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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 Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Musical Intelligence in kindergarten children
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The childhood of the important stages in which the adopted child's personality, mental and physical, motor and configure , as well as gain experience , it is the basis on which the future life of the child , studies have unanimously competent in the fields of childhood verily the first five years of a child of the most important stages of life and the most fertile life . Because the stage Childhood its an active role as the foundation upon which to build human personality , it was necessary to create all leads to raise the level of intelligence of children , because intelligence is the first element in the organization of thinking makes the child able to do the activities characterized by mental qualities .
Indicated most of the scien

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Publication Date
Sun Apr 14 2019
Journal Name
Political Sciences Journal
The political system in North Korea
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النظام السياسي في كوريا الشمالة

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Publication Date
Tue Sep 19 2017
Journal Name
Al-academy
Aesthetic performance in the mobile sculptures
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Aesthetic performance in the mobile sculptures
Ali Abd Almohsen Ali
Abstract
Chapters of this research are discussed one of the turning points in the In the history of sculpture, which sparked a debate in artistic circles, namely the introduction of the actual movement in sculpture . The researcher highlighted on one of the corners of the controversy on this subject for discussion and looking in and Found results contribute to answer some questions . the Beginning been allocated to the statement of this Research Methodology , research problem, and its importance, and its goal, and borders , the main problem is Lack of clarity of the concept of real motion (physical) in the sculpture , And how the audience understand the aspects

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Publication Date
Wed Jun 02 2021
Journal Name
Journal Of Al- Farahidi Arts
The Sponsorship Role in Brand Marketing
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Adyertising sponsorship is one of the most prominent public activities, hich drives many public relations relations practitioners in companies to rely heavily on it in order to achieve positive results that contribute to the marketing of the brands of these sponsoring companies. The problem of Our research can be identified by the main question: What is the role of advertising sponsorship in brand marketing "The research aims to identify the role of sponsorship in brand marketing, and its role in attracting the public's attention to the products of the sponsors. As well as clarifying the role of the care method in the popularity of the products of the Sponsorship companies.

Publication Date
Tue Oct 31 2023
Journal Name
College Of Islamic Sciences
Orphan care In the Islamic perspective
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I was invited to deliver a research paper on orphan care at the Center for Psychological and Educational Research. So I sought help from God Almighty and began writing a research in which I explained the meaning of the orphan, his condition, and the Holy Qur’an’s care for him. Therefore, I intended for the title of my humble research to be (Caring for the Orphan in the Islamic Perspective), since the papers were mixed up in the time of accidents, disasters, and deadly weapons, all of which reap men more than what we suffer. In this wounded country of ours, with civil wars, sectarianism, and insecurity, research began to solve the problem of orphans at a time when society had become an orphan with no shepherd. When I addressed this to

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
Metaphorical correlation in the contemporary sculpture
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The present research is concerned with the way in which different dialects interact with each other in contemporary sculpture through the use of the metaphor for various shapes, meanings and materials and placing them in contexts that conflict with the familiar. These attempts come in harmony with the spirit of the times in seeking exoticism, surprise and splendor as a means of renewal. modern Art . Therefore, the research was divided into four axes, the first of which included the research problem, its importance and its aim, which is to attempt to uncover the metaphorical metaphorical relational mechanism in modern sculpture. The second axis included the theoretical framework. The third axis included the research procedures of determin

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Publication Date
Thu Jan 01 2015
Journal Name
مجلة دراسات قانونية
Consumer protection in the electronic contract
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Abstract: Consumer protection in electronic contracts is of great importance in Iraqi law, as there are detailed legislations that enhance consumer rights and provide mechanisms for compensation when necessary. In Iraq, the Consumer Protection Law of 2010 regulates these rights and ensures the availability of sufficient and clear information to consumers.

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
Assess the quality of air Basra province
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Iraqi provinces suffer many of the environmental problems, appear explained these problems in the city of Basra, Basra, the largest province and is among Iraq's provinces in the annexation of oil fields, which is experiencing an oil production operations of large, it suffers from the burning of gas associated with oil extraction resulting in the emission severe gas process including toxic hydrogen sulfide gas (h2S) and oxides of carbon, sulfur and nitrogen in addition to the release of toxic metal elements such as mercury, arsenic, vanadium, which caused the man many serious diseases. , And perhaps one of the most important of these problems are worsening air quality and increasing cases of air pollution and the deterioration of the qual

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Measuring the Historical Concepts of Kindergarten Children
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Historical concepts are among the concepts that are difficult to present to the pre-school child except by using modern techniques, as well as the difficulty of making visits to all historical monuments and going back to antiquity and the lack of studies in this area, therefore, we need an attractive medium that children love which is able to convey some abstract concepts that are difficult to teach to children using traditional methods, and among these activities that the kindergarten provides to children are the stories through which they develop their linguistic wealth, consolidate their religious and spiritual inclinations, refine their correct morals, and form their proper attitudes, knowledge and life concepts.

The

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
The intellectual contents of science fiction films
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The research consisted of four chapters, the first of which wasa methodological framework. The problem of research was determined by a question drawn up by the researcher as follows: What are the intellectual contents of science fiction films ?. The main objective of the research was to uncover the intellectual contents of contemporary science fiction films. The most important research terms (content, thought, ideology, science fiction, contemporary) were defined as either the second chapter (the theoretical framework) The second topic was entitled "The Intellectual Contents of Contemporary Science Fiction Films", in which the films of the science fiction and its current intellectual contents were discussed. The third topic included the

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