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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
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
the role of time management in facilitate the work requirements for employees of the administrative department at the ministry of higher education and scientific research
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The aim of the present study is to provide the adequate knowledge about the role of time management in facilitate the work requirements for employees of the administrative department at the Ministry of Higher Education and Scientific Research. The research depend on studying four important dimensions which are (time planning, time organization, time direction and time observation). In addition to study other five dimensions which are (new procedures, clear procedures, short procedures, the available information and the simplicity of the methods

used).Questionnaire sheets consist of (38 questions) distributed to (170) employees and (146)  sheets only were considered in the study. SPSS program was used

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Publication Date
Sun Dec 28 2014
Journal Name
Journal Of Physical Education
Setting standards for the quality of the performance scale school Aariyadah from the viewpoint of supervisors (specialists and technicians) in the districts of Baghdad breeding
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To achieve excellence in the quality of performance in school sports administration, which has suffered a lot of problems and constraints on the administrative system, supervision and education level as well as the regulatory environment and available resources available and contribute to the provision of some processors and overcome difficulties to participate in the formation of the individual good of itself and society through sports activities. Hence the importance came this study to create a reference to the quality of the performance criteria school sports from the perspective of supervisors (specialists and technicians) in the districts of breeding Baghdad, to be of help to all those involved in school sports and maintaining an excep

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Publication Date
Tue Jul 13 2021
Journal Name
International Journal Of Interactive Mobile Technologies
The Impact of Teaching by Using STEM Approach in The Development of Creative Thinking and Mathematical Achievement Among the Students of The Fourth Scientific Class
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Publication Date
Thu Dec 02 2021
Journal Name
International Journal Of Interactive Mobile Technologies
The Impact of Teaching by Using STEM Approach in The Development of Creative Thinking and Mathematical Achievement Among the Students of The Fourth Scientific Class.
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The research aims to know the impact of science, technology, engineering, and mathematics education on both creative thinking and mathematical achievement. To achieve it, the two researchers followed the quasi-experimental approach with an experimental design for two groups, one experimental and the other a control. The research sample consisted of (32) female students from the fourth scientific grade in Al-Intisar Preparatory School for Girls/ AlRasafa, First Directorate. The sample was chosen intentionally and was divided into two groups: a control group studying by the traditional method, their number (16), and an experimental group that applied the STEM approach, their number also (16). There was parity between the two research groups i

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The Role of Tabuk University in Intellectual Education for Students in the Light of the Requirements of Enhancing the Intellectual Security
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The study aims to identify the degree of Tabuk University practices to raise the intellectual awareness of students through scientific research, as well as to identify the degree of Tabuk University practicing to raise the intellectual awareness through the educational process (faculty member – activities). The study also seeks to identify the degree of Tabuk University practicing to raise the intellectual awareness of students through community service and university media. The study is descriptive in nature that employed the questionnaire as a tool in collecting data. Total of (540) students were chosen randomly from different colleges at universities of Tabuk to form the study sample. The results showed that faculty member has pract

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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Enhancing the effectiveness of the company in light of the practice of leadership empowerment: Applied research in the National Insurance Company
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The aim of the research is to demonstrate the importance of leadership empowerment in its dimensions (knowledge, participation in decision-making, incentives, trust between the leader and subordinate, delegation of authority and communication) and its impact on enhancing the effectiveness of the company in its dimensions Represented by (achievement of objectives, quality of insurance service, adaptation to work environment and job satisfaction), by adopting the questionnaire as a main tool in collecting data from officials in the National Insurance Company, numbering (56) surveyed in job sites (section manager, division official and unit official) Their answers were analyzed using the SPSS statistical program in calculating the a

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Publication Date
Sun Nov 23 2025
Journal Name
Journal Of Physical Education
The reality of the physical education lesson in the schools of Baghdad governorate from the point of view of the applied students
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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The effect of transformational leadership in the employee’s motivation in the organizations
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The transformational leaderships in all organizations  consider Motivations policies which is one of the main and basic policies adapted by the successful leaderships in all organizations, in order to be able to achieve essential goals, such as enhancing loyalty of employees towards their organizations and also developing and empowering their capacities and abilities in work, leading to development and increasing productivity and reducing production costs to the minimum, then reaching immense profits and benefits, in addition to development of excellence in the market of competition.

The research was performed in the (General Company of Leather Industries/ in Baghdad ,in alkarada) the study reached

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Publication Date
Tue Dec 21 2021
Journal Name
Journal Of Engineering Mathematics
Fluid inflow from a source on the base of a channel
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Publication Date
Tue Feb 01 2022
Journal Name
Current Pharmaceutical Analysis
Analytical Methods for the Identification of Pigments in Tattoo Inks and Some of Their Physiological Side Effects: A Review
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In this review, numerous analytical methods to distinguish pigments in tattoo, paint, and ink items are discussed. The selection of a method was dependent upon the purpose, e.g., quantification or identification of pigments. The introductory part of this review focuses on describing the importance of setting up a pigment-associated safety profile. The formation of different degradation chemical substances as well as impurity trends can be indicated through the chemical investigation of pigments in tattoo products. It is noteworthy that pigment recognition in tattoo inks can work as a preliminary method to identify the pigments in a patient's tattoo before being removed by laser therapy. Contrary to the stud

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