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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 Mar 15 2021
Journal Name
Al-academy
Variables related to the performance styles of batik art to achieve linear tactile effects in the printmaking: نجلاء المرضوف السعدي
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The art of batik is one of the ancient arts that has a long history in East Asian countries, especially in Indonesia, where it was considered a traditional craft with which many Indonesian tribes lived. This art began to move to other continents and develops and progresses due to the artist’s connection to the surrounding technological and intellectual development, as art became more outgoing and liberated, it helped the artist to create and innovate in his designs. In this research, he focuses on modern performance methods through which print paintings can be produced through design elements, especially calligraphy, to create aesthetic and creative effects in the productive work. The current research aims to identify the various perfo

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The effect of the reciprocal reading strategy in developing innovative reading skills for fifth-year secondary school students / scientific branch
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       This research aims to identify the impact of the reciprocal reading strategy on developing the innovative reading skills of fifth-grade secondary school students/ scientific branch. To achieve the goal of the research, an achievement test to measure the academic achievement of fifth-grade secondary school students in  Arabic language grammar was prepared,  a sample of (60) female students from the secondary school of Al- Bawaba Al-Sharkey for Girls in Baghdad were chosen for the academic year (2019-2020). For the purpose of applying the experiment, the test was applied on a pilot sample consisting of (30) students from the same research community. The researcher herself had taught the three

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Publication Date
Tue Jun 30 2015
Journal Name
College Of Islamic Sciences
From the responses of Imam Abi Zakaria al-Nawawi 676 AH on the grammarians in his commentary on Sahel Muslim
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From the responses of Imam Abi Zakaria al-Nawawi 676 AH on the grammarians in his commentary on Sahel Muslim

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Publication Date
Mon Feb 13 2023
Journal Name
Journal Of Educational And Psychological Researches
The Reality of Using Electronic Applications in Teaching Language Skills to People with Mild Intellectual Disability from the Mothers’ Perspective
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Abstract

This study aims to identify the reality of using electronic applications in teaching language skills to people with mild intellectual disabilities from the mothers’ perspective. A descriptive approach was used. The electronic questionnaires were administered to the study sample, 122 responses were received from mothers of the students with mild intellectual disability in Hafer Al-Baten schools. The response average rate was 94%. The results showed that there are statistically significant differences that are related to the variant of monthly income as for the barriers to using electronic applications in such schools, whereas there were no differences regarding the variant of monthly income regarding t

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Publication Date
Sun Apr 04 2010
Journal Name
Journal Of Educational And Psychological Researches
The Factorial Structure of The Emotional Intelligence Scale to Bar-On Applied on Students from Preparatory School in Baghdad City.
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The aim of the study was to know the factors analysis of scale Bar-On & Parker, post analysis is found fourteen factors for the first degree of the scale. Also we extracted five factors from the second degree.

  The scale consists of (60) items , applied on sample of (200) students (Male &Female ) age (15-18) years randomly chosen from preparatory schools . The scale unveiled satis factors  validity and reliability. An others aims is to low the  emotional  Intelligence level and  know the difference of statistical in sex , age variable and the specialization variable .The result was no difference of statistical in sex and specialization variable , but the difference appear

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Female Characters In The Pre-Raphaelite Novel: M.E. Braddon’s Lady Audley’s Secret (An Extracted Research of Master Degree Letter)
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Victorian age is known as a time of perpetual change. It is a time of new industrialization, increased urbanization and new technology. Therefore, one of the strongest undercurrents of this is the position of women. Woman at that time was viewed as “an angel in the house” especially this who belongs to the upper-middle class. She is described in such term because she spends much time in her domestic domain. Therefore, she should be passive, obedient and dependent. Despite the Victorian society contains several classes; women are defined under two labels: the angel and the demon or the whore. The angel woman can be any woman from the lower middle class to the aristocracy, while the whore refers to any working class woman. The differen

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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Engineering
The Effect of Total Suspended Solids on the Electricity Generation in Microbial Fuel Cell Treating Actual Potato Chips Processing Wastewater
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This study aimed to investigate the effect of total suspended solids (TSS) on the performance of a continuously operated dual-chamber microbial fuel cell (MFC) proceeded by primary clarifier to treat actual potato chips processing wastewater. The system was also tested in the absence of the primary clarifier and the results demonstrated a significant effect of TSS on the polarization curve of the MFC which was obtained by operating the graphite anodic electrode against Ag/AgCl reference electrode. The maximum observed power and current densities were decreased form 102.42 mW/m2 and 447.26 mA/m2 to 80.16 mW/m2 and 299.10 mA/m2, respectively due to the adverse effect of TSS. Also

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Publication Date
Sun Sep 04 2011
Journal Name
Baghdad Science Journal
Spectroscopic Study for Resonance Effects on the Carbonyl Double Bond Order in Urea Schiff Bases Which Contain Conjugated System
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In this work we prepared some schiff bases by condensation urea and benzaldehyde or its derevative ( bromo benzaldehyde or hydroxy benzaldehyde ) as ( 1 : 1 ) mole ( urea : benzaldehyde or its substitution ) to prepare compounds ( A1 , B1 , C1 , D1 , E1 , F1 , G1 ) and ( 1 : 2 ) mole ( urea : benzaldehyde or its substitution ) to prepare compounds ( A2 , B2 , C2 , D2 , E1 , F2 , G2 ) . The prepared compounds identified spectroscopic by infrared spectroscopy FT-IR and Thin layer chromotography T.L.C . The force constant calculated from the wave number for the carbonyl stretching from FT-IR chart and by using the following equation K = 4?2C2?'2? The change in double bond order for carbonyl deteremined in according with some past re

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Publication Date
Sat May 11 2024
Journal Name
Tech Hub Journal
The prevailing leadership Patterns and personal traits and their relationship to innovative thinking of female physical education teachers in middle schools in Baghdad
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Teachers play a critical role in planning, organizing, coordinating, monitoring, and instructing, hence the topic of leadership styles receives a lot of attention. As a result, the physical education school is regarded as the most significant component of the educational process because it has the ability to weave together the teaching and educational skills, attitudes, and capacities that its students develop. Fits into their identities through her relationship with them. Teachers play a critical role in planning, organizing, coordinating, monitoring, and instructing, hence the topic of leadership styles receives a lot of attention. As a result, the physical education school is regarded the most significant aspect in the educational proces

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Publication Date
Mon Aug 31 2020
Journal Name
Journal Of Research In Medical And Dental Science
The Effect of Super Oxidized Water Mouthwash on the Level of IL 1? in Gingival Crevicular Fluid for Patients with Gingivitis Randomized Clinical Trial
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Background: One of the most predominant periodontal diseases is the plaque induced gingivitis. For the past 20 years, super-oxidized solutions have be..

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