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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 Jan 01 2022
Journal Name
Journal Of Pharmaceutical Negative Results
Morphological and Anatomical Review of Some Veronica Species from the Plantaginaceae Family
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Publication Date
Sat Oct 12 2019
Journal Name
Journal Of The College Of Education For Women
Uncompleted Personality and it’s relation with Some Variables of the University Students
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Uncompleted Personality and it’s relation with Some Variables of the University Students

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Publication Date
Mon Feb 14 2022
Journal Name
Journal Of Educational And Psychological Researches
The Educational and Psychological Effects of Social Networking websites on Iraqi Society
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The aim of the research is to identify the educational and psychological effects of the positive and negative aspects of using social networking websites. The researcher administered a number of questions to (250) users of different types of social networking websites. He analyzed his research results and obtained a number of results. The research has reached a number of recommendations and suggestion: Regulating the use of social media. Monitoring the parents of the sites used by children in a way that they do not feel they are observers. It is necessary to devote an hour daily to show the importance of real social life for children other than using social media. It is necessary to show the importance of choosing friends who hav

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Publication Date
Sat Dec 01 2018
Journal Name
Political Sciences Journal
The strategy of spreading extremism and its impact on Egypt regional role
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ABSTRACT The importance and objectives of the study were an attempt to understand the methodology of disseminating radical thought and the reasons of social acceptability that make young people embrace this thought. It also sheds light on the impact of this phenomenon on the regional role of Egypt and examines the strategic means and standards that the Egyptian state focuses on in immunization and prevention of extremism.

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
Self-control and its relation to the work pressure of educational counselors
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1- The degree of self-control of the educational counselors.

2- The level of work pressures that educational counselors are exposed to from their point of view.

3- The significance of the differences in the degree of self-control and work pressures according to the gender variable (male / female).

4- The relationship between self-control and work stress for the sample as a whole.

The current research was limited to educational counselors of both sexes in Anbar Governorate, Ramadi District, affiliated to the Anbar Education Directorate. The researcher adopted the steps of the relational descriptive approach to achieve the research objectives. The current research community consists of (100) m

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of The College Of Languages (jcl)
To Shape a Silence While Breaking it: Toni Morrison’s the Bluest Eye
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Toni Morrison (1931-), the first African-American winner of Noble Prize in literature (1993) and the winner of the 1988 Pulitzer Prize for fiction, regards herself as the historian of African-American people. She does not think of her writings as literature but as a sacred book dedicated to explore the interior lives of blacks. She creates history by disregarding European standards and the white man's view of African- Americans. She adopts her people's point of view, invests their heritage, voices their pains and uses their vernacular. She even writes to a black audience. She establishes the black novel  by depicting the blackness of American literature. In choos

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Publication Date
Tue Mar 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Designing a Quality System using the Goals Programming Method -An Applied Research
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Due to the continuous development in society and the multiplicity of customers' desires and their keeping pace with this development and their search for the quality and durability of the commodity that provides them with the best performance and that meets their needs and desires, all this has led to the consideration of quality as one of the competitive advantages that many industrial companies compete for and which are of interest to customers and are looking for. The research problem showed that the Diyala State Company for Electrical Industries relies on some simple methods and personal experience to monitor the quality of products and does not adopt scientific methods and modern programs. The aim of this research is to desi

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Publication Date
Thu Oct 01 2020
Journal Name
Wireless Communications And Mobile Computing
Developing a real time navigation for the mobile robots at unknown environments
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<p><span>This research deals with the feasibility of a mobile robot to navigate and discover its location at unknown environments, and then constructing maps of these navigated environments for future usage. In this work, we proposed a modified Extended Kalman Filter- Simultaneous Localization and Mapping (EKF-SLAM) technique which was implemented for different unknown environments containing a different number of landmarks. Then, the detectable landmarks will play an important role in controlling the overall navigation process and EKF-SLAM technique’s performance. MATLAB simulation results of the EKF-SLAM technique come with better performance as compared with an odometry approach performance in terms of measuring the

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Publication Date
Tue Jun 02 2009
Journal Name
Albahith Alalami
A proposed scientific strategy for public relations activity at the Integrity Authority.
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This study deals with knowing the public relations activities of the Integrity Commission for the year 2007, knowing the contents of these activities, knowing the contents of the advertisements that it published, whether the contents of the advertisements were convincing, and whether press photographs were used in these advertisements, as well as whether symbols and slogans were used. What language and words were used to address the recipient? 1- What feelings do the contents of advertisements arouse? 2- Research objectives: This research aims to answer the following questions: What are the public relations activities carried out by the Integrity Commission? B: Are the contents of the advertisements published by the Authority convincing to

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Publication Date
Fri May 18 2018
Journal Name
Thesis
The Arabian killifish (Aphanius dispar) as a novel model for mycophysiological studies.
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Abstract Candida albicans is a commensal fungal pathogen that grows in yeast and hyphal forms in the human gut. C. albicans causes mucosal and cutaneous diseases that can result in significant mortality following systematic infections and it also exhibits drug resistance. Zebrafish have been an excellent model to investigate C. albicans infections because of their transparency and the availability of many transgenic lines. However, there is a limitation in using zebrafish as a model because the fish embryos cannot survive at 37°C therefore it is not suitable for studying Candida infections at physiological relevant human body temperature. In this thesis, the normal embryonic development of Arabian killifish (A. dispar) is investigated, rev

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