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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
Sun Jun 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The Organizational Climate Development in the Light of Job Stress Treatment: A Field Study in Governmental Sheltered Accommodation Houses in the Ministry of Labour and Social Affairs
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        Job stress is considered one of the most important obstacles that may appear in the work field. In order to deal with the obstacles and challenges , the idea to deal with job stress has come to address job stress as one of the most important trends that enable organizations to face those challenges through focusing on the role of job stress and the organizational climate of the organization.

       The research deals with two variables: the job stress as an independent variable, and the organizational climate as a dependent one. Each variable includes five sub-dimensions. These dimensions have been involved in an interaction to form

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Publication Date
Mon Dec 31 2012
Journal Name
Al-khwarizmi Engineering Journal
Experimental Study on the Impact of External Geometrical Shape on Free and Forced Convection Time Dependent Average Heat Transfer Coefficient during Cooling Process
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In this research, an experimental study was conducted to high light the impact of the exterior shape of a cylindrical body on the forced and free convection heat transfer coefficients when the body is hold in the entrance of an air duct. The impact of changing the body location within the air duct and the air speed are also demonstrated. The cylinders were manufactured with circular, triangular and square sections of copper for its high thermal conductivity with appropriate dimensions, while maintaining the surface area of all shapes to be the same. Each cylinder was heated to a certain temperature and put inside the duct at certain locations. The temperature of the cylinder was then monitored. The heat transfer coefficient were then cal

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Human Sport And Exercise - 2019 - Spring Conferences Of Sports Science
The effect of special force training on the development of biomechanical variables for running raising awareness during the performance on the jumping table
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Publication Date
Sat Dec 01 2018
Journal Name
Political Sciences Journal
Protecting woman during armed conflicts under the development of international humanitarian law
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The international humanitarian law found the special rules to protect women meanwhile the armed conflicts whether international or non-international. These rules are adopted for woman because of two reasons : that she is from civilians and on the other hand that her special constitution demands a special protection. The international community's attention of women is increased as a result of the tragic situation that faced women around the world especially in the Middle East and particularly in Iraq during the American-British war and ISIS period, these two periods sort many negative effects that reach women such as captivity, slavery, sexual enslavement and rape women especially Yazidis and Christians....

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Requirements of stress tests model and the possibility to apply in Iraqi banks exploratory study of the views of a sample of staff in the central Bank of Iraq .
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Abstract

This research attempt to explain the essential aspects of one important model in management of Bank risks , that is (stress testing) , which increase the concentrate on it resulting the negative affects of Global financial crisis that it accuar in 2008 to study the application possibilities in iraqian banks to enhancing the safety and financial soundness Becuase the classical tools  in Risk management don’t give clear image on Banks ability  in facing risks, hence the Basel committee on Banking supervision focusing in agreement of Basel 2,3 on stress testing when it doing the internal capital adequacy assessment process (ICAAP) .

To achieving the reseach obje

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
The phenomenon of building the act of the actor and the effect in the Quranic readings                          (Structural and semantic study)
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After this systematic presentation of the phenomenon of rotation of formulas, ie the construction of the verb and the verb, and the narrated narratives therein differed among the readers, it became clear to us how the difference was clear between reading and the other, and how readers have varied in their readings of the verb, As we have noted through our modest research that the phenomenon of building the verb for the actor and the effect have included the act of both past and present tense, and not limited to a specific time, and this difference in reading was not limited to a particular environment, but beyond To more than one environment This is evidenced by the readings of various readers from the environment of Kufa, Basra, Mecca,

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Publication Date
Sun Sep 29 2024
Journal Name
مجلة نسق
The diplomatic role of IGAD in regional peacemaking: Sudan after 2011 as a case study
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The research discusses the most important goals and means of IGAD in making peace in Sudan and then regional peace.

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Publication Date
Thu Feb 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Job Enrichment in Building Differentiation Strategy Service: Analytical Exploratory Study of the Views of a Sample of the General Managers and Heads of Departments and Officials of the People in the General Establishment of Civil Aviation
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According to the importance of the subject of research, and the importance of the surveyed organization as a dynamic sector of the country in general , The research attempts to suggest to service organizations in general reconsidering the currently adopted mechanisms in the redesign of its functions , and in the services provided industry . The data was collected from (98) Director Mangers , head of department and head of division . The research tool is the questionnaire , which included (50) items . The results show Significant Effect & Correlation relationship between the two variables due to their dimensions . These lead to he application of job enrichment technology will increase the organization's ability to possess efficient hu

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
Attitudes of the Private Sector towards the Application of Operational Contracting in Private Education Schools in the Sultanate of Oman: A Qualitative Study
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Abstract

The research aims to investigate the private sector attitudes toward operational contracting in special education schools. The research adopted the qualitative approach by using personal interviews with a sample of (45) private school owners and managers in Oman. The results of the research revealed that there is an agreement among the majority of respondents on the ability of the private sector to manage special education schools, the advantages of the partnership, as well as the need for guarantees to support this partnership. The government should fully assume it. The role of the private sector remains to raise the operational efficiency of schools. Opinions vary about the level of powers granted to t

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Publication Date
Fri Sep 30 2022
Journal Name
College Of Islamic Sciences
Educational Purports concluded from Verse No. 22 of Azzaryiat Surra/“And in the heaven is your provision, and that which you are promised”
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This research investigates the meanings and significance of the verse and the concluded educational purports. The expression “And in the heaven is your provision” signifies the deism of Allah. This research introduces the what have been said by Quran Explainers about meaning of Heaven & Provision. It introduces also the meaning of the sentence “which you are promised” and its concluded educational purports. This research discuses the role of educational institutions as well as the family and mosques in connecting Muslims and their children with the promise given by Allah.

Provision is guaranteed for all people if moral and material causes have been considered.

Key Words:

Purports – Educational – Co

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