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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 Jun 02 2025
Journal Name
Journal Mustansiriyah Of Sports Science
A comparative study of mental abilities and athletic achievement motivation among students of the College of Physical Education and Sports Sciences at the University of Baghdad
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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Cyber security technology and the reflection of its application on the quality of financial reports: An exploratory study of a sample of internal and external auditors
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Abstract

                 This research aims to define the roles of auditors by clarifying the concept and risks of cyber security in protecting information and financial data in economic units. Najaf, Babylon and Karbala, then the results were analyzed and the results were presented and analyzed to show that adopting cyber security improves the quality of reports Finance through what it achieves in displaying information with credibility and transparency, in a way that suits the needs of users, and cyber security has a role in managing economic resources more effectively to obtain benefits that would have been lost in the event of an

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Publication Date
Sat Jul 22 2023
Journal Name
Journal Of Engineering
The Influence of Politics on Architectural Thought A Descriptive and Analytical Study of the Effect of Political Ideology on the Achieved Architecture (Berlin City as an Example)
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The research investigates the political effect and its directions on the architectural thoughts and its achievements and how can this political system affect all fields of life in communities including architectural urban design. The problem of the research lies in the ambiguity effects of the ideological national directions of the Nazi Party on the architecture and urban design of the city of Berlin, then determining the aims of the research to discuss the concepts of politics and architecture and their relation to the way of thinking that plays a role in the process of design that works on property and achieving the suitable urban environments for those communities. After that, the Nazi's party's thought would be studied and analyzed,

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Publication Date
Mon Dec 26 2022
Journal Name
Journal Of The College Of Basic Education
The directorial vision of the theatrical text In the concept of a picture theater
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أثر تنوع الرؤى الاخراجية للاتجاهات والحركات المسرحية المعاصرة في أتساعالاشتراطات الجمالية لبنية الخطاب المسرحي + الامر الذي ادى الى انزياح مكوناتالعرض وعناصره ؛ ومنها المنظومة السردية للنص التي شكلت في بدايات المسرحجغرافية العرض المسرحي والمرتكز النظري والفكري الذي يمد العرض المسرحي أغلبتدفقه الجمالي وعنصر أستعلائي لعناصر العرض الاخرى ؛ وضمن التطورات اللاحقةأنسحب المخرج المسرحي من سطوة البنية النص

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
Building a Training Program in the development of the Willpower of the Kindergarten Children
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The research aims to build a training program to develop the willpower in the kindergarten children. In order to achieve the objective of the research, the two researchers have developed a Training Program according to the following steps:

- Determining the general objective of the Training Program.

- Determining the behavioral objectives of the Training Program.

- Determining the content of the Training Program.

- Implementing the content of the Training Program sessions.

- Evaluating the Training Program.

The training program consisted of (15) sessions, each session included a set of parts (title, general objective, methods, time and place to implement the sessions, behavioral goals, tool

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Publication Date
Tue Oct 30 2001
Journal Name
3rd. Jordanian Civil Engineering Conference ,29-31 Oct.2001. 2001
The Use of the F.E.M. to Study the Performance of Stone Columns in Soft Soil
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In this paper, the penetration of the stone column was investigated in order to get the minimum length of the stone column above which the increase in length has little advantage. The effect of using different materials in column are also studied. The material used is granular of different angle of internal friction (). The results of the investigation indicated that the effect of stone column remains constant when the ratio of the thickness of the soft clay layer to the stone column’s diameter is more than 15. The results also indicated that a pronounced effect is obtained when the angle of internal friction of the stone column material is increased.

Publication Date
Thu Mar 09 2023
Journal Name
Tajseer Journal For Multidisciplinary Research And Studies
The general principle governing the duty of care (Study in the light of English law)
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The duty of care is the essence of the error of negligence under the English legal system, and without it, responsibility for negligence cannot be judged, regardless of the extent of the damage incurred. contained in English law. In view of the importance of proving the existence of the duty of care on the defendant so that it is possible to judge his responsibility for negligence, the need arises to find a general principle to which the defendant is subject in order to decide whether he owes the plaintiff with the duty of care and therefore responsible for the negligence, and this is what we will explain in the research topic the study.

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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of The College Of Education For Women
protect the environment from destruction in light of the verses of the Quran (Subjective Study)
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Environment suffered in recent years a large corrupting by human; and because of his ignorance of the dimensions of Caliphate in the ground and ignore what it means gearing. The gearing is that the son of Adam, which will benefit the board of Allah Almighty to him in the land of the causes of life, without exaggeration or negligence and without prejudice to the cosmic Balnoames enacted by the Almighty Creator, has urged verses of the Quran Muslim to preserve and protect the environment which is a religious duty, as it showed a great verses he is the author and the splendor and beauty of workmanship and manufacturer greatness of the Almighty, who created all things beautiful.
Koran played a major role in the consolidation of environmen

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Publication Date
Sun Jul 17 2022
Journal Name
Al–bahith Al–a'alami
Post-interactive communication A study to build a model for the flow of communication in social networking sites
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The issue of the research lies in the non-representation of the models developed for the communication process in the interaction and networking processes through social media, as the research sought to build a network model of communication according to the specific data and features of social media platforms in order to reach a special generalization to understand how the process of networking operates in cyberspace.

The researcher followed the analytical survey approach as she described the communication models outwardly in order to be able to build a networked communication model that represents the flow of post-reactive communication. Therefore, it has been named "Nebula - Sadeem" after the concept of post-space and cosmic g

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Publication Date
Wed Mar 16 2022
Journal Name
Journal Of Educational And Psychological Researches
The Extent to Which Future Skills are Employed During Teaching from the Viewpoint of Students of Islamic Studies and their Relationship to Students' Attitude towards Future Profession
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The research aims to identify the relationship between employing future skills during teaching from the viewpoint of students of Islamic studies at the Northern Border University, as well as their attitudes towards future professions. The researcher employed the correlational descriptive approach. The tools were a questionnaire for employing future skills, and a scale for the attitude towards the future profession. The two research tools were applied to a random sample of (242) male and female students from the department of Islamic Studies, College of Education and Arts. The findings showed that the total level of employing future skills and their three axes during teaching was average. It was also found that the attitude towards future

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