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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
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
The Impact of the Strategy of Cooperative Integration of Fragmented Information in the Acquisition of Physical Concepts and Science Processes among Fourth Scientific Students
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The current research aims to reveal the impact of the strategy of cooperative integration of fragmented information in the acquisition of physical concepts and science processes among fourth scientific students through the null hypotheses:

1- There is no statistically significant difference at the level of significance (0.05) between the average grades of female students of the experimental group studying physics according to the strategy of cooperative integration of fragmented information and those who follow the traditional method in the test of acquiring physical concepts.

2-There is no statistically significant difference at the level of indication (0.05) between the average grades of female students of the experimen

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Publication Date
Sun Nov 23 2025
Journal Name
Enterpreneurship Journal For Finance And Business
The role of psychological ownerships&#39; dimensions in deterring the effects of toxic leadership: Analytical research in some companies at the Ministry of Industry and Minerals in Iraq
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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Physics: Conference Series
Measurement the Concentrations of Radon and Thoron and Their Progeny in the Air Samples of Al-Haswaa City in Babylon province
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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Educational And Psychological Researches
Anxiety of death among pregnant women in the light of some Demographic variables Governorates Bethlehem and Tulkarm as a model
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This study aims to identify the anxiety pregnant women have of dying, in the light of some Demographic variables in Bethlehem (age, residence, and the mother's job). The descriptive method was used in this study. To achieve the study purposes, the researchers developed a questionnaire as a tool of study, which consisted of (19) paragraphs ,after been verified of its validity & stability.

The researchers distributed questionnaires, and then analyzed them. Results illustrated that the levels of anxiety pregnant women in Bethlehem had of dying was average,  with a mean total score of (3.11),  and with a standard deviation that had the total score of (0.476). Results also illustrated statistical differences in the pregn

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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
The designed housing projects as an alternative for the informal building and their impact in addressing the heterogeneity of the urban escape in the built residential areas
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The phenomenon of informal building Spread recently in Iraqi residential areas, in general, and in Baghdad, in particular, due to the urgent housing need, on the one hand, and lack of commitment to building controls, on the other hand, to highlight the phenomenon of uncommitted building to controls and housing governing legislation in Iraq, leading to heterogeneity in both building densities and plot areas, and disorder in the urban fabric and urban escape of those areas. Research problem identified as the absence of a clear vision about the General aspects of the phenomenon of informal building in residential street scene, and the role of designed housing projects as a substitute for informal building in built residential areas. The des

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Publication Date
Thu Dec 13 2018
Journal Name
Al-adab Journal
A Victim of "Love": A Study of Beatrice’s Character in "Rappaccini's Daughter" By Nathanial Hawthorne
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Nathaniel Hawthorne (1804-1864) has been widely known for his special interest in the female characters. In many of his novels, he narrates the conditions, values, and the institutions that surround and control the life of women, leading them to be victims. In “Rappaccini’s Daughter” (1844), the heroine, Beatrice is created to be victimized by her loved ones (her father and lover). This paper focuses on the term “victim,” it shows its aspects through the development of Beatrice’s character. The paper also studies a female character in the male-dominated society, to show the cruelty done to her, and how she is considered to be a second rate person, who is unable to live normally, or at least to save herself from dea

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
(The role of strategices to manage the human resources in enhancement the process of knowledge management : Field Search in the Ministry of Transportation)
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The aims of the research is to know the role of strategic to manage the human resources in enhancement the process of knowledge management in the Ministry of Transportation , In addition to the effects occurred on outcomes for both the managers and practitioners .

For the purpose of achieving the objectives of the research , the researchers designed a questionnaire that included (40 Points for collecting the primary data from the sample of the research which contained (51) indiviluals. In light of that, the data was to collect and analyzed and hypotheses were tested by using the (SPSS) Program, and a number of statistical techniques was used to attain the goal of the research such as the means ,  Sta

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Publication Date
Sun Nov 23 2025
Journal Name
Journal Of Babylon Center For Humanities Studies
Reflection of Zionism in the literature of the Jews of Iraq ... Read in the novel &quot;The Dove Flyer&quot; by Elie Amir
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The upbringing of Yehuda Amichai and the conditions he lived in had a great influence on his deep sense of pain, which made him think of death and suicide. Especially after the Nazis came to power in Germany, and his emigration with his family. Amichai searched for love throughout his life, and his failure was one of the most important factors affecting his psyche, which is A deep influence that made him live in harsh and painful pains that broke him, and prevented her from achieving his ambitions in life.Dramatic texts are characterized by repetition in writing and presentation. It is a textual discourse that has two advantages, first, that it can be read as a literary text like all other literary texts, and second, that it can be consider

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Arts Faculty Of Baghdad University
The Discourse of Christian Minority in Saad Hana's Novel "Abducted in Iraq": A Critical Perspective.
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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
Search for Identity in Michael Ondaatje's Post colonial Novel In the Skin of a Lion
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In his post colonial novel, In the Skin of a lion, the Canadian/Sri Lankan writer,
Michael Ondaatje is so interested in the term "Post colonialism" because he wants to show
that the term doesn't only refer to a period of time that comes after colonialism. In other
words, post colonialism is not only referred to as a literal description of formerly colonial
societies. He deals with the termas a literary genre and an academic construct that describes
the global conditions of a man after a period of colonialism. He shows that post colonialism is
a theory that tries to examine and explore the different styles and faces of European authority
to control the colonized. Ondaatje's attempt through such term is to unmask Europ

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