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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
Fri Jun 30 2023
Journal Name
College Of Islamic Sciences
Financial policy in the caliphate of Imam Ali (peace be upon him)
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Praise be to God who has guided us, and we would not have been guided had it not been for the guidance of God Almighty. The life of the Commander of the Faithful, Imam Ali bin Abi Talib, peace be upon him, represented the highest meanings of sacrifice, redemption, courage, heroism, patience, altruism, and truth, which were embodied in his unique personality, whose counterpart is rare, if not unparalleled in history. Except for the person of the Holy Prophet Muhammad (may God bless him and his family and grant them peace). In this research, we have presented pictures from the life of Imam Ali bin Abi Talib (peace be upon him), as we have clarified his life, upbringing, conversion to Islam and his ma

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Science Processes Included in the Teacher's Handbook of Middle School Science Experiments
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The aim of this research is to uncover the science processes included in the teacher’s guide to scientific experiments for science books for grades (first-second) for the intermediate stage, The research sample included all the scientific experiments contained in the teacher’s guide for scientific experiments for the intermediate stage, The researcher used the descriptive and analytical method, and designed an analysis tool, The content of science operations, and verified its validity and consistency, and after using percentages and ranks for statistical treatment, the research reached the following results: The number of practical experiments varies from one class to another in the intermediate stage, where the highest percentage ap

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
Historical knowledge of the Arabs in an era          Pre-Islam: Quranic connotations
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This paper examines the most important historical knowledge and knowledge of the Arabs in the pre-Islamic era based on the Holy Quran, which is the oldest and most reliable Arab Islamic sources recorded at all, as a major source of this study, to ensure a great interest in history, especially the news of the prophets, and the positions of their nations Some of them, as well as some of the news of the old Arab people such as Aad and Thamud and the owners of the elephant and others, and some of which are repeated in several Quranic fence and various methods of presentation, cited as a lesson and exhortation to the Arab opponents of Islam and a reminder of what befell the peoples of the world B relict of doom to discredit them the apostles

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Publication Date
Wed May 18 2016
Journal Name
Al-academy
Actor performance features in the types of theatrical silent: راسل كاظم عوده
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Each art has its own language. Per his style as an artist, which is characterized by the other. The methods differ and vary expressive art to another depending on the tools and methods used, and is a theatrical phenomenon did, and see, and touch, grasp, understand, and imagine, and emotion, and the blending of ideas and images. When unable to speak the language of the traditional theater For the delivery of a specific meaning or a single non-current at the time the highlight of our new language with a very wide area up to the extent of the unification of the languages of the world as it is in fine painting, it's the body of actor language, so it has become a mime art, which expressed Representative meanings reference and movement of vari

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Publication Date
Wed Jun 05 2024
Journal Name
International Journal Of Engineering Pedagogy (ijep)
The Impact of Artificial Intelligence on Computational Thinking in Education at University
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This study aims to reveal the role of one of the artificial intelligence (AI) techniques, “ChatGPT,” in improving the educational process by following it as a teaching method for the subject of automatic analysis for students of the Chemistry Department and the subject of computer security for students of the Computer Science Department, from the fourth stage at the College of Education for Pure Science (Ibn Al-Haitham), and its impact on their computational thinking to have a good educational environment. The experimental approach was used, and the research samples were chosen intentionally by the research community. Research tools were prepared, which included a scale for CT that included 12 items and the achievement test in b

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Publication Date
Mon Feb 01 2021
Journal Name
Journal Of Engineering
The Effecting of Human Body on Slotted Monopole Antenna in Wearable Communications
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In this paper, the characteristics of microstrip monopole antennas are studied firstly in free space. Secondly, the effects of the human body on the studied antenna's performance are investigated for wearable communications. Different patch shapes of microstrip monopole antenna are chosen to operate at two bands: industrial scientific and medical band (ISM) and ultra-wideband (UWB) for wearable applications. The studied antenna consists of a radiating element on one side of the substrate and a partial ground plane on the other side. The antenna is supposed to fabricate on cloth fabric whose relative dielectric constant is Ɛr =1.7. At the same time, the pure copper could be used as the conducting part representing both t

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The importance of providing Islamic finance services for non- Muslims in Europe
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Abstract

             This paper follows the growing interest and continuity of Islamic finance products worldwide, which has encouraged the formulation of financial institutions based on the concepts of Islamic Sharia in many countries of the world and is no longer limited to Islamic countries only, and  Not exclusive to Muslims which is due to Islamic finance services and their ability to apply in non-Islamic societies, and perhaps what encouraged the development and progress of this industry Islamic history, which was attended by many different models With the development of trade's share between different countries as well as trips carried out by Muslims

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Publication Date
Mon Feb 18 2019
Journal Name
Iraqi Journal Of Physics
The evaluation of left ventricle stiffness index in patients suffering from hypertension
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Many diseases can produce cardiac overload, of these disease hypertension, valve disease congenital anomaly in addition to many other disease. One of the most common diseases causing left ventricle overload is hypertension. A long term hypertension can cause myocardium hypertrophy leading to changes in the cardiac contractility and reduced efficiency. The investigations were carried out using conventional echocardiography techniques in addition to the tissue Doppler imaging (TDI) from which many noninvasive measurements can be readily obtained. The study has involved the effect of hypertension on the myocardium stiffness index through the measurement of early diastolic filling (E) and the early velocity of lateral mitral annulus (Ea

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Publication Date
Thu Jul 01 2021
Journal Name
Review Of International Geographical Education (rigeo)
Walkability as one of the Planning Treatments to Face Epidemics in Cities
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Walkability as one of the Planning Treatments to Face Epidemics in Cities

Publication Date
Tue Mar 30 2021
Journal Name
Baghdad Science Journal
Investigating the Sensitivity Effect of Actuarial Assumptions on Pension Liabilities in Malaysia
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Malaysia will be an ageing population by 2030 as the number of those aged 60 years and above has increased drastically from 6.2 percent in 2000 and is expected to reach 13.6 percent by 2030. There are many challenges that will be faced due to the ageing population, one of which is the increasing cost of pensions in the future. In view of that, it is necessary to investigate the effect of actuarial assumptions on pension liabilities under the perspective of ageing. To estimate the pension liabilities, the Projected Unit Credit method is used in the study and commutation functions are employed in the process. Demographic risk and salary risk have been identified as major risks in analyzing pension liabilities in this study. The sensitivity

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