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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 Nov 24 2025
Journal Name
University Of Anbar Sport And Physical Education Sciences
The Impact of the Concept Maps Strategy in the Guided Discovery Method at Learning the Skill of Layup Shooting of Basketball
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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of the Alternative Evaluation Strategy on the Achievement of Fourth-Grade Female Science Students in the Subject of Biology
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Abstract

The aim of the current research is to identify the Effect of the alternative evaluation strategy on the achievement of fourth-grade female students in the subject of biology. The researchers adopted the zero hypothesis to prove the research objectives, which is there is no statistically significant difference at the level (0.05) between the average scores of the experimental group who study according to the alternative evaluation strategy and the average scores of the control group who study in accordance with the traditional method. The researchers selected the experimental partial adjustment design of the experimental and control groups with the post-test. The researchers intentionally selected (Al-fed

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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
The Degree of Availability of the Dimensions of Organizational Immunity Systems t the University of Tabuk in KSA from the Perspectives of Academic Leaders
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This study aims to investigate the academic leaders’ perceptions towards the degree of availability of the dimensions of organizational immunity systems at the University of Tabuk, as well as to reveal the statistically significant differences between the average responses of the study sample members about the degree of availability of these dimensions at their university due to the variables of (gender, leadership position, and college specialization). To achieve the objectives of the study, a descriptive survey method was used. The study population consisted of (200) male and female leaders who were academic leaders at the University of Tabuk. A questionnaire was used as a tool for collecting data, which its validity and reliability

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Publication Date
Thu Mar 10 2022
Journal Name
International Journal Of Early Childhood Special Education
The effect of reciprocal style exercises in developing some physical abilities in learning the performance of female players for the effectiveness of the long jump
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The importance of the research lies in knowing the effect of the exercises of the reciprocal method in developing some physical abilities in learning the performance of the players for the effectiveness of the long jump in an economical manner in terms of time and effort and knowing their positive impact and the extent of their impact in creating the required learning for students, and the research aims to prepare reciprocal style exercises in developing some abilities The researchers used the experimental method in the pre and post test for the experimental and control groups to suit the nature of the research, and the research community was identified for the long jump players, the Specialized School for Talent Care in the 2022 sports sea

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Publication Date
Wed Jan 03 2024
Journal Name
Eximia
The reality of the organizational brilliance of physical Educators in the college of Physical Education and Sports Sciences / University of Baghdad from female students point of view
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Achieving goals effectively reflects the success of the institution. However, unless this indicator is coupled with efficiency when achieving goals, the institution will be equal in its achievements, and distinction will remain unachieved. Perhaps the role of the teaching staff in pushing the institution or college towards brilliance focuses on their ability to motivate people on the one hand and their interest in achieving brilliance for the institution. On the other hand, the importance of the research lies in the institution’s reaching a prominent position through the brilliance and creativity of teaching and achieving competition between institutions that make it more brilliance. The study seeks to achieve the goal of the real

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Governance And Regulation
An empirical study to detect agency problems in listed corporations: The emerging market study
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The aim of this paper is to shed the light on the concepts of agency theory by measuring one of the problems that arise from it, which is represented by earnings management (EM) practices. The research problem is demonstrated by the failure of some Iraqi banks and their subsequent placement under the supervision of the Central Bank of Iraq, which was attributed, in part, to the inadequacy of the agency model in protecting stakeholders in shareholding institutions, as well as EM, pushed professional institutions to adopt the corporate governance model as a method to regulate the problem of accounting information asymmetry between the parties to the agency. We are using the Beneish M-score model and the financial analysis equations in

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
The Study of properties structure and some optical properties forcopper Oxid (CuO) Thin film prepared by thermal evaporation in Vacume
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in this paper copper oxide (cuO thin films were prepared by the method of vacum thermal evaporation a pressure.

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The use of water resources in light of the challenges of water security in Iraq
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Iraq suffers from lack of water resources supply because the headwaters of the rivers located outside its borders and the influence of upstream countries on the quantities of flowing water, in addition to the increase of pressure on available water as a result of population increase and not adopting the principle of rationalization where misuse and wastage and lack of strategic vision to treat and manage water use in accordance with the economic implications fall.  This is reflected fallout on water security and subsequently on national and food security, while the issue of using water resources is development top priority in different countries in the world because of the importance of water effect on the security of indivi

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Publication Date
Thu Jun 29 2017
Journal Name
College Of Islamic Sciences
Balance and moderation in dealing with the oppressor and the oppressed in the Sunnah - "Applied models")
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Research Summary

In The Name of Allah Most Gracious Most Merciful

The word injustice and its derivatives were repeated in the Holy Qur’an in several places, approximately (154) times. This is due to the severity of its danger, and that the most dangerous thing that our Islamic nation suffers from in our time is; It is injustice in all its forms and types, so we should all have an honest review of the sincere change in the right direction, and uncover cases of injustice and explain their causes and causes, and work to treat them and rid the wrongdoers of their injustice, and help them to correct their condition. To reveal their grievances and explain their causes and causes, and work to remedy them, and support them and mi

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Analysis the Expected Profit By the Relation Between the Sustainable growth and Actual growth: Apply Study for Iraq Stock Exchange
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The research aims to analysis the future profits of companies listed on the Iraq Stock Exchange through analyzing the relationship between Actual Growth and Sustainable Growth, The study was applied to the sample of companies included in the Iraq Stock Exchange for the period (2010- 2014), The Internal Growth Rate has been used as a measure for the Actual Return Rate but the Sustainable Growth Rate has been measured under the Rose model, The research showed group of conclusions, the most important are:1. From the analysis of sustainable growth for the banks sample and the variables involved in its measure shows that investment in the investors amounts have achieved a significant return, which demonstrates the company's efficiency at gene

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