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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
Sat Nov 22 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The influence of recent adhesive onlay fabrication techniques on the fracture resistance of endodontically treated premolars (An in vitro study)
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Background: Endodontically treated teeth have low resistance to fracture against occlusal forces. The strengthening effect of bonded esthetic onlay restoration on weakened tooth has been reported. This study aimed to assess the fracture resistance of endodontically treated premolars restored with composite with and without cuspal coverage by using direct and indirect techniques. Indirect technique done by CAD/CAM system (computer aided design –computer aided manufacturer) and laboratory processing. Material and methods: Forty human extracted maxillary premolars of approximately comparable sizes were divided into four groups: Group (A): Ten endodontically treated teeth directly filled with Filtek Z250xt without cuspal coverage. Group

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Publication Date
Sat Sep 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of initial credit ratingAnnouncement of bonds on stock prices: An analytical study in the Abu Dhabi Securities Market
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The purpose of the research is to investigate the response of stock prices of companies that issued debt instruments (bonds) listed on the Abu Dhabi Securities Exchange for information content from the Moody's first credit rating announcements for the period 1 January 2005 - 30 May 2017. The study methodology was used to verify the existence of this response by the market and the Market efficiency of the Semi-strong shape.  The research focused on testing the impact of the initial announcement.The research showed that there is an influential information content to announce credit ratings in stock prices, with different responses between negative and positive. It was also found that the industrial sectors sample research separately d

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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Improve operational performance by simulating the Holonic manufacturing system A case study at the rubber product plant in Al-Najaf Al-Ashraf
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The research aims to improve operational performance through the application of the Holonic Manufacturing System (HMS) in the rubber products factory in Najaf. The problem was diagnosed with the weakness of the manufacturing system in the factory to meet customers' demands on time within the available resources of machines and workers, which led to time delays of Processing and delivery, increased costs, and reduced flexibility in the factory, A case study methodology used to identify the reality of the manufacturing system and the actual operational performance in the factory. The simulation was used to represent the proposed (HMS) by using (Excel 2010) based on the actual data and calculate the operational performance measures

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Publication Date
Fri Oct 17 2025
Journal Name
Ieee Access
Optic Flow-Based Gait Symmetry Assessment of Center and Peak Pressure Trajectories Applied to Foot Deformities
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Analyzing plantar pressure trajectories is crucial for assessing foot behavior in dynamic gait stability. We propose the identification of foot symmetry and the detection of deformities by analyzing the trajectories of the center of pressure (CoP) and peak pressure (PP). First, using a foot pressure mapping system, plantar pressure data are acquired during a normal gait cycle. After the data have been acquired, post processing extracts both the CoP and PP trajectories over the spatiotemporal domain of foot motion for each foot independently. For this purpose, we used the optical flow technique which accurately estimates the direction of foot motion. The extracted trajectories of each foot are then segmented into, the medial and lateral regi

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Population Therapeutics And Clinical Pharmacology
Evaluation of the Expression of RCC and KIM-1 Biomarkers in Nephrotoxicity of Rabbits Treated with Ochratoxins A
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Publication Date
Thu Feb 01 2024
Journal Name
Iop Conference Series: Earth And Environmental Science
Processing and re-interpretation of gravity bouguer map of a selected area in the W-NW of Iraq
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Abstract<p>Geophysical data interpretation is crucial in characterizing the subsurface structure. The Bouguer gravity map analysis of the W-NW region of Iraq serves as the basis for the current geophysical research. The Bouguer gravity data were processed using the Power Spectrum Analysis method. Four depth slices have been acquired after the PSA process, which are: 390 m, 1300 m, 3040 m, and 12600 m depth. The gravity anomaly depth maps show that shallow-depth anomalies are mainly related to the sedimentary cover layers and structures, while the gravity anomaly of the deeper depth slice of 12600 m is more presented to the basement rocks and mantle uplift. The 2D modeling technique was used for </p> ... Show More
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Publication Date
Fri Jul 01 2016
Journal Name
Al–bahith Al–a'alami
The Winged Bull in the Assyrian Civilization- A Semiotic Perspective
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Every cultural achievement is a creative text, and every text is a group of signs. The Winged Bull sculpture is a sort of text that is not confined to some signs; indeed, its cultural signs go far beyond as they are open-ended, everlasting and it lends itself to various horizons of interpretation. The recipient has to combine the signs of this sculpture, which belong to different patterns, in the pursuit for perfection so that he can decode its media message.
I have tackled this sculpture by adopting a semiotic approach. The semiotic approach is a modern critical approach which is as wide as culture and as rich as knowledge. It has been linked to modernism, which in turn has been linked to modern critical approaches, because it can

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Impact of the global financial crisis on the efficiency of activity of the Iraqi Stock Market, "An Empirical Study for the period 2006-2008”
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Abstract
  financial market occupy very important place in the economic activity all over the world countris, and its importance increased with considerable technological progress in the world of transportation ,communications and information where its impact have spread over the whole world, which led to link the international economy in a kind of international relations so that the open policy became the prevailing trend in national and regional economies within the framework of the new world order.

the international economy has faced the financial crisis, global, that hit all world economies although the United States is the center of the crisis and the starting spark for it w

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Publication Date
Thu Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The influence of the personal values of the workers in the performance of the work teams
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The research aims to know the impact of workers values on their performance which is reflected on increasing productivity and improving its quality as well as the organization's progress and success.  Application of this research took place in the General Company Of Electrical Industries; it contained four main pillars; the first involved research methodology، regarding the problem، importance، aim، basic theory، and method of data collection، the second is dedicated to the theoretical framework related to the research basic variables (values and workgroups) the third is assigned to analyze the actual data by using number of statistical methods، such as mathematical medium and standard deviation and also spearman rank

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Publication Date
Mon May 01 2023
Journal Name
Materials Today: Proceedings
An experimental study of the effects of matrix acidising on the petrophysical characteristics of carbonate formation
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