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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 Apr 01 2017
Journal Name
Desalination
Heat transfer coefficients and yield analysis of a double-slope solar still hybrid with rubber scrapers: An experimental and theoretical study
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Publication Date
Sat Jul 18 2020
Journal Name
College Of Islamic Sciences
The jender and how it transformed into the Islamic world
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يتناول هذا البحث دراسة واحدة من المفاهيم المهمة الوافدة الى المجتمع الاسلامي، بعد أن تطور في بيئة غربية وتبنته حركة نسوية متطرفة، تدعو الى مركزية الأنثى والعداء للرجل والأسرة النمطية، إنتقل هذا المصطلح الى المجتمع الإسلامي بعد أن تبنته أجندة عالمية تحاول وباستمرار طمس معالم الفطرة الإنسانية وتغير هوية الشعوب.

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Publication Date
Wed Mar 15 2023
Journal Name
Al-academy
The Abilities Musical level and its relation with the forgiveness
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This study aimed to recognize the Abilities Musical level and its relation with the for positive thinking, The present study relied on the analytical correlational descriptive approach The study population consisted of 167 female students who participated in musical activities, among the students of Maysaloon Elementary School for Girls affiliated to the Directorate of Education for the Bani Ubaid Brigade in Irbid Governorate. While the sample of this study consisted of (65) female students; , from level: intermediate .

The correlative analytic descriptive method was used, Was applied to the study sample Seachor tests of musical capabilities (the abbreviated image), which was codified by the Arabic (Sadiq (2001), the scale of posi

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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of accounting standards, audit and finances in control On agricultural activity to achieve sustainable development
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The agricultural activity has a great significance in the all four dimensions of sustainable development. Firstly, the economic dimension which it contributes with the GDP, as well as, it is considered as an important source to attract the investment. Secondly, the environmental dimension which also contributes with conserving of the biodiversity, combating the desertification, and increasing the farmlands. Thirdly, for its role in the social dimension to achieve the food security, to eradicate the poverty, and providing jobs. Fourthly, toward the institutional dimension as well it is considered as a source that allows all people to participate effectively, and to exchange of the local and universal experiences and perspectives. For conf

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
University Students' Attitudes towards Reading and Its Relationship to Some Demographic Variables in the Sultanate of Oman
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Abstract

The current study aims to identify university students' attitudes towards reading and its relationship to some demographic variables in the universities of the Sultanate of Oman. The study sample consisted of (1434) male and female university students from various Omani public and private universities affiliated with the Ministry of Higher Education. The study covered all (11) governorates of Oman. The researcher adopted the descriptive analytical approach. The researcher employed a scale of reading attitudes to collect the needed data. The study results showed that university students' reading attitudes recorded a high degree. The results also showed there are statistically significant differences at th

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Publication Date
Sun Dec 15 2019
Journal Name
Al-academy
The strategy of visual thinking and its applications in teaching arts (photography model): نورا عبد الله علي
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The study aims at:
1- Identifying the contemporary educational approaches in teaching arts.
2- The effectiveness of using the visual thinking strategy in photography subject for the first year students in the institute of fine arts/Holy city of Kadhimiyah.
The study sample is made of (30 ) first year students (in the institute of fine arts/in Holy city of Kadhimiyah) distributed into two groups, an experimental group made of (15) students and a control group having the same number of students in order to conduct the test. The test for the visual thinking strategy in the subject of photography has been designed and the validity and reliability for the research tool have been verified. In order to demonstrate the results of the

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Social Responsibility initiatives in Financial Performance on economic unit and create value for it
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        Many of researchers have written about social responsibility and business strategy and competitive advantage, and they have given particular attention to the relationship between economic and social responsibility , but what is missing in this aspect is how the economic units that use their core competencies to advance social responsibility initiatives so that they can achieve a significant competitive advantage and create value for it ?

The current research aims to verify the view that "the economic and social objectives in the long term is not contradictory in nature but complementary objectives essential", as well as make sure that the s

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Publication Date
Thu Apr 13 2023
Journal Name
International Journal Of Research In Social Sciences And Humanities
Subject Review: The Effectiveness Of Integrating E-Learning On Learning Outcome And Student Perceptions In Tertiary Education
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The literature shows conflicting outcomes, making it difficult to determine how e-learning affects the performance of students in higher education. The effect of e-learning was studied and data has been gathered with the utilization of a variety of qualitative and quantitative methods, especially in relation to students' academic achievements and perceptions in higher education, according to literature review that has been drawn from articles published in the past two decades (2000-2020). The development of a sense of community in the on-line environment has been identified to be one of the main difficulties in e-learning education across this whole review. In order to create an efficient online learning community, it could be claim

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Publication Date
Mon Dec 28 2020
Journal Name
Journal Of The College Of Education For Women
Evaluating the Indicators and Quality of Potable Water Networks in Al-Shatrah City: سميع جلاب منسي السهلاني
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The present paper aims at evaluating the vailability quality and future horizons of potable water in the city of Shatra as a model. This is done in accordance with certain subjective and objective factors alongside the classification map of Shatra as a residential area. This system follows geographical studies specialized in urban construction. The problem of the present paper as well as the data approaching that problem have been chosen from the records of 2018. The researcher offered (919) questionnaire forms to be answered by a sample of dwellers in that area. Besides, the researcher also followed lab analysis of water samples collected from districts in the city of Shatra. GIS technology was also used to arrive at the real water shar

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
International variables and their impact on the flow of foreign direct investment in Gulf Cooperation Council (GCC)
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Abstract:

The six Arab Gulf states (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, UAE) play a vital role, especially with its geographical location and natural  resources (oil and gas) as well as other cultural and civilizational elements, in achieving  global economic balance and more specifically global energy security, naturally  because of  these countries have a comparative advantage in the field of fossil energy (oil and gas), thus this sector becomes more attractive for local and international investments alike. Being  the energy sector a leader sector in the economic development process, and the basic factor to achieve savings and financial surpluses in thes

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