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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
Tue Dec 16 2008
Journal Name
Journal Of Planner And Development
The relationship between the uses of land and the network of movement and roads (study area, Najaf city)
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The interaction in the city is reflected in the movement of people motivated by their activities and their economic and social goals, which include many variables subject to the planning process in the interpretation of this movement and the mapping of trends of transport intensity through the concept of transport function and its functional relationships with the uses of the earth in the sustainability and effectiveness of the movement of transport and Economic activity and population movement. Transport planners are concerned with the requirements of land use, which are linked to and included in the transport planning process as a factor for the future transport needs. There is a strong relationship between the transport system

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Publication Date
Sat Feb 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Behavior of passive single pipe pile in sandy soil
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Abstract<p>This research focuses on studying the effects of soil movement on the behavior of an existing pile driven in sandy soil. A physical model has been manufactured to investigate the effect of construction of an embankment adjacent to free head single pile driven in sand of dry unit weight of 13.5 kN/m<sup>3</sup>. The model pile of diameter (D) of 10 mm are tested under two conditions of loading: loaded axially and without load. The model piles are instrumented with strain gauges along the embedded length to measure strains resulting from the soil movement. The embankment loads are applied at distances of 2.5, 5, and 10D from the edge of the pile. The results obtained from the </p> ... Show More
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Publication Date
Mon Jul 04 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of agricultural insurance in the prevention of financing risks in the form of slam : "An Empirical Study on Shikan Insurance and Reinsurance Company
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The aim of this research is to introduce agricultural insurance, to define financing in the form of salam and the role of agricultural insurance in the prevention of risks to agricultural finance operations in the form of salam by verifying the hypotheses through which to reach the results, including the imposition of risks for agricultural finance in the form of salam, The study of agricultural finance in the form of salm, the deductive approach to the development of the problem of research and hypotheses, and the inductive method to extrapolate the results through analysis and brother The researcher concluded that agricultural insurance works to bridge the risks facing agricultural finance in the form of the ladder in cases of

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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of Engineering
Comparative Biosorption Of Pb(II), Cr(III) AND Cd(II) Ions In Single Component System By Live And Dead Anaerobic Biomass, Bath Study
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In this study, dead and live anaerobic biomass was used in biosorption of Pb(II), Cr(III) and Cd(II) ions from a synthetic wastewater. The biosorption was investigated by batch adsorption experiments. It was found that, the biosorption capacities were significantly affected by biosorbent dosage. The process follows Langmuir isotherm (regression coefficient 0.995, 0.99 and 0.987 for Pb(II), Cr(III) and Cd(II) ions, respectively, onto dead anaerobic biomass) model with uniform distribution over the biomass surface. The experimental uptake capacity was 51.56, 29.2 and 28 mg/g for Pb(II), Cr(III) and Cd(II), respectively, onto dead anaerobic biomass, compared with 35, 13.6 and 11.8 mg/g for Pb(II), Cr(III) and Cd(II), respectively, onto live

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
Obscene speech in the Qur'anic perspective An objective study based on the verses and interpretation of the Noble Qur’an in diagnosis and treatment
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t:

The most famous thing a person does is talk. He loves and hates, and continues with it confirming relationships, and with it, too, comes out of disbelief into faith. Marry a word and separate with a word. He reaches the top of the heavens with a kind word, with which he will gain the pleasure of God, and the Lord of a word that the servant speaks to which God writes with our pleasure or throws him on his face in the fire. Emotions are inflamed, the United Nations is intensified with a word, and relations between states and war continue with a word.

What comes out of a person’s mouth is a translator that expresses the repository of his conscience and reveals the place of his bed, for it is evidence of

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Using the international standard for Training (ISO-10015) to Improve the Quality of the Control Activity – A Survey Study at the Federal Board of Supreme Audit.
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The great  importance of training made it as an investment for the organization, and assert the Quality of performance which support it by prepare the employee to the Current and future Jobs . The Research problem a rounded about How to measure the impact of training based on (ISO 10015) and its effect on the Quality of performance , How to evaluation the results of training to attained the training goals . The Research aims to find out the effects of application of international standard guidelines (ISO 10015) to attained the quality of audit work achieved in the Federal Board of Supreme Audit. The Research sought to achieve a number of objectives cognitive and applied on the basis of four key assumptions, and other su

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
The semiotic of the Islamic blazon - a related analytical study between the Islamic blazon and its publicity message: رغده بنت فيصل بن خضر الدعواني
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This study discusses the semiotic of the Islamic blazon - a related analytical study between the Islamic blazon and its visual publicity message. The aim of the current study is to explore the related relationship between the Islamic blazon and its visual publicity message. The sample is contained Five of Islamic blazon in the Mamelukes period which is between 1250 to 1517. The methodology is descriptive-analytical, and the result is that there is a clear relation between the Islamic blazon with its visual publicity message. This study's recommendation is to go towards analyzing the meanings of the cultural legacies of the Islamic civilization, and researching the implicit meanings accompanying these features leads to a deeper understand

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Publication Date
Thu Oct 18 2018
Journal Name
Al–bahith Al–a'alami
The Pressures Affecting the Performance of Iraqi Media before the Legislative Elections of 2018 (Iraqi Satellite News Channel- as a Model): A Survey Study  Dr.Safad Husam Hammody
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The modernity of election practices of the elections in Iraq, according to the democratic approach, has led to a struggle between political rival forces reflecting a deep pressure on the tools involved in the management, marketing or control of these elections across the general social level. Hence the problem of research resides in answering the following question: What is the nature and size of the pressures affecting the media performance of Al-Iraqia News channel before the legislative elections of 2018 in Iraq?
      The objectives of the research were the following:
1. to identify the nature of the pressures that limit the Al-Iraqia News channel’s perfo

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Publication Date
Thu May 12 2011
Journal Name
Iraqi Journal Of Medical Science
A comparative study between the side effects of copper intrauterine device in women with non-scarred and scarred uterus
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Publication Date
Sun Jun 08 2025
Journal Name
Al-fatih Journal
A comparative study of resistance training on land and in the aqueousTo develop some capacity for three Al Wathba
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أن التطور العلمي الحاصل فيما يخص المجال الرياضي أرسى آفاق جديدة لمواكبة التطور الكبير في مجا ل الألعاب والفعاليات الرياضية المختلفة ,و أن تحقيق النتائج الجيدة في فعاليات العاب القوى بشكل عام والثلاثية بشكل خاص في التدريب الرياضي يتطلب إتباع الأساليب العلمية الدقيقة والموضوعية بشكل سليم ومخطط له،فضلا عنة تطبيق نظريات ومنحى جديد لمواكبة الاتجاهات الحديثة في تحقيق النتائج الجيدة للوصول إلى المستويات العالية

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