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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 Jan 15 2021
Journal Name
Palarch's Journal Of Archaeology Of Egypt/egyptology
Belief and practice in the teaching of pronunciation in the Iraqi EFL context
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IH Abdul-Abbas, QJ Rashid, M RasimYounus, PalArch's Journal of Archaeology of Egypt/Egyptology, 2021 - Cited by 9

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Publication Date
Thu Jun 01 2023
Journal Name
جعفر الصادق
The Role of Criminal Policy in Iraq in Protecting and Improving the Environment
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Publication Date
Thu May 01 2025
Journal Name
Dirasat: Human And Social Sciences
The Role of Russian Writers and Intellectuals in the 1905 Revolution in Russia
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Objectives: The main objective of this study is to examine the crucial role that Russian writers and intellectuals played in catalyzing the 1905 Revolution in Russia. Specifically, the study sought to analyze how their literary works, philosophical ideas, and political writings challenged Tsarist autocracy, depicted the suffering of the masses, and inspired opposition movements. The study aimed to highlight the defiant writings that contributed to the rise of political figures and the eventual overthrow of the repressive regime. Methods: The historical narrative and analytical methods were employed, conducting a comparative analysis of prominent works by renowned authors such as Tolstoy, Gorky, and Chekhov. This analysis focused on

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The role of the learning organization in the behavior of the work teams \ exploratory research in the Rasheed Bank
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This research aims to examine the relationship between learning organization and behavior of work teams. The variable of the learning organization took four dimensions depending on the study (sudhartna & Li, 2004): Common cultural values ​​, communication, knowledge transfer and the characteristics of workers. The behavior of teams was identified on the basis of realizing of the respondents of their organization to work as a team where the research relied concepts applied in the study (Hakim , 2005) , and chose to research the case of a service organization for the study and relied on four dimensions of coordination , cooperation , sharing of information , the performance of the team, and was a curriculum approach and des

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Publication Date
Thu Feb 09 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of A cognitive Behavioral Counseling Program in Enhancing Self-Management in Reducing the Academic Procrastination of Tenth grade male Students
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This study aims to find out the effectiveness of a cognitive-behavioral counseling program in enhancing self-management in reducing the academic procrastination of tenth-grade male students. The sample consisted of (26) male students divided into an experimental group of (13) students and a control group of (13) students. Two scales of self-management and academic procrastination were used, prepared by the researcher. The counseling program was prepared by the researcher. The results showed the program's effectiveness in enhancing self-management and reducing academic procrastination in the posttest, as it showed the continuation of this enhancement in self-management and the increase in the reduction of procrastination in the follow-up

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Relationship and impact of the Analysis and evaluation jobs with employees performance : Survey study
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        The aim the research that definition on the impact a lot of Analysis and evaluation jobs impact in support the employees performance the property that are Analysis and evaluation jobs is one of the jobs however of the human resource management on organization and the impact footpace big on the chractericties and performance of the people and the impact that success of the organization , And here problem stool of the research in the omission the role for the Analysis and evaluation jobs impact in support the employees performance from the upward management in the organization , Polls were adopted as tools for obtaining data and the Depart

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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi Journal Of Physics
Preparation and study the structure of pure and impure barium titanate with Mg2+ ion
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Pure and doped barium titanate with Mg2+ ion at two molar ratios x= (5%, 10%) mol. has been synthesized by solid state reaction technique. The powders sintered at two temperatures (1000 °C and 1400 °C). An XRD technique was used in order to study the crystal structure of pure and doped barium titanate, which confirmed the formation of the tetragonal phase of BaTiO3, and then calculate the lattice parameters of pure and doped barium titanate, the addition of magnesium ion Mg2+ can lead to decreases lattice parameters.

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Publication Date
Tue Sep 11 2018
Journal Name
Iraqi Journal Of Physics
Preparation and study the structure of pure and impure barium titanate with Mg2+ ion
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Pure and doped barium titanate with Mg2+ ion at two molar ratios x= (5%, 10%) mol. has been synthesized by solid state reaction technique. The powders sintered at two temperatures (1000 °C and 1400 °C). An XRD technique was used in order to study the crystal structure of pure and doped barium titanate, which confirmed the formation of the tetragonal phase of BaTiO3, and then calculate the lattice parameters of pure and doped barium titanate, the addition of magnesium ion Mg2+ can lead to decreases lattice parameters.

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Impact of climatic fluctuations in the production of citrus in the province of Karbala
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The relationship between the elements of the climate and the productivity of citrus (kg
/ tree) in the province of Karbala has been determined through the use of simple correlation
coefficient of Pearson (rp) and (t) test. The result for each of oranges, limes and tangerine had
all shown moral and relevant statistical indications; except for relative humidity, which were
not linked to a moral relationship with productivity of tangerine, oranges and limes.As for the
relationship between climatic factors and yield of bitter orange were all not significant
statistically and very weak.
In order to determine the strength of the correlation between fluctuations in the
climatic elements and fluctuations in the productivi

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Publication Date
Wed Jun 03 2020
Journal Name
Political Sciences Journal
The world'srefugeesbetween the aggravation of the situation and the endeavors of international organizations
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Human witnessed over the centuries many of the important issues faced by the international community was centered on human rights in general and the persecution of refugees, especially according to many forms may be directly or indirectly leaves behind economic crises, social and humanitarian push world countries to rethink the mechanisms and the feasibility of developing agreements and laws and the role of international and regional organizations to protect peoplerefugeestatus.

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