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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
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
Polygamy in light of societal changes in Iraq (A Field Study in Baghdad)
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The polygamy as a social was known before Islam, has kept Islam on this system after it organized and put his controls and conditions, as justice between wives and the ability to alimony, it was not the purpose of satisfying the instinct of man and enjoyment, but his goal nominal than that, because it addresses problems humanity has goals noble, so the pluralism overlap of the fabric of families belonging to governance and benefits for women and men and society, which leads to increased ties of love between people of the same society and thus increases the cohesion and importance of the topic and its association with financial conditions have emerged as needed so you viewed in the second scientific Conference of the Department social Ser

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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
The Degree of Using Computers in Administrative Jobs and the Obstacles of Usage in Public Education Schools in Sharoorah Governorate: Saudi Arabia
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This study aimed to identify the degree of use computers in administrative functions (planning, organization, controlling, and evaluation) among school leaders and assistants in public education schools in Sharoorah governorate ، as well as to identify obstacles of  use computers in administrative functions from the perspective of school leaders and assistants male and female in public schools during the academic year 1439-1440, the study sample  (66) school leaders and assistants, males (58), a and females (44), , and to answer the questions of the study, the researchers developed a questionnaire consisting of  (60) items, has been verified sincerity and persistence, and data analysis was used frequencies, percentages an

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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Affect of learning the bag in the acquisition of historical concepts for students in the fifth grade literary history
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The  adopted method in the teaching of history is conservation and indoctrination in all grades, and this will lead to a lack of students interact with teachers in the course of the lesson, and poor use of teachers to questions that raise students' thinking during the lesson, which leads to a lack of interest in the topic of the lesson and wasting opportunities contribution making it the teacher at the center of the educational process, and to provide arrogating the researcher to contribute to teaching style with the belief that the use of this method of teaching could lead to overcome the difficulties and problems faced by the teaching material.

And there are educational complexes integrated approac

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Publication Date
Sun Apr 07 2013
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Clare's Plan on Female Students' Achievement in the History Subject in the Institute of Teachers' Preparation
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Teaching through the system of personal learning, known as (Clare's plan) is amongst the most prominent plans which depend on self-education, as it received worldwide recognition. The plan lets the learner achieve learning by depending on himself after being familiar with the educational goals given to him, then he starts to solve the exercises and the drills accompanying the unit. After that, he checks his achievement by answering the self-evaluation tests. This method offers more opportunities for personal interaction than do the traditional systems, and individual leaning is a methodical expression aims at taking care of the learner and making him the locus of the processes of teaching and learning.

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Publication Date
Sun Oct 19 2025
Journal Name
Lecture Notes In Networks And Systems
The Role of Artificial Intelligence in Studying the Impact of Contemporary Revolutions on Political Systems in the Middle East
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In this study, we tackle the understudied area of Artificial Intelligence (AI) and its role in examining how modern revolutions may affect political systems across the Middle Eastern region. despite hundreds of studies documenting Middle Eastern uprisings over the past three decades, there has been little effort to harness AI to better understand or predict these multifaceted events. This study seeks to address this gap by assessing the performance of AI-intelligence in analyzing (broadly) revolutionary processes and their effects on regional political systems. The research uses a mixedmethod methodology that involves a systematic literature review of contemporary scholarly articles, and an analytics study using AI tools. Our results show t

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Publication Date
Sat Jan 01 2022
Journal Name
Specialusis Ugdymas
The Effect of the Idea Filtering Strategy in Second Grade Middle School Female Students for the Subject of Science in their productive habits of the mind
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RHS Nasser, NHY Al-Afoun, SPECIALUSIS UGDYMAS, 2022

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of international auditing standard (320) of materiality in defining the analytical procedures of the auditor: Applied research in the Iraqi company for seed production
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The study seeks to clarify the role of International Auditing Standard No. (320) of the relative importance in determining responsibility for planning and implementing the process of auditing financial statements and expressing neutral technical opinion through the analytical procedures of the auditor, whose responsibility is to obtain appropriate and reliable audit evidence that helps the auditor to form a general conclusion about whether The financial statements were consistent with the auditor's understanding of the entity. The relative importance contributes to defining the important accounts that help to set priorities for the auditor to set the necessary analytical procedures for these accounts. One of the most important co

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Publication Date
Mon Feb 13 2023
Journal Name
Journal Of Educational And Psychological Researches
Evaluation of Activities and Evaluation Questions Implied in the Content of the Computer Textbook for the Fifth Preparatory Grade According to Creative Thinking and Developing Suggestions
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The current research aims to evaluate the activities and evaluation questions implied in the content of the computer textbook for the fifth preparatory grade according to the creative thinking and developing suggestions through answering the following question: what is the percentage of creative thinking skills in the content of the computer textbook for the fifth Preparatory grade students issued by the Iraqi Ministry of Education/ Directorate General of the curriculum in the academic year (2019-2020)? The researchers followed the descriptive-analytical approach.  The research community was determined by the content of the computer textbook for the fifth preparatory grade. As for the research sample, it was limited to all activitie

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Publication Date
Wed May 05 2021
Journal Name
Mustansiriyah Journal Of Sports Science
The Effect of Parachute Exercises and Cloud Pockets in the Water Ocean on Some Special Physical Abilities and the Achievement of 50-Meter Swimming for Youth
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ولاء طارق حميد, Mustansiriyah Journal of Sports Science, 2021

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Publication Date
Thu Oct 01 2015
Journal Name
Al-academy
When Krochh aesthetic implications and their impact in raising the artistic and aesthetic taste among the students of the Department of Art Education: صلاح رهيف أمير
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The goal of current research to:1 - Know when aesthetic implications (Korchh)2 - To form the structure of systemic indicators and results that reflect the visions of intellectual, philosophical and aesthetic art for this study.The theoretical framework for the study of the search for the meaning of beauty, definition ( Krochh) being a philosopher, his views, his own aesthetic philosophy, knowledge, art and beauty, as well as a subject of artistic and aesthetic taste and Study in Art Education.The goals have been achieved during the search of Investigation theoretical framework for the search, which tried (INT) to form a clear vision check the second goal by the indicators reached.In light of this, the researcher recommended the need for

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