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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
Mon Jan 01 2024
Journal Name
Journal Of The College Of Languages (jcl)
Individualism and the Symbolic Language of Imagination (Pablo Neruda as an Example)
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Pablo Neruda's artistic distinctiveness can be considered in two ideas or attitudes of romanticism. First, the imagination, which is the result of conduct and spirituality, and second, the individualism, which is a collection of mysterious mysteries from the texts of individuality based on philosophical sonnets. His collection of poems points out the ethereality and indescribability of life, employing the reality of life at the level of human perception in a symbolic language. In other words, Pablo Neruda recreates the meanings in poetry through the three ideas of reduction, interpretation, and analysis. "What is the essential connection between individualism and the symbolic language of Pablo Neruda's imagination and What are the reason

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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 Apr 01 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Relationship between the microorganisms isolated from septicemic neonates and place of delivery
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Background: Neonatal septicemia is a significant cause of morbidity and mortality worldwide especially so in developing countries. To reduce the mortality caused by neonatal septicemia, it became vital to diagnose it as soon as possible and treat with administration of appropriate antibiotics.Objective: To study the relationship between themicroorganisms isolated from septicemic neonates with place of delivery.Patients and Methods: Blood sample was obtained from 76 neonates (50 of them are born in Baghdad teaching hospital (Inborn), 26 of the babies are born at home or in Al-Elwya teaching hospital (out born) ,the laboratory diagnosis for the out born patients done in the same hospital(Al-Elwya teaching hospital .The aged of the neo

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Publication Date
Sun Jul 01 2012
Journal Name
Journal Of Educational And Psychological Researches
Self Protection and it's Relation with the social ignorance OF UNIVERSITY STUDENTS
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The aim of this research is to find a relation between self-protection and the social - ignorance of the univresity students. In applying the aims of the reaearch, the ressearcher has constructed two scales to measure
self - protection and the social - ignorance. After finding their validity and stability and their discriminative power, the researcher has applied them on a sample of (200) male and female. University students, who were selected randomly. The results of the research has arrived at finding a positive relation between self-protection and social - ignorance.

The researcher has recommended a concentration on the role of parents in raising their childern depending on themselves and making f

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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
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Infallibility of the prophets peace be upon them between Islam and Judaism
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In this research, I have tried to explain about the prophets' peace be upon them sent by God which is one of the commonalities between Islam and Judaism, but the two religions are different about whether the prophets are infallible or not. This study has tried to independently explain to describe both Islam and Judaism on this subject. Eventually, we concluded that there is a big difference between the two religions regarding their view of the infallibility of the prophets of all sins.

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Publication Date
Wed Mar 01 2023
Journal Name
Shift
Construction Safety Personnel Qualifications: The Impact of Education, Experience, and Certificate Programs
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Publication Date
Sun Sep 15 2019
Journal Name
Route Education And Social Science Journal
The influence of textual and visual reading on EFL Iraqi students' comprehension
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Reading roles as the third skill in the range of English as a Foreign Language (EFL) learning. Although the capability of reading in both academic and non-academic texts is assessed on standardized tests, few of oral interpretation of written language excludes images from estimating literary knowledge. This paper highlights strategies of reading comprehension and visual literacy. It aims to investigate either textual or visual reading in EFL can make an impact on students' comprehension. The effective use of visuals changes instructing reading comprehension recently.The imagery-text model can affect developing reading comprehension and enhancing intellectual thinking. The study hypothesizes that there is no relationship between reading and

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The role of competitive intelligence and reverse engineering to achieve competitive advantage
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Abstract

In light of the great technological development and the emergence of globalization has increased global competition, where it became competitive exercise pressure on all sectors. In light of this companies mast enviorment depend on the means that keeps them on the competitive position through access to information about competitors in order to help them to draw a strategy that will achieve a competitive edge either through excellence or reduce the costs of their products and this means intelligence competitive and reverse engineering that help to gain information on competitors analyze and put of the decision-maker From this point formed the idea of ​​research in the statement of the role of

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