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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
Tue Aug 15 2023
Journal Name
Al-academy
Emotional Motivation in industrial products design and its reflection on the consumer
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This research discusses the subject of emotional stimulation factors through the stages of product design interaction with the consumer and what they reflect in the formation of a self-consideration of the design in his emotional memory regarding the specific brand through the following question (What is the emotional stimulus in the design of certain products and its reflection on the consumer during the processes of receiving and using it?), The importance of the research comes in the connection of design elements with many sensory factors used and motivating to attract the consumer to the acquisition of a specific design and the demand for its experience, the study aims Detection and access to emotional stimulation in the design of th

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Publication Date
Mon Jan 09 2023
Journal Name
College Of Islamic Sciences
(Behavioral and ethical reasons for happiness in the holy Qur’an, elected models)
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Research Summary:

Seeking happiness and searching for it have been among the priorities of mankind from the beginning of his creation and will remain so until the end of this world, and even in the next life, he seeks happiness, but the difference is that a person can work in this world to obtain it, but in the next life he is expected to get what he done in this world. And among these reasons are practical actions that a person undertakes while he intends to draw close to God Almighty, so they lead him to attain his desired perfection, and to attain his goals and objectives, which is the minimum happiness in this life, and ultimate happiness after the soul separates the body, and on the day of the judgment, Amon

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Future Prospects for the Natural Gas Industry in Iraq and Investment Opportunities
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Abstract

  Natural gas is characterized by features that made from it a fuel and a raw material for many industries. Deepening its position as a favorite fossil supplier between other types of fossil fuel is the efficiency, diversity of its uses, low costs and compatibility with the environment which leads to increasing of its uses then increased global demand. So, the natural gas must take its place as an important resource in Iraq and participate the oil in the economic development process of building and financing of the general budget.

  Iraq is planning to continue of increasing the export capacity of raw oil to meet ambitious production targets emanating from the mai

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Publication Date
Wed May 01 2019
Journal Name
Journal Of The College Of Education For Women
The Complex Relationship Between Darwinism, Geopolitics and Geographic Colonization Research the Relationship Between Geopolitics and Ethnography
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Research on geopolitical and geopolitical studies relates to a range of sciences that can be called auxiliary sciences, such as political science, international relations in particular, and history, but their focus is rarely on science and ethnography

That the issues and problems of the world today has become so large and complex that does not allow a specific field or knowledge to solve one of the need for the newly known knowledge integration (geopolitics and geopolitics) in particular to move towards cognitive integration to understand many of the problems and global issues that faced The importance of this study comes to clarify the relationship between Darwinism, geopolitics and geopolitics. The geopolitics in modern terms d

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Humanitarian Intervention between the Legal And Political Considerations: Humanitarian Intervention between the Legal And Political Considerations
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Abstract:
Humanitarian intervention has taken different forms included within the
peaceful and military means to stop the human suffering, whether caused by
natural disaster or humanitarian disasters.
Intervention can not be acquitted because it carries with it political cover,
but sometimes it may be legitimate cover for the occupation and the violation
of sovereignty. Therefore, the research worked to capture the legal and
political aspects of international law and the role of international organizations
to intervene and the right to use force.
The research concludes that international law had not been fairly
successful in controlling the behavior of some countries in the use of force,
and that there is

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Publication Date
Wed Jan 23 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Role of the External Auditor in Review of Interim Financial Information Accordance with the Internation: بحث تطبيقي في عينة من الشركات المدرجة في سوق العراق للأوراق المالية
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In light of the increasing importance of interim financial statements they provided these lists of information that enables users of accounting information to make wise investment decisions and predict the company's activities in light of changes the updated rather than wait until the end of the year and accessing information provided by the annual financial statements. In light of this research has come to the most important set of conclusions the adoption of interim financial information has been audited by the external auditor to the availability of basic qualitative characteristics in the accounting information contained in the (appropriate and timely manner, reliability and comparability) and this in turn leads to the impact on reli

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Crossref
Publication Date
Wed Mar 16 2022
Journal Name
Journal Of Educational And Psychological Researches
The Degree to Which Princess Rahma University College Students Possess E-Learning Skills Related to Moodle from their Point of View, in Light of the Corona Crisis
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This study aims to identify the degree of students of Princess Rahma University College owning e-learning skills related to MOODLE as they perceived in the of light Corona crisis. The researchers' questionnaire consisted of (37) items, distributed in three areas of e-learning skills related to the MOODLE on (147) students were chosen randomly. The results of the study showed that the degree of students 'possession of e-learning skills related to the MOODLE was significant. The results also revealed that there were statistically significant differences in the degree of students' possession of electronic learning skills related to the MOODLE due to sex in favor of females. Finally, there were no statistically significant differences in the

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Publication Date
Wed Jun 14 2023
Journal Name
Al-academy
The Impact of Critical Reading on Viewers Understanding and Astatic Judgment at Artworks
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This study reveals the impact of critical reading on viewers understanding and astatic judgment at artworks. And aims to find out the reasons and motives behind their issuing of these judgments towards artworks.
The study adopts the qualitative method as two pre and post interviews were conducted and analysed according to a thematic analysis method.
The results show that critical reading contributes to their understanding of the content of artworks and the message that the artist would like to convey to the recipient audience. and directs them towards the aesthetic judgment that is based on full understanding of the philosophical contents of the artwork, which, in turn, contributes to the development of artistic culture and a

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Publication Date
Sun Jul 01 2018
Journal Name
Journal Of Educational And Psychological Researches
Family violence and its impact on the educational achievement of primary school children
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The research included four chapters starting with the chapter dealing with the problem of child abuse which was one of the most important educational and social problems faced by children from their parents or family members. The most common forms of abuse are physical and psychological violence. The problem of school delays is also one of the most important educational and psychological issues that concern educators, which occur because of violence and neglect of the family. The study pointed out that domestic violence is one of the issues that has started to alarm both the global and local communities, because childhood is one of the most important stages of the human development system, which is healthy in terms of physical, mental, p

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Publication Date
Sat Oct 01 2022
Journal Name
Baghdad Science Journal
The Effect of Combination Ovariectomy and D-galactose Administration on Alzheimer's Animal Model
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Background and purpose: Animal model helps researchers to evaluate new treatment plan for human and understand pathological mechanism involved in a development of disease. The use of rats as an animal model for Alzheimer's research has become a favorite among researchers. Rats are capable in mimicking Alzheimer disease due to their intelligence and quick adaptation to nature. At present there are several methods that can be used to induce Alzheimer's animals, but each method has advantages and disadvantages. We need to learn other methods that can provide many advantages and few disadvantages. The Amyloid-beta 42 (Aβ-42) and Reactive Oxygen Species (ROS) are thought to play an important role in the pathology of Alzheimer’s disease. Th

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