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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
Thu Jun 01 2023
Journal Name
مجلة اداب المستنصرية
The Concept of dialogue, it's importance, it's goals and it's character A descriptive Study
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Dialogue is one of the most important means of calling to the Creator, as it is one of the scientific and verbal activities carried out by a group of interlocutors to present ideas they believe in, and evidence and proofs that express their views and demonstrate the reason for their belief in them, In order to arrive at the truth or a radical solution to a specific problem, so the interlocutor should pay attention to this science, study it and its etiquette, because the purposeful dialogue requires that the funniest of them be the most knowledgeable and knowledgeable about the axis of the hadith, and the funniest must also be able to be convinced of the rule of difference of opinion that does not spoil the issue of friendly They must also c

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Organizational citizenship behaviors under theory of servant leadership: A exploratory study in a sample of faculties of the University of Alqadisiya
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This study aimed to identify the role of servant leadership in promoting organizational citizenship behaviors in a sample of faculties of the University of Alqadisiya .It tried to answer several questions represented its problem.

 

 The most important questions are the followings:

1- Is there enough perception among administrative leaders in the aforementioned faculties toward the concept of servant leadership? And under what level?                                    &

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Strategic orientation and its reflection on the Learning organization: Survey study of a sample of Makers decision the Iraqi Ministry of Communications
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The current research focuses on the extent to which the strategic orientation(entrepreneurial orientation, customer orientation, technology orientation, learning orientation, and investment orientation) affects the learning organization (building common vision, systemic thinking, personal dominance, mental models, team learning)The first hypothesis to test the connection relation between research variables and The second hypothesis was to test the relationship between these variables. In order to ascertain the validity of the hypotheses, the research was based on a questionnaire questionnaire prepared according to a number of In addition to building a fifth sub-variable for the strategic orientation (investment orientation) based

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Publication Date
Mon Jun 14 2021
Journal Name
Turkish Journal Of Physiotherapy And Rehabilitation
A STUDY OF THE DIMENSIONS OF COMPETITION ANXIETY AND ITS RELATIONSHIP TO THE DIMENSIONS OF SPORTING ACHIEVEMENT MOTIVATION FOR YOUNG TENNIS PLAYERS
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One of the most important phenomena facing the athlete is the anxiety of sports competition, as he faces many psychological problems during training and in competitions of psychological tension, fear and anxiety that accompany him sometimes, which leads to affecting his level, and sports competition anxiety is a special type of anxiety that occurs in the athlete It is related to the attitudes of sports competitions and that participation in sports competitions and the associated emotional experiences are among the important factors that motivate the practice of sports activity and try to advance and develop his sports level. It is assumed that when the individual begins to practice any activity, he aims to reach a level or degree of achie

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Publication Date
Thu Oct 20 2022
Journal Name
Iraqi Journal Of Industrial Research
Study of the Effect of Epipremnum Aureum Extracts and Tribulus Terrestris L. as a Natural Alternative for the use of Industrial Antioxidants
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In this study, two types of local plants were chosen, the first is the plant golden pothos Epipremnum aureum and the second is the Iraqi Sheikh's chin plant Tribulus terrestris L, for the purpose of making a comparison between them in terms of their possession of chemical groups with antioxidant activity in order to use them as a natural alternative to using antioxidants Industrial that cause negative effects on human health, the samples were prepared using the method of water and alcohol extraction (ethanol 70%) for both plants. It revealed the presence of a number of chemical groups (tannins, carbohydrates, phenols, flavonoids, alkaloids) for both plants, the aqueous and alcoholic extracts. Coumarins are only found in the sheikh's chin pl

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Publication Date
Sat Jan 01 2022
Journal Name
Results In Chemistry
Effect of Polyeugenol coating on surface treatment of grade 23 titanium alloy by micro arc technique for dental application
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Titanium alloy (Ti-6Al-4V or Gr.23) was widely used as a dental alloy. In the current study, polymerization of eugenol (PE) on Gr.23 titanium alloys was conducted by an electrochemical process before and after being treated by Micro Arc Oxidation (MAO). The formed films were characterized by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and X-ray diffraction (XRD). The corrosion behavior of Gr.23 alloy in an artificial saliva environment at a temperature range of 293–323 K has been studied and assessed by means of electrochemical polarization and impedance spectroscopy techniques. Three cases are taken into consideration; bare Gr.23, Gr.23 coated by PE, and Gr.23 coated by PE after MAO treatment. The maxi

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Publication Date
Thu Feb 18 2021
Journal Name
Journal Of Optical Communications
Theoretical investigation of multiple input–multiple output (MIMO) technique for line of sight (LoS) underwater wireless optical communications system
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Abstract<p>In this paper, a theoretical investigation was suggested to study underwater wireless optical communication (UWOC) system based on multiple input–multiple output (MIMO) technique. The modulation schemes such as RZ-OOK, NRZ-OOK, 32-PPM and 4-QAM applied under different coastal water types. MIMO technique enabled the system to transmit data rate with longer distance link. The performance of the proposed system examined by BER and data rate as a metrics. Several impairments such as the types of water by the attenuation of coastal water and the distance link were taken into account for the transmission of the optical signal to appreciate the reliability of the MIMO technique. The theore</p> ... Show More
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Publication Date
Thu Nov 01 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Factors that Contribute of Lung Cancer
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Abstract A descriptive study to assess of factors that contributes of lung cancer. The study was carried out in Specialized Surgery teaching hospital, Ibin Al- Beetar hospital and Ibin Al- Nafees hospital for the period From January 2004 to October 2004 .The study aimed to assess the factors that contribute to lung cancer and to identify the relationship between the variables of the study with lung cancer. A purposive (non-probability) sample of (70) patients with lung cancer was selected for the study. An assessment form was employed for the purpose of the study. Test- retest reliability was employed through

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of The Faculty Of Languages
A Psychological Reading of The Problem of the Black in John Steinbeck’s Of Mice and Men
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Publication Date
Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
A Psychological Reading of The Problem of the Black in John Steinbeck’s Of (Mice and Men)
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The present paper applies Fanon Psychological reading of the problem of the Black introduced in his book Black Skin White Mask to Crooks, The black Character in John Steinbeck’s  Of Mice and Men. The analysis of this character infers three essential points regarding the artistic achievement of the author. First, he uses a fictional character that offers a psychological interpretation of the black problem of alienation and loneliness in a way that does not disgrace the black. Second, he applies Fanon’s way of showing the various attitudes that the black adopts in contact with the white society. Third, he affirms that the black inferiority complex comes as a result of double proc

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