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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
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The economic importance of nanotechnology
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Abstract

Toady technology Nano since it launched human Alivia third interest and anticipation unusual and that by the decision-makers in the world's governments and its institutions and research departments productivity, especially after the US Congress enact a law (the National Initiative for Tknlojba nanotechnology in the United States of America) and the allocation of large sums of money To support this initiative, the research aims to shed light on the concept of technology nanotechnology, which is technology atheist and the twentieth century, and reflect its economic importance and in order to reach the objectives of the research has been the division of research into several axes has been allocated

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Publication Date
Mon Mar 15 2021
Journal Name
Al-academy
Aesthetic Levels in Shape Variables in Spectacular Films the Indian Film (Main Tera Hero) a Model: غسان محسن حمد
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The spectacular film is a type of feature films which has specific elements that contribute in increasing the aesthetics of the shape in its structure. The researcher started studying this type of films by researching the spectacular film concept, the history of its development, who are its most important stars and then tackling the Indian cinema represented by Bollywood, which is considered a school for this type of film. The researcher addressed the most important influential elements that entre in its production as well as studying these elements that contribute to building the shape including the configuration, movements of cameras, lenses, the lighting, colors, costumes etc. and what influence they have in forming a special aestheti

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Publication Date
Wed Mar 01 2023
Journal Name
Human Gene
The deubiquitylase-ubiquitin-specific protease 4 absence in HeLa cells leads to a reduction in Semliki Forest virus replication
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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
The passive As a grammatical phenomenon in four selected textbooks: Das Passiv Als grammatisches Phӓnomen in vier ausgewӓhlten Lehrwerken
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The research work is "The passive voice as a grammatical phenomenon in four selected textbooks". The research deals with the grammatical phenomenon passive in German. The research consists of two parts, the theoretical and the empirical part. The present research work is divided into 3 sections:

The first section includes the definition of passive, passive types, process passive, state passive, passive with modal verbs, and other types of passive. The second section provides illustrations of the four selected textbooks. The third chapter presents the passive voice in textbooks, namely German language teaching for foreigners by Dora Schulz and Heinz Griesbach, Delfin von Aufderstrasse H. and others, Em von Balme, M. and others and

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Publication Date
Wed May 17 2023
Journal Name
College Of Islamic Sciences
Despondency in the Qur'an
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the door of interpretation cannot be closed; Because the Qur’an is a living message, until the Day of Judgment, and Muslims continue to come to it, study it, stir it up, move with it, and live in its shadows until the Day of Judgment.
In anticipation of the blessing of revelation and the lights of revelation, and in pursuit of the service of the Book of God, I decided to choose the subject of my research:

Despondency in the Qur’an an objective study

As the study of one of the topics of the Qur’an on the foundations and steps of objective interpretation makes the reader stand on the Qur’an’s method in dealing with various problems and topics.

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Extravagant in the Koran
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This research deals with a disease of the diseases our Muslim society, which works in the
body operate deadly epidemics in the bodies and of bodies, but it is extravagant; has spread
and rampant in our uncle everything which threatens significant damage in this life and the
afterlife, as well as that it shows that Alasirafla limited to extravagant in wasting money and
with this blessing should not have, and not be used as created him .
Excessive linked to all aspects of life, physical and moral it has many pictures and various
forms, came at the forefront of research and five sections:
The first topic: the meaning of truth and extravagant.
The second topic: Photos extravagant reprehensible contained in the Koran.<

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Publication Date
Fri Jan 01 2021
Journal Name
Annals Of Parasitology
The role of intestinal protozoa in chronic obstructive pulmonary disease exacerbation
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chronic obstructive pulmonary disease (COPD) is a common respiratory disease with episodes of exacerbation. Variable factors including infectious pathogen can predispose for this exacerbation. The aim of this study is to evaluate the role of intestinal protozoa in COPD exacerbation. A total of 56 patients with COPD were included in this study. Patients were categorized into two groups based on the frequency of exacerbation during the last 6 months: those with ≤1 exacerbation (32 patients) and those with ≥2 exacerbations (24 patients). Stool specimens from each patient were collected two times (one week interval) examined for intestinal parasite. In univariate analysis, rural residence and parasitic infection were more common among patie

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Scopus
Publication Date
Mon Nov 10 2025
Journal Name
Al–bahith Al–a'alami
SPECIALIZED JOURNALISM IN IRAQ : (After The Events of 09-04-2003)
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The specialized Journalism plays an important role in our daily lives using all of its different ways, including news, caricature, commentary and dialogue. The specialized Journalism deserves vigilance and interest for it is caring about having a new media system. It is meant by “specialization”, first: identifying the areas of work in which the person concerned possesses great knowledge in the specialty resulting from a long experience, it also means being able to continuously develop required skills in that specialty. The specialization is not only a feature of the press, but also a feature of human development; thousands of years ago, the primitive society consisted of people from different specializations: fishermen, farmers, her

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Publication Date
Thu Apr 01 2021
Journal Name
Iop Conference Series: Materials Science And Engineering
Evaluating the Efficiency of some Wastewater Treatment Plants in Najaf Governorate
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Abstract<p>Although there are many wastewater treatment plants, we still suffer from many problems resulting from a lack of experience or technical operating problems. In this research, the service’s efficiency is evaluated according to the design laws required for small factories in the province of Najaf, which works with filtering technology through point filtration, the old project in the Al-Baraka plant, and the second works. Within the biological treatment mbbr + activated sludge, which is a biomass technology where samples were taken from both plants and annual values of the pollutant rate after treatment in the old Al-Baraka plant project COD 64 mg/L and the demand for biochemical oxyge</p> ... Show More
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Publication Date
Sat Feb 12 2022
Journal Name
Engineering, Technology &amp; Applied Science Research
Investigating the Causes of Poor Cost Control in Iraqi Construction Projects
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Controlling cost in construction projects is an essential issue. This study investigates the most critical problems that cause weakness in cost control in Iraqi construction projects. The quantitative technique was used by conducting a survey directed to professionals who work on construction projects. One hundred and sixty-four questionnaire forms were distributed to private sector companies, government companies, and government institutions, and the responses were subjected to the required statistical analysis. The results indicate that the most influential factors are the weakness in keeping up with the use of modern concepts, methods, and technologies, the delay in receiving the amounts due for work done from the owner, fluctuat

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