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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 Sep 30 2023
Journal Name
Journal Of The College Of Education For Women
Topic Management in Selected Dementia Patients' Speeches: A Clinical Discourse Analysis Study
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Topic management is the awareness of how speakers deal with initiating, developing, changing, and ending a topic and how they fix the relationship when a misunderstanding occurs. It is such an important unit of conversation as it includes the transition from one strategy to the other to be accomplished in a systematic and orderly manner. These strategies are impaired in dementia patients thus lead to communication breakdown. This study aims at detecting the dementia patients' topic management strategies in selected speeches and answering the questions of which of these strategies are fully or partially detected in these speeches. The researchers use a qualitative method to examine the speeches of those patients and they adopt an eclectic

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of The College Of Education For Women
Identity in Sonia Sanchez's Poem "right on: white america" :A Stylistic Study
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Language is an important means through which one can construct one's social world. Accordingly, the way we view ourselves and the world is basically formed by language use whereby identities, relations, and values are constructed and maintained. Most discourse analysts consider narrative not only the locus of construction and enactment of identity, but also a distinguished genre for its analysis.The present study is concerned with how identity can poetically be informed, hence exploring the way black poets use language when reflecting their identity and culture. The poem, right on: white america by the black American poetess Sonia Sanchez, is chosen to be analyzed based on Simpson's stylistic model (2004). In this model, the ana

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Publication Date
Tue Mar 01 2016
Journal Name
Journal Of Engineering
Critical Success Factors in Construction Projects (Governmental Projects as a Case Study)
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The importance of the construction sector and its Great role in the provision of services and infrastructure, reduce poverty, improve living conditions and improve the economic situation in the country, impose attention to the way in which the projects implemented for its improvement and to get successful projects. The objective of this research was to determine the criteria for success as well as critical success and failure factors that have a significant impact on project success. A selected 75 engineer (department managers, project managers and engineers) are asked to fill  the questionnaire form, Sixty-seven valid questionnaire forms were analyzed statistically to get search results, which were as follows : Twe

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Publication Date
Sun Jan 08 2023
Journal Name
Journal Of Planner And Development
Design bases for waste recycling rules in cities/ Baghdad, a case study"
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Waste is one of the most important problems affecting the city’s environment and its urban landscape, which results from the activities and activities of man and the natural environment. Its sources have varied between residential, commercial, industrial, medical and hazardous, and its spread in cities, on roads and on abandoned open lands, has led to significant negative effects and risks to human health and the environment.

  Therefore, there were serious attempts to deal with waste and follow sequential steps that formed a waste management system such as (collection, sorting, transport, then treatment and disposal). Preventing and reducing waste, then recycling and recovering by composting or burning, and ending with bu

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Publication Date
Tue Jun 01 2021
Journal Name
Journal Of The College Of Languages (jcl)
A Multimodal Analysis of Hyperbolic Devices in Advertisements of Health and Beauty Products
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         This paper examines the use of one of the most common linguistic devices which is hyperbole. It shows how hyperbolic devices are used as an aspect of exaggeration or overstatement for an extra effect in which the speaker can use hyperbole to add something extra to a situation in order to exaggerate his idea or speech. It is, like other figures of speech, used to express a negative or positive attitude of a specific unit of language. Thus, this paper is set against a background of using hyperbole concerning two main fields (advertisements and propaganda). So, the use of hyperbole will be implied by analyzing them concerning their meaning) literal and non-literal).  Methodology of this

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Publication Date
Fri Mar 04 2022
Journal Name
International Journal Of Research In Social Sciences & Humanities
Functional Load and Pronunciation Instruction in the Iraqi EFL Context
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MR Younus, 2022

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Publication Date
Sun Sep 04 2011
Journal Name
Baghdad Science Journal
The relationship between Hypertension and weight status in Iraqi population
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Most medical books and researches documented that increased body weight is a predisposing factor to hypertension , and there is recent work in this field as well. In this research , the relationships between hypertension and body weight with age were studied in Iraqi population . It is concluded that diastolic hypertension is separated from systolic and combined hypertension and increased body weight has little effect on increased blood pressure.

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Publication Date
Sun Feb 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The ownership in economic thought and religious postural Contemporary Vision
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Since the property in Islam is based on the principle of succession , "which made ​​you Khalaúv land and raise yourselves above some degree of Iblukm with Atakm The Lord of the fast punishment and it is Forgiving, Merciful " [cattle : 165 ] and human only Mstkhalaf where " God promised you who believe and do good deeds for Istkhalvenhm Normans in the ground as those before them " [Nur : 55 ] , considering that King God alone any talk about having ownership in Islam in the contemporary sense of ownership , containing three rights are:

1- right to dispose of the right of usufruct tenure

2-The concept is ambiguous as long as that man Mstkhalaf does not have the right to dispose

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Publication Date
Wed Jun 03 2020
Journal Name
Political Sciences Journal
The general budget and censorship on it in Iraqi legislation
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The main idea of the financial censorship is to submit the states funds to a censorship because they are the funds of the people and because this censorship is a right and role ensured by the constitution for specific devices in the state, thus the role of the financial censor should be launched to achieve this goal in all walks of the state. • The power of this censorship depends basically on the independence of the censorious bodies over a job which is submitted to this censorship and the censor should have a reverence , this censorship is practiced as a precautionary procedure before preparing the budget to avoid mistakes after and during the execution for maintaining the states funds. • The importance of the censorship comes from

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Publication Date
Thu Jan 24 2019
Journal Name
Journal Of Education College Wasit University
Postmodernism and Technology in Don Delillo's Novel The White Noise
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This paper aims at investigating the effect of postmodernism and technology on the social life in Don Delillo's novel The White Noise. In this novel, Don Delillo portrays the chaotic life by using modern technology which has been presented by three ways. The first way is by television as being a source of information and entertainment. The second way is by the toxic event whereas the third is by Dylar's episode and its destructive consequences. He depicts that through the atmosphere of Jack's family plus its effects on the life and thoughts of the elders and society. He proves that technology is leading humanity not to safety, but to death. He further highlights that by showing the impact of technology on the life of the main charac

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