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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
Fri Jun 12 2026
Journal Name
Albahith Alalami
Tendencies of Scientific Research in the Specialized Journalism the Media Researcher Magazine A survey study
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Publication Date
Sun Jun 30 2013
Journal Name
College Of Islamic Sciences
ا Hadiths prohibiting the intimidation of a Muslim in the six books - an analytical study
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This research deals with the hadiths of intimidation. An analytical study of the serious effects of intimidation in society. Intimidation and intimidation of a Muslim is a serious matter, because of the anxiety, intimidation, and dispossession of others ’rights, but some consider it easy, and others intimidate jokingly or seriously, which may lead to such intimidation to have effects Serious.
For intimidation entails the death of the individual, the disappearance of his mind, or the loss of his money, etc., from here the need was urgent; to show the vision of the prophetic Sunnah in denouncing intimidation, so we had this humble research tagged with (hadiths prohibiting the intimidation of a Muslim in the books The six are an analyt

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Publication Date
Wed Sep 15 2021
Journal Name
Al-academy
Designing Clothes that Meet the Functional and Aesthetic Needs of Children with Hip Dislocation: تهاني عبد الله القديري
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Children who have a health problem need special requirements for their clothes. The purpose of the study is to design functional and aesthetic clothes to meet their needs. The research used the applied descriptive approach. The research sample comprised 120 women whose children suffered from hip dislocation. Designs for injured children presented and submitted to the arbitrators for evaluation regarding the functional and aesthetic aspects. The finding was achieving the design solutions. The most important recommendations are to increase attention to designing clothes to suit all the needs of society.

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Publication Date
Thu Jun 01 2023
Journal Name
Journal Of Engineering
Automatic Spike Neural Technique for Slicing Bandwidth Estimated Virtual Buffer-Size in Network Environment
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The Next-generation networks, such as 5G and 6G, need capacity and requirements for low latency, and high dependability. According to experts, one of the most important features of (5 and 6) G networks is network slicing. To enhance the Quality of Service (QoS), network operators may now operate many instances on the same infrastructure due to configuring able slicing QoS. Each virtualized network resource, such as connection bandwidth, buffer size, and computing functions, may have a varied number of virtualized network resources. Because network resources are limited, virtual resources of the slices must be carefully coordinated to meet the different QoS requirements of users and services. These networks may be modifie

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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
Sat Aug 21 2021
Journal Name
مجلة الدراسات المستدامة
A Linguistic Study of Comment Clauses in the American Series “Friends “
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The present study is a linguistic study of comment clauses in the American Series „Friends‟ .Comment clauses refer to those clauses which comment on the content of the main clause or the attitude of the speaker towards the way of speaking .The problem of this study is to answer the following questions ; what types of comment clauses can be used in the face- to –face conversations , for what functions these comment clauses could be used , and how these comment clauses are used by the participants of these conversations . This study is a qualitative one . The study aims to investigate the types of comment clauses used in the American Series “Friends‟. The study also aims to investigate the pragmatic functions of these comment clause

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Publication Date
Sun Sep 30 2007
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
A Study in to the Dynamic Behavior of Packed Distillation Column
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The study of the dynamic behavior of packed distillation column was studied by frequency response analysis using Matlab program. A packed distillation column (80 mm diameter) (2000 mm height) filled with glass packing (Raschig Rings 10mm), packing height (1500 mm) has been modified for separation of methanol-water mixture (60 vol%). The column dynamic behavior was studied experimentally under different step changes in, feed rate (±30%), reflux rate (±22%), and reboiler heat duty (±150%), the top and bottom concentration of methanol were measured. A frequency response analysis for the above step response was carried out using Bode diagram, the log modulus and the phase angle were  used to analyze the process model. A Matlab progra

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Publication Date
Tue Jun 30 2015
Journal Name
College Of Islamic Sciences
The formula is effective in Surat Nisa: (A study of gramophone)
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The formula is effective in Surat Nisa
(A study of gramophone)

in the name of o Allah the Merciful
Praise be to Allah, Lord of the Worlds, and prayers and peace be upon the Seal of the Prophets and Messengers. The envoy is a mercy to the worlds Muhammad Sadiq Al - Amin and to the pure and good companions of the Tayyibites.
The formula of the morphological formulas, which have diverged from other meanings, whether lexicon or contextual and what this formula contains many meanings (effective source) and (effective in the sense of effective) and (effective sense reactor) and (effective sense) and ( (F) in the sense of a similar character) and ((the name of the) (collect). This was dealt with in the formula in Surat al-Nisaa

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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
Wed Dec 15 2021
Journal Name
Arab World English Journal
Reading Difficulties in English as a Second Language in Grade Five at a Saint Patrick’s High School for Boys, Hyderabad- India
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Reading is one of the essential components of the English language. Countries that use English as a second language (ESL) sometimes have difficulties in reading and comprehension. According to many researches, mother tongue has proved some interferences with learning a second language. This study investigated the results of reading difficulties of young second language learners in terms of accuracy, comprehension, and rate using the Neale Analysis of Reading Ability test. The study was carried out in one of the High Schools for Boys in Hyderabad, India and included Grade five, aged 10-12 years. In order to understand the reading difficulties of English as a second language, a qualitative approach was employed. Interview, reading tes

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