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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 Jan 01 2022
Journal Name
Journal Of Advanced Pharmacy Education And Research
Estimation of the healing effects of the topical use of MEBO and hyaluronic acid gel in the burned rats
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Exposing the dorsal superficial skin of rats to partial-depth burn leads to bacterial and microbes Invasion. Topical treatment is required in most superficial burn cases Moist exposed burn ointment (MEBO) protects wounds from infection and enhances healing without any harmful effects of purified chemicals is caused. The topical using of HA gel in rat models with full and partial thickness surgical wounds shows enhancement in wound repair. In this study, we compared the healing efficacy of topical use of hyaluronic acid gel products with MEBO as standard management in rats that were exposed to a partial-thickness burn. The experiment included twenty-four (24) adult albino rats of male sex with weight (150-220 gm) of 3 months’ age divided i

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Publication Date
Sat Nov 22 2025
Journal Name
Al–bahith Al–a'alami
THE ROLE OF IRAQI SATELLITE TV TOWARDS A CULTURE OF PROTEST AND REMONSTRATION
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The research dealt with a topic that has been practiced and transmitted news in satellite channels in recent years a lot. That is to say the role of satellite channels in the culture of a protest. In general, this study aims to reach to know the extent of the impact of television, especially the impact of the programs that bear the contents of protest and remonstration on the public; and what can be resulted out of these programs as cognitive, emotional and behavioral effects as a result of the individual's exposure to these programs and their impact from the culture of pretense. In addition to that, the research was interested in explaining the role of Iraqi satellite channels in developing and cultivating such culture; and following up

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Publication Date
Sun Apr 01 2018
Journal Name
Academy Of Accounting And Financial Studies Journal
Factors influence the growth and penetration of microfinance institutions: A case of Egypt
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Microfinance Institutions (MFIs) offers small loans with easy repayment system and till now these institutions have served millions of needy people around the globe. This study highlights the hurdles influence the smooth working and growth of Microfinance institution in Egypt. The structured interviews were conducted from the top and mid-level managers of MFI's. This study revealed that interest rate, political and economic conditions, corruption, customer outreach, competition and technology are the important elements for MFI's success. It is evident that lack of use of technology and less importance drawn on customer outreach programs are the main challenges of MFI's in Egypt. This study provides a roadmap for practitioners and strategic

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Publication Date
Sat Nov 22 2025
Journal Name
Webology
Is the Stealth Marketing an Element of Promotion Mix? A Review of the Techniques
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Stealth marketing is considered as one of the contemporary issues that researchers have begun to explore as a current understanding. It is the marketing approach used by organizations to promote their products and services to the public in implicit and indirect manner. In this article, the concept of stealth marketing will be discussed throw its advantages and disadvantages. In addition, the different techniques of stealth marketing have been discussed including: viral marketing, celebrity marketing, brand pushers, bait-and-tease marketing, video games marketing, and marketing in music. Furthermore, a new technique of marketing entitled “Marketing through social responsibility” has been added and discussed according to the themes in the

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Publication Date
Mon Feb 01 2016
Journal Name
Al-academy
Building the foundations of a formal system of the laptop table: حنان غازي صالح
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The study of the laptop computer table is one of the important studies at the present time due to the importance of electronic computers that are used in work sites and homes for very long hours, so one of the most important basics of caring for the comfort of the user lies in the design of the laptop table in different shapes and sizes and multiple functions in addition to calculating the measurements of the human body and the extent Its compatibility with the design and measurements of laptop computer tables by taking into account the calculations and measurements of the dimensions of the user's body of all ages and their consistency and use with the general measurements of the tables and the importance of research comes through the es

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Publication Date
Sun Oct 01 2017
Journal Name
مجلة القادسية للعلوم الرياضية
The impact of leverage in two different environments on the development of weapons and arms explosion strength on some physiological indicators and the accuracy of the performance of the service and crushing volleyball skills
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ھدف البحث الـــــى : ١ -إعداد تدریبات القوة الارتدادیة في وسطین متباینین على بعض المؤشرات الفسیولوجیة لتطویر القوة الانفجاریة ودقة مھارتي الأرسال والضرب الساحق بالكرة الطائرة . ٢ -التعرف على تأثیر تدریبات القوة الارتدادیة في وسطین متباینین على بعض المؤشرات الفسیولوجیة لتطویر القوة الانفجاریة.. ٣ -التعرف على تأثیر تدریبات القوة الارتدادیة في وسطین متباینین على دقة مھارتي الأرسال والضرب الساحق بالكرة الطائرة

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Stages of integration scenarios with strategic management From the perspective of study the historical development of scenarios
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Purpose: The present study seeks to examine various history stages in which undergone by the concept of scenarios, and development of this concept to integration with the strategic management practices:
Methodology: The current study relied on a literature review and approach in providing total picture of different stages undergone by this concept.
The main results: the scenarios did not reach maturity in their quest for integration with strategic management, and still need a great effort for the maturation of this thought in the framework of strategic management, and through it can contribute in creating important knowledge evolution.
Originality and value: providing a contemporary model linking the roots of this concept and cu

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Publication Date
Sun Oct 01 2023
Journal Name
History Of Medicine
Study of the quality of attach algae to the concrete supports of some bridges within Baghdad city
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A study of taxonomic quality of algae attaching Three concert bridges built on the Tigris River within city of Baghdad including Al-Jadriyah Bridge in Al-Jadriyah area and the Bab Al-Mu'adam Bridge in Al-Shalajiya area, while the third site included Al-Muthanna Bridge in north of Baghdad city, for the period from Autumn 2021 and Winter 2022. The study identified 114 species of 32 Genus in which the predominance of Bacillariophceae (74 species, 14 Genus) Followed by Cyanophyceae (30species, 12 Genus) and 10 species (6 Genus) of Chlorophyceae. The study showed an increase in species of Bacillariophceae, Cyanophyceae which has the ability to secretion gelatinous substances that enable it to stick to solid stand, the number of the larges

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Concept Maps in Academic Achievement among Family Education Students in the Subject of the Art of Elegance and Fashion
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Abstract

The current research aims to identify the effectiveness of concept maps in the academic achievement of the art of elegance and fashion for third vocational students. The current research is a quasi-experimental one. The research sample consisted of (74) female students in Al-Saydiyah secondary school for girls, they were divided into two groups: the experimental group and the control group. The following hypothesis was developed: There are no statistically significant differences at the level (0.05) between the average scores of the students who studied the subject using concept maps and the average scores of the students who studied the subject in the traditional method in the post-achievement test. The

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Publication Date
Sun Jan 04 2015
Journal Name
Journal Of Educational And Psychological Researches
Effectiveness of the self-questioning strategy in the achievement of the third stage Institutes of teacher preparation and decision - making in Chemistry
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This research aims to find out "the effectiveness of the self-questioning strategy in the achievement of students Phase III institutes of teacher preparation and decision-making in chemistry." The researcher follows approach quasi-experimental with a post-test, and the sample consisted of (27) from " Teachers Training Institute-AL-Byaa "in Directorate of Education Baghdad Karkh / 2 students divided into two unequal groups: experimental its number (14) students studied using reciprocal teaching strategy and control its number (13) students have studied in the usual way.The two groups were equivalent extraneous variables.

The researcher was prepare achievement test consist of 40 items was the adoption of a measure of decision-makin

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