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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
Sun Nov 23 2025
Journal Name
College Of Basic Education Researches Journal
Identify the effect of exercise of the arm is the practice in the development of accurate performance skill transmission (short and long) arm of practice for students badminton
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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The use of standard rates in the test of the financial stability for the banking sector in Iraq For the period 2009-2013
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ABSTRACT

The research focuses on the key issue concerning the use of the best ways to test the financial stability in the banking sector, considering that financial stability cannot be achieved unless  the financial sector in general and the banking sector  in particular are able to perform its key role in addressing the economic and social development requirements, under the laws and regulations that control  banking sector , as the only way that increases its ability to deal with any risks or negative effects experienced by banks and other financial institutions. The research goal is  to evaluate the stability of the banking system in Iraq, through the use of a set of econometrics an

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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of Planner And Development
Spatial analysis of rural services in the district of Fallujah, Zgharit village, as a model
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          The study of services in villages is one of the imperative matters that must   be focused on, because it leads to increased attention, which reduces the differences between the countryside and the urban. The extent of its.

  It is well known that community services need to be reached by a person, unlike the anchor services that reach people, here the population distribution plays an important and prominent role in signing these services, so the dispersed distribution pattern and the gathering pattern appeared in the distribution, thus an effect on the time and distance that the person walked to obtain The services are community-based. Therefore

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the competitiveness for commercial banks in Iraq for a period of 2004 – 2012
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This study was conducted on a sample of commercial banks in Iraq, chosen according number of considerations for twenty banks, contained two public banks and eighteen private banks.                                                                                             &

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Publication Date
Tue Aug 01 2023
Journal Name
Journal Of Engineering
The Role of Project Health Check Reports in Identifying Indicative Factors of a Troubled Project
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Government-sponsored projects in Iraq significantly improve the economic situation and provide services but face high rates of troubling blocks. This work aims to identify indicative factors of the Troubled Project using periodic health check reports based on a literature review and interviews with Iraqi experts. As a result, a questionnaire was prepared that included four sections. The first is personal information; the second section is information about knowing the level of institutions’ implementation of project management through prepared documents. The third section is about indicative factors for the project's trouble, including 25 workers; the fourth section is about the questions in the periodic reports to che

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Publication Date
Sun Dec 30 2007
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Effect of Feed Concentration on the Production of Pregelatinized Starch in a Double Drum Dryer
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Double drum dryer is operated for producing pregelatinized maize starches using feed starch slurries of different
solids(7, 10 and13 g/100 g )content . Steam pressure (2,3,and 4 bar), the level of pool between the drums (4,7,and 10
cm) , and speed of drums rotation (3,4,and 6 rpm) are varied together with the feed solids content in a practical range of
values. The response of the dryer is registered by measuring several output variables, i.e. external drum temperature,
product moisture content, mass flow rate.

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Publication Date
Mon Dec 31 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
ELEMENTS OF MARKETING MIX AND THEIR ROLE IN CONSUMER PERCEPTION OF BRAND IMAGE: A SURVEY OF SAMPLE OPINIONS FROM CONSUMERS OF ENIEM BRAND IN THE ALGERIAN MARKET.: ELEMENTS OF MARKETING MIX AND THEIR ROLE IN CONSUMER PERCEPTION OF BRAND IMAGE: A SURVEY OF SAMPLE OPINIONS FROM CONSUMERS OF ENIEM BRAND IN THE ALGERIAN MARKET.
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The current research aimed to analyze the importance, correlation and the effect of independent variables represented by marketing variables on the dependent variable represented by local brand, through taking ENIEM as a model for this study, which represents a sensitive sector for the Algerian consumer. The results of the study evinced that the Algerian consumer has a positive image toward the brand ENIEM given marketing variables which has acquired considerable importance to this consumer. Also, the results of this study showed a statistically significant correlation between marketing variables and good perception toward the brand ENIEM, at the same time, the existence of a statistically significant effect for each of these variables o

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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
Measuring and analysis of the impact of public budget deficit on external debt in lraq with in the framework of joint integration of the period (1990 – 2016 )
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The concept of deficit in public budget becomes a chronic economic phenomenon in most of the world, whether the advanced countries or developing countries. Despite  the difference in the visions of the economic schools to accept or reject the deficit in public budget but the opinion that prevailed is the necessity of the state to reduce the public spending which led to a continuous deficits in the public budget which consequently increased the government borrowing ,increase income taxes and wealth, consequently this weakened the in motivation in private investment which contributed to the increase of in factionary stagnation , so that governments have to cover the lack of local funding sources which become difficult to be eq

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Evaluating the Distance Learning Experience in light of the Spread of the Corona Pandemic - Covid 19 from the Teachers' Point of View in Islamic Science Institutes in the Sultanate of Oman
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The study aimed to evaluate the distance learning experience in light of the spread of the Corona pandemic - Covid19 - from the teachers' point of view in Islamic Science Institutes in the Sultanate of Oman, which was applied during the second semester of the 2019/2020 academic year. The study sample consisted of (77) teachers from The Islamic Science Institutes of The Sultan Qaboos Higher Center for Culture and Science. The researchers prepared a questionnaire to evaluate the reality of the experience. The study results  revealed, the followings: The Department of Educational Affairs and Training at The Sultan Qaboos Higher Center for Culture and Science was able to a moderate degree in the rapid transition to a distance learning s

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Publication Date
Sun Dec 06 2015
Journal Name
Baghdad Science Journal
Find the concentration of radon gas emitted naturally from the bones and skin of some kinds of birds and local and imported chicken available in the City of Baghdad
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In the present research we the study the deposition of radioactive elements naturally and particularly radioactive radon gas in parts of the body of organisms which are of direct relevance to human life in the city of Baghdad as the samples which were collected from the bones and skin of some kinds of birds and chicken based on the principle that radioactive elements are concentrated always on the bones. We use of this as the exercise detector impact nuclear (CR-39), using the technology Cylindrical diffusion , the results indicated that the largest concentration of radon found in the bone bird Seagull tapered as it was (625 ± 37) Bq.cm-3, and less concentration of radon gas in the chicken bones of Al-kafeel as it was (105 ± 10) Bq.c

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