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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
Wed Jun 01 2022
Journal Name
Political Sciences Journal
The political thought of Robert Nozick
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  Robert Nozick is an American thinker who formulated his political theory in his book (Anarchy, State, Utopia) in 1974, which included his most important main ideas represented in the emergence of (The Minimal State) as well as (Entitlement Theory), through which he expressed his rejection of stereotypical distributive justice theories such as equality In Marxism and social liberalism, his ideas were characterized by a very extreme individualist tendency, and his ideas contributed to supporting the neo-liberal trend.     

 

             

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Publication Date
Mon Feb 14 2022
Journal Name
Journal Of Educational And Psychological Researches
The Organizational Values of Kindergarten Teachers
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The current study aims to identify the organizational values ​​of kindergarten teachers as well as to identify the difference in the organizational values ​​of kindergarten teachers in term of years of service, to do this; the researcher designed a scale to measure the organizational values. The scale was applied on a sample of (400) kindergarten teachers. The resesults revealed that kindergarten teachers have a high level of organizational values ​​within the classroom. The result of the second objective showed significant differences among the organizational values ​​(political,

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of The College Of Education For Women
The Educational Ideology of John Dewey
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The Educational Ideology of John Dewey

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Publication Date
Wed Oct 11 2023
Journal Name
Journal Of Educational And Psychological Researches
Agentic Thinking of the University Students
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The research aims to identify the level of Agentic thinking among a sample of male and female undergraduate students for both disciplines (scientific, and humanities). The researcher targeted the third and fourth stages for the academic year

(2021-2022). The study sample is (382) male and female students who were selected randomly from the University of Baghdad. To achieve the above-mentioned study aims. The researcher has developed a scale of Agentic thinking consisting of (25) items distributed over three domains. The results showed that the study sample has a high level of Agentic thinking. There are significant differences in agentive thinking in terms of gender in favor of females. There are no statistically significant diff

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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
The Identification Party of University Students
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The Political loyalties of the individual considered as the most important democracies through direct psychological identification in a particular party. The political parties regarded as the important elements and the foundations of the democratic system. They have effective interaction between the voters and the government institutions. The aim of the current research is to identify the quality of Islamic, the Civilian parties, and the most preferred for students. also, the research attempt to identify the level of identification  party that the  university students have, and the difference of identification party  according to the gender (male, female), the difference of of social class (upper, middle, poor). The sample

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Publication Date
Sat Jan 08 2022
Journal Name
Arab Scientific Heritage Journal
Weights of the Tawshih art (review)
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This study presented more than twenty books that dealt with the subject of (Weights of the Tawshih art), whether their study was independent and dedicated the art of Tawshih as a part of book. Therefore, the review of the sources and references on the art of the Tawshih is not specific for place or time, it was a broad and comprehensive review of all the places where the muwashahat appeared in the east and west, Andalusia was one of the most important areas covered by the study arbic Maghreb and Iraq. The art of tawshih took different forms according to the countries in which they appeared. Muwashahat is a new art that appeared in Andalusia, its main goal was to renew the Khalilian weights and to find the poetic rhythm that fits with the so

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Possible Self of University Students
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The current research aims to identify the possible self of university students and the differences in the level of possible self of students in terms of gender, specialization (scientific-humanitarian), and the interaction between them. In order to achieve the objectives of the current research, the two researchers have prepared a scale of the possible self, based on the theory (Markus and Nurius, 1986). The research tool was applied to a sample of (400) male and female students who were selected through a random stratified method from Al-Mustansiriya University students/morning studies for the academic year (2019-2020). The researcher reached the following results: the research sample has a high level of possible self; there is a differ

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of The College Of Languages (jcl)
Self-rhythm of the Belenoby Poet
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Al- belenoby , Andalusian obscure poet .I choose to study poetic rhythm in this poetic and the appropriateness of with what  rhythm touring in his self to give beautiful meaning raise to receiver to put the hands of continental placements creativity in poetry .I divided my research into ideas are presented in a sequential manner , I started researching with poetic rhyme than rhyme they represent the form of the poem, they represent the external form of the poem and their music that farm the general concept then the rhetorical styles that represent the internal form of the poem and it music that the listener works and enjoying it part by part all this led to the put the hands of the receiver placement creativity in Belenoby Poet.&nbs

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Publication Date
Wed Mar 14 2007
Journal Name
Journal Of Education College Wasit University
On the deviation of literary language
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DBN Rashid, Journal of Education College Wasit University 1(1):412-423, 2007

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Policies governing the mechanisms of referees
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The importance of research stems from the prominent role of leaders in the political, administrative, economic and societal spheres in general, which requires highlighting this angle. Research Hypothesis Modern policies work with mechanisms that limit the clear role of governors and transform the ruler into an executive man. It can be assumed that the type of public policy of the state is the only criterion that transfers the ruler from a ruler to an executive.

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