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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 Sep 24 2022
Journal Name
Arab World English Journal
A Critical Stylistic Study of the Notion of Women Empowerment in the Mona Lisa Smile (2003)
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This study unveils the ideologies of women empowerment encoded in the Mona Lisa Smile movie (2003). It reveals how the stereotypical image of women born only to be wives and do the duties of upbringing and housework is challenged. Katherine Ann Watson (Julia Roberts), the main character in the movie, wants to make a difference in the next generation of women. She rejects the imposed traditional ideologies. Linguistically, she opposes conventional thinking and seeks to persuade her students that life is about more than getting married. The primary focus of this study is to examine and clarify how the characters’ linguistic choices convey their ideologies concerning the notion of women empowerment. To do this, the researchers apply

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Publication Date
Tue Jan 29 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Implementing of Social Responsibility Standard ISO 26000 in Consumer Issues Market: Research and Consumer Protection Center -Study Case
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Abstract The aim of this research is to show the grade of implementation of ISO 26000 (Social Responsibility Standard), specifically which related in clause sex (consumer issues), this study was achieved in Market Research and Consumer Protection Center (MRCPC) / University of Baghdad. The seven consumer issues of ISO 26000 was analyzed to show the extent of its implementation in MRCPC depending of using a check list as a principle instrument to collect research data and information. Results analysis was achieved by percentages and mean average. The research was leaded some of results and the most importance one was that the grade of implementation of the center in related to consumer issues given in the standard was medium

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Publication Date
Sun Dec 08 2019
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Estimating total dissolved solids and total suspended solids in Mosul dam lake in situ and using remote sensing technique
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Publication Date
Tue Dec 13 2022
Journal Name
Journal Of The College Of Languages (jcl)
A Contrastive- Acoustic Study of Jacqueline Kennedy and the Actress Natalie Portman’s Voice Qualities in the Film” Jacki”.
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As performers in a social world, we communicate with other people by sharing information on many different levels. Each utterance includes linguistic information and conveys much information about the speaker’s identity. Variation in voice quality indexes information about the speaker and marks the speaker’s identity as a unique individual. The present study aims to validate the belief that each individual has an inalienable voice print that can’t be imitated. The study verifies that, even the more similar personality between two individuals, or the close position in society the variance is voice quality. The acoustic analysis is performed via analysing the acoustic parameters namely: the fundamental frequency, amplitude, inten

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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
The Use of English as Lingua Franca in the Classes of UKM: as A Case of Study
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           English has for long been one of the most widely used media of communication globally, especially in the Malaysian universities. It has been termed as a Lingua Franca because it is shared with other languages which are considered first languages by different speakers. For this reason, English as a Lingua Franca (ELF) has attracted a number of researchers to investigate its variety via other languages in various communities. The objective of this paper is therefore to establish the strategies which are employing by the international students at the National University of Malaysia/ UniversitiKebangsaan Malaysia (UKM) as an example of one of the Malaysian universities; when they e

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Publication Date
Sat Feb 03 2018
Journal Name
Chinese Journal Of Physics
A true random number generator based on the photon arrival time registered in a coincidence window between two single-photon counting modules
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True random number generators are essential components for communications to be conconfidentially secured. In this paper a new method is proposed to generate random sequences of numbers based on the difference of the arrival times of photons detected in a coincidence window between two single-photon counting modules

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Publication Date
Wed Apr 19 2023
Journal Name
Lasers In Medical Science
Immunohistochemistry technique for effect of gold nanoparticles, laser, and photodynamic therapy on FoxP1 level in infected mice with mammary adenocarcinoma
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Publication Date
Fri Sep 30 2011
Journal Name
Iraqi Journal Of Science
Using the band ratio classification method to detect the regions that need to remove sedimentation in Tigris River
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LandSat Satellite ETM+ image have been analyzed to detect the different depths of regions inside the Tigris river in order to detect the regions that need to remove sedimentation in Baghdad in Iraq Country. The scene consisted of six bands (without the thermal band), It was captured in March ٢٠٠١. The variance in depth is determined by applying the rationing technique on the bands ٣ and ٥. GIS ٩. ١ program is used to apply the rationing technique and determined the results.

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of promotion means in the developing the activity of financial markets: A case study of Iraqi stock Exchange
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The promotion by its means lead a vital and important role at the level of all organizations, whether (industrial or service) in general, and financial markets in particular. The promotion is earns delved to be as one of the main operations which  market uses it through various means of financial markets and companies which its shares listed in the aim of (finance or investment), with a view to the implementation and financing of public and private projects the one hand, or with a view to achieving profits through investment of speculative or... For other purposes, on the other hand.Accordingly, we find that the set of public and private goals joint between the financial markets and listed companies respectively, will serve the stra

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Publication Date
Fri Sep 30 2022
Journal Name
College Of Islamic Sciences
The Effectiveness of Combining the Meanings of Grammatical Tools in Understanding the Arabic Sentence A study of Some Linguistic Evidences
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abstract

The grammatical tools (the letters of meanings) are of great importance in understanding the meanings of the Arabic sentences,

This research is a simple attempt to show how our venerable scholars employed the meanings of these tools when they interpreted the linguistic evidence, that is, the grammatical structure largely depends on the tool in forming the meaning within the sentences and employing the meanings of these grammatical tools in explaining the linguistic evidence by clarifying their significance in the contexts of their use and effectiveness. Synthesis of the meanings of grammatical tools is an important tool in understanding the linguistic structure in order to reveal its meaning.

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