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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
Wed Dec 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of salary Domiciliation in the rate of return on assets (ROA): Applied research of a sample of Iraqi banks
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Abstract

The research attempted to find an explanation and solution to a problem related to the fluctuation and decrease In the rate of return on assets for the research sample banks during the duration of the research, The search started from the hypothesis that, The effect of salary Domiciliation on the banking profitability of a sample of Iraqi banks participating in the salary settlement system for the period (2016-2019),The research used the descriptive historical approach, the quantitative analytical approach and the statistical approach. The research reached a set of conclusions, the most important of which is The effect of salary Domiciliation on banking profitability was achieved in three banks

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Publication Date
Mon May 25 2026
Journal Name
Journal Of Physical Education
The Effect Of Absolute Strength Training On Knee Injuries Rehabilitation And Special Strength In Muay Thai Fighters
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Publication Date
Sun May 08 2011
Journal Name
Journal Of Planner And Development
the best way to deal with the center of the ancient city of Najaf
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The historic cities in the Arab and Islamic world (including the cities of the holy shrines in Iraq) suffer from many and varied problems and most notably it is clear in its origin functional structure. It had been transformed from a basic place to live for a few thousand of the population to the center or part of the main center of large city populations of more than one million. Functional structure of the ancient city have been change with the beginning of the twentieth century and accelerated rate of change in the second half of the last century. The research aims to analyze the problems of the historic centers of holy cities and analyze the methods of dealing with these problems, leading to discrimination method could be the

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Publication Date
Sun Jul 20 2025
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Study and Investigation of the Charge Transfer Rate Production in N3-Senstized Dye Contact with ZnS Semiconductor System
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In this work, the rate of charge transfer (CT) reaction at the N3-ZnS interface was calculated using a quantitative computational model to evaluate the efficiency of N3-ZnS heterojunction dye-sensitized solar cell devices using different types of solvents. This work discussed the influence of the effective driving energy force on the charge transport rate and performance of N3-ZnS devices with various solvents based on a donor-acceptor model. A solar cell model was used to study the optical efficiency when changing some of its parameters, such as the type of material and the thickness of the film, as they are important factors influencing the quality of the solar cell. It was found that the transition energy varies with different so

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Publication Date
Mon Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
Fabrication and Characterization of Tri Metal Oxides by Chemical Spray Pyrolysis Technique as a Gas Sensor
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In this research tri metal oxides were fabricated by simple chemical spray pyrolysis technique from (Sn(NO3)2.20 H2O, Zn(NO3)2.6 H2O, Cd(NO3)2.4 H2O) salts at concentration 0.1M with mixing weight ratio 50:50 were fabricated on silicon substrate n-type (111). (with & without the presence of grooves by the following diemensions (20μm width, 7.5μm depth) with thickness was about ( 0.1 ±0.05 µm) using water soluble as precursors at a substrate temperature 550 ºC±5, with spray distance (15 cm) and their gas sensing properties toward H2S gas at different concentrations (10,50,100,500 ppmv) in air were investigated at room te

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Publication Date
Tue Mar 30 2021
Journal Name
College Of Islamic Sciences
Taking Over The Judiciary By Women And The Position Of Law From That: مثالا
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لمقدمة

     الحمد لله رب العالمين والصلاة والسلام على سيد الأنبياء والمرسلين نبينا محمد صلى الله عليه وسلم وعلى  واصحابه أجمعين  ومن تبعهم وأهتدى بهداهم الى يوم الدين اما بعد :

        فوظيفة القضاء وظيفة سامية يراد منها اقامة العدل ولا يستقيم حالهم الا به دفعاّ للظلم ، ولقد اولى النبي صلى الله عليه وآله وسلم ومن بعده الخلفاء الراشدون

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Publication Date
Mon Dec 20 2021
Journal Name
لارك
The Theme of the Family in Russian Literature during the "Thaw" on the Material the story of M. Sholokhov "The Fate of a Man"and the story of V. Panova "Seryozha" and F. Abramov "Fatherless".
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The article approaches the characteristics of Russian literature in the time of Khrushchev or the "thaw" period a very short period of Soviet history, characterized by the easing of the dictatorship of power and relaxation in various areas of people's lives. The interest in the research is focused on the importance of interpreting the family portrait in a short but distinct period in the development of Russian/Soviet literature. The research material is the story of Sholokhov's “The Fate of Man” 1956, the story of Panova “Serioga” 1955, and Abramov’s story “Fatherless” 1961. В статье рассматриваются особенности художественной литературы периода хруще

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
“The Theme of Deliberate Contrasting Coincidence in Beckett's "All That Fall"”
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In most of Beckett’s plays , there are prominent elements of absurdity that are landmarks of his style and the way of his writing like : the physical and the spiritual decay of characters, the disintegration of language as it becomes no longer a means of human communication because there is an inability to establish any kind of mental contact among them. These elements are quite apparent in Beckett’s “All That Fall”. The play exhibits a list of  conflicts: one is between powerful forces as that between the force of life represented by Maddy and the forces of death represented by Dan .The second is  the conflict and contempt between the old generation and the new one in the case of Dan’s desire to kill the boy fetching

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Attitude of the University of Baghdad Students towards the Mixed and Single-Sex Learning
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The study aims at finding out:
1. The students' attitude towards the mixed learning at the university.
2. The statistically significant differences in attitude towards the mixed learning at the university according to the specialization variable.
3. The statistically significant differences in attitude towards the mixed learning at the university according to the gender variable.
The researcher has constructed a scale for measuring the students' attitude towards the mixed learning at the university.
After assuring its validity and reliability, the scale has been given to a sample of (100) students. The sample is selected randomly from (4) colleges of the university of Baghdad, (2) for scientific specialization and (2)for h

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Publication Date
Wed Jan 20 2010
Journal Name
Mustansiria Dental Journal
Traumatic dental injuries of the permanent incisors and its relation to malocclusion in patients attending the pedodontic clinic in College of Dentistry, Baghdad University
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