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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
Sun Jul 27 2025
Journal Name
Journal Of Physical Education
The Effect of Using Mental Maps On Cognitive Achievement In Rhythmic Gymnastics
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Publication Date
Thu Oct 01 2015
Journal Name
International Journal Of Engineering Sciences & Research Technology
IMPROVEMENT THE MECHANICAL WEAR RESISTANCE OF METAL KNIFE USED IN HARVESTER MACHINE
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SKF Dr. Abbas S. Alwan, Dhurgham I. Khudher, INTERNATIONAL JOURNAL OF ENGINEERING SCIENCES & RESEARCH TECHNOLOGY, 2015

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Publication Date
Sat Mar 25 2023
Journal Name
International Journal Of Drug Delivery Technology
The Protective Eff ect of Cinnamic Acid against Ulcerative Colitis in Mice
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Objective: To study the protective eff ects of cinnamic acid on dextran sodium sulfate (DSS) induced ulcerative colitis (UC) in mice. Materials and methods. Forty adult male mice were randomLy divided into fi ve groups, control group, an induction group received 3% DSS in drinking water for 7 consecutive days. Two treatment groups received oral suspension of cinnamic acid 50 and 25 mg/kg, respectively and 3% DSS in drinking water, for 7 consecutive days. The fi nal group received oral suspension of cinnamic acid 50 mg/kg for the latter 7 days without DSS in drinking water. All the animals were euthanized on day eight. The colon of animals was extracted and divided into two sections, the middle was homogenized and biochemically analy

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Publication Date
Sun Jul 06 2014
Journal Name
Journal Of Educational And Psychological Researches
the role of theater in promoting linguistic wealth among primary school pupils
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Included a research problem , pointing to deficiencies and neglect in Arabic language teaching in primary and middle school , what makes sense to form your linguistic Bell ( Listening ) is missing , especially grammar, vocabulary endings .

And stressed the importance of research that teaching students the Arabic language is the balance of the next life , and that any defect infects will demolish an important part of their structure and the fact that the theater is a form of human directcommunication , and it`s way is the word this helps students to develop some communication skills , and language the backbone of these skills ,1-      The research sample was identified in all age children ( 6-12 ), which c

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Publication Date
Thu Jan 01 2015
Journal Name
Al-ustath
Figuring Out the Intended Meaning of Intonation in Some English Conversational Utterances
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The study aims at figuring out the intended meaning of intonation in some English conversational utterances together with identifying pitch variations that are determined by various syntactic constructions that impart the same illocutionary force of utterances. However, intonation is needed to delimit the communicative forces of utterances by virtue of its structure which the speakers intend to convey .This paper consists of four sections .Section one deals with phonology and its types .Section two discusses intonation in relation to style , forms and functions. Section three sheds some light on pragmatics. Section four deals in details with the intended meaning of intonation in some English conversational utterances. This paper comes up wi

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
The impact of advancing age on total serum IgE in asthmatic patient
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Abstract

The current study was conducted to assess the effect of advancing age on total serum IgE level in asthmatic patients. To this purpose, 90 asthmatic patients and 30 healthy individuals ( control group ) were enrolled. Asthmatic patients were categorized into four groups. Group A consisted of asthmatic patients (9) whose age was more than 20 and up to 30 y. Group B contained asthmatics (13) of age more than 30 and up to 40 y. Group C comprised those (23) of more than 40 and up to 50 y. Group D consisted asthmatic patients (45) of age more than 50 y. Total serum IgE level significantly changed in group D patients when compared with those of

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
The Effect of Assessment Techniques on EFL Learners’ achievement in TOEFL Test
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While many educators are highly focused on state test, it is important to consider that
over the course of a year, instructors can build in many opportunities to assess how learners
are learning. Therefore, assessment techniques are considered a good method to get benefit
for both instructors and learners in the process of teaching and learning. The sample consists
of 27 learners who participated in TOEFL training course in the Development and Continuous
Education Centre. Validity and reliability were verified.
To fulfill the aims and verify the hypothesis which reads as follows” It is hypothesized
that the TOEFL learners' scores will not be increased after TOEFL course training.” T-test
for two dependent samp

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Publication Date
Sun Feb 03 2019
Journal Name
Iraqi Journal Of Physics
Determination the concentration of radon in human urine using LR-115 detector
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In the present study twenty samples of human urine were taken
from healthy male and female with different of: ages, occupation and
place of residence. These samples were collected from the hospital to
measure the concentration of radon gas in human urine by using one
of solid state nuclear track detectors LR-115.
The results obtained of the concentrations of radon in healthy human
urine are varying from 2.12×10-3 Bq.l-1 to 4.42×10-3 Bq.l-1 and
these values are less than the allowed limits 12.3×10-3 Bq.l-1.

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
The Training Needs of Middle StagLeaders in Bisha, Saudi Arabi Teachers’ Perceptions
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The present study is meant to inquire about the training needs of middle stage leaders in Bisha, (Saudi Arabia) from the perspective of teachers. To achieve this purpose, the researcher has designed a questionnaire containing (31) items, distributed to a sample of (157) teacher (male and female) from the target population.

This research has demonstrated that the level of training needs for middle stage leaders was moderately reported with an arithmetic mean equivalent to (2.42), and a standard deviation of (0.36). Results have shown no significant differences at (α=0.05) in the sample’s expectations of the study’s variables.

The study concludes with a list of recommendations such as working on developing training pro

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Publication Date
Sat Dec 31 2022
Journal Name
Wasit Journal Of Computer And Mathematics Science
Cheating in E-learning from the perspective of lecturers within Iraqi universities
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Online examination is an integral and vital component of online learning. Student authentication is going to be widely seen when one of these major challenges within the online assessment. This study aims to investigate potential threats to student authentication in the online examinations. Adopting cheating in E-learning in a university of Iraq brings essential security issues for e-exam . In this document, these analysts suggested  a model making use of a quantitative research style to confirm the suggested aspects and create this relationship between these. The major elements that might impact universities to adopt cheating electronics were declared as Educational methods, Organizational methods, Teaching methods, Technical meth

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