for middle ,and high school day schools affiliated to the Directorate of Education in Dhi Qar, and by the intentional test, the research sample was s

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Publication Date
Mon Oct 01 2018
Journal Name
Iraqi Journal Of Science
Theoretical Study of The Electromagnetic Structure of Boron Isotopes Using Local Scale Transformation Technique
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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
Ministry of Hamdy Al-Bachachy (the first) 3rd of Jun – 28 Aug. 1944 in Iraq The Ministry forum and the political and economical issues
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This study Studied Ministry of Hamdy Al-Buchachy(the first)and explain the features of
this Ministry in a critical time in the history of Iraq. The second world war had began and its
end had reached .The political situation in Iraq is so complicated. The Ministry had made
many things. The Ministry had situated in internal and external complicated time. The
situation in Iraq was so difficult, therefore the recommendor (Abdul-Ilah)asked Hamdy Al-
Bachachy to make be the head of the new governments Al-Bachachy had made irrelevant
government, thus it didn’t last more than three months and the British governorate and of
direct in terference in Iraq who worked to reduce the Iraqi army and the Minister of Defence
refus

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Publication Date
Mon Aug 01 2016
Journal Name
Enzyme And Microbial Technology
In Search of the E. coli Compounds that Change the Antibiotic Production Pattern of Streptomyces coelicolor During Inter-species Interaction
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