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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 Dec 31 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
THE IMPACT OF ETHICAL LEADERSHIP BEHAVIOR IN UNIVERSITY PERFORMANCE- STUDY EXPLORATORY AT SUMER UNIVERSITY: THE IMPACT OF ETHICAL LEADERSHIP BEHAVIOR IN UNIVERSITY PERFORMANCE- STUDY EXPLORATORY AT SUMER UNIVERSITY
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The aim of the study was to find out the correlations and impact between the variable of ethical leadership behavior and university performance at Sumer University. Use the descriptive analytical method by adopting the questionnaire tool to collect data. The questionnaire was distributed electronically to 113 teachers at Sumer University and the response was from 105 teachers. The research results showed that there is a correlation and effect relationship between the search variables. In addition, the responding university does not have ethically defined standards in terms of performance of the work of the cadres working there. Finally, the research presented a set of recommendations aimed at tackling problems in the ethical lead

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of The College Of Education For Women
Assessing the Brief Book of the Modern and Contemporary History of Asia from the Perspective of the Students in the Department of History - University of Baghdad
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The current research aims to assess the Brief Book of the Modern and Contemporary History of Asia from the perspective of the students in the Department of History, University of Baghdad. The study is carried out in Iraq and the research group has included students of the Department of History in the College of Education--Ibn Rushd and the College of Education for Women- University of Baghdad. The chosen sample of the assigned research consisted of (72) students from third stage in the Department of History, which equals (0.38%) of the total group members amounted (188) female and male students representing (40) students from the College of Education--Ibn Rushd, and 32 students from

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Publication Date
Fri Mar 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The effect of Analysis of internal environment in the quality of health care service survey study at AL_Elwiya Maternity Teaching Hospital
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he current research aims at showing the correlation and effect of the internal environment analysis in the quality of health service in AL_Elwiya Maternity Teaching Hospital, researcher depended on the integral method in the "analytical descriptive method" for the study of the relation between the main variables and the sub-variables throughout data collection required by the theme of this study, a case study" in tackling the data and information related to the financial aspects of the internal environment.

The problem of the study was manifested in the essential question, that is (is there internal struc

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Publication Date
Thu Mar 31 2022
Journal Name
Journal Of The College Of Education For Women
The Impact of a Counseling Program with a Cognitive Reconstruction Method on the Development of the Psychological Hardness among Middle School Students
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The current research aims to determine the impact of the cognitive reconstruction program on the development of psychological hardness among middle school students through the experimental verification of three hypotheses. The research sample consisted of (16) out of (450) students selected from Ibn Rushud preparatory school- Al-Rusafa 2. These participants have been randomly distributed into two equal groups. The researcher has used the method of cognitive reconstruction with the experimental group, whereas with the controlling group, he used nothing. The researcher has further used the scale of psychological hardness of Kobassa with the participants; the scale has been built in a way that suits the sample of the study, which consisted

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Publication Date
Sun Jun 02 2019
Journal Name
International Journal Of Multidisciplinary And Current Research
The security problem in the Gulf Cooperation Council countries Study on internal challenges and future prospects
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The importance of our research is that it examines the causes and sources of the security challenges in the internal security environment of the GCC countries, and aims to address the most important issues that are of great interest, namely, the issue of inter-GCC differences and addressing the issues of regional security for the Gulf region, After it is one of the most dynamic and more polarized areas for the emergence of threats and challenges because of the multiplicity of sources of threat and their complexity due to the specificity of the strategic environment and the negative repercussions it can have on the Gulf region, especially the issue of regional security of the Gulf Cooperation Council Which has become a magnet for competing i

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Theoretical study to find the thermal stress and strain generated in the Wood silica using lasers
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In this research study theory to find the stress and emotion gases in the glass as a result of exposure to pulses of the laser beam has been the study using vehicles three major on-system axes cylindrical (r, 0, z), where I took three models of glass silica glass soda glass fused and shedtwo types of lasers where the study showed that the thermal stresses and emotions ...

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Publication Date
Mon Oct 06 2025
Journal Name
International Journal Of Innovative Research And Scientific Studies
The requirements of total quality management and the determinants of its application in private Iraqi press institutions: Al-zaman newspaper as a model
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This study investigates the requirements of total quality management (TQM) and the determinants affecting its application in Al-Zaman newspaper, one of Iraq’s leading private press institutions. The research employed a survey methodology, using a structured questionnaire administered to 30 participants representing journalistic, administrative, and technical staff. Five TQM dimensions, each measured through four indicators, were assessed to capture the perceptions of employees regarding the availability and effectiveness of quality practices. Data were analyzed using the Statistical Package for the Social Sciences (SPSS). The results revealed that while senior management at Al-Zaman demonstrates formal support for TQM, there is a

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Publication Date
Thu Feb 06 2014
Journal Name
2nd International Conference On Innovation And Entrepreneurship
Is the Organizational Performance of Small Businesses Influenced by HRM Practices and the Governmental Support? A Case of Small Manufacturing Businesses in Malaysia
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YY Lazim, NAB Azizan, 2nd International Conference on Innovation and Entrepreneurship, 2014

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Publication Date
Fri May 17 2013
Journal Name
Sensors
Evolution of Electroencephalogram Signal Analysis Techniques during Anesthesia
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Biosignal analysis is one of the most important topics that researchers have tried to develop during the last century to understand numerous human diseases. Electroencephalograms (EEGs) are one of the techniques which provides an electrical representation of biosignals that reflect changes in the activity of the human brain. Monitoring the levels of anesthesia is a very important subject, which has been proposed to avoid both patient awareness caused by inadequate dosage of anesthetic drugs and excessive use of anesthesia during surgery. This article reviews the bases of these techniques and their development within the last decades and provides a synopsis of the relevant methodologies and algorithms that are used to analyze EEG sig

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Measure the effectiveness of the Balanced Scorecard strategic performance management in public institutions of Jordan )An Empirical Study on the Social Security Corporation – Irbid(
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The goal of this research to identify a set of criteria that can be measured on the basis of which the effectiveness of the application of the Balanced Scorecard in the Jordanian Public Institutions in order to identify the basic requirements to ensure the application of balanced performance measures. The study population consisted of the staff of the Public Institution for Social Security - Irbid of directors of departments and heads of departments and administrative staff, was the use of a random sample of (50) an employee and the employee. The questionnaire was used as a tool to collect data, and as a result of subjecting these standards for the field test and the use of statistical analysis tools to the results of the study c

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