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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
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Illegal migration and the European Union " a perusal of securing the phenomenon"
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Abstract This study seeks to deal academically with how the EU treats clandestine immigration, through adopting a purley security approach, based on the European understanding of security threats posed to the security of communities and States in EU at all levels. So they agreed upon criminalizing this threat within the bloc while using repressive tools and steps to limit illegal immigrants flow to European territories. Accordingly, the EU gave the phenomen a security character. So it takes it from low politics level , that of employment and economic field to that of high politics, as a new security problem lying within a new security language embraced by ruling European elites, in other words EU touched on this issue as a speech act emp

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
Vue sur la technique de point de vue dans le ROUGE ET LE NOIR de Stendhal
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It is axiomatical that the narrative prospective is profoundly significant to the writer who intends to commence his sketch of projected novel. It is the pillar of comprehensive absorbing as the writer should commit himself to circular his own concepts to the reader of his narrative characters.                                

   The dilemma of plot-perception is a twofold aspect; partly offers the question: what is the authors stand in regard to his characters? And: what is the aim of this theme? These correlative questions are inseparable since the reader who wishes

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Publication Date
Mon Feb 19 2018
Journal Name
Al-academy
The Mechanisms of build up the dramatic construction in the films of the world of nature - National Geographic's films as a model-
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The subject of  research entitled "The Mechanisms of build up the dramatic construction in the films of the world of nature - National Geographic's films as a model" emerges from the importance of the subject of the dramatic construction and its departure from its classic style due to the evolution of the visual  presentation and its instruments and the specificity and emergence of a form of television production represented by the films of the world of nature which began to occupy an important space in the map of television and television channels specialized in this subject, which drove the researcher to study the mechanisms of producing the dramatic construction in this kind of film s. This research came in three  chapt

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Publication Date
Sun Sep 04 2016
Journal Name
Baghdad Science Journal
The Synbiotic Effect Of Volaticle Oil Extracted From Leaves Rosmarinus Officinolis And Nigellai Sativa On Microbial And Sensory Characteristics Of Minced Poultry Meat During Cold Storage
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The objective of present study was to investigate the effect of using duplex volaticle oil of Rosmarinusoficinolis and Nigella sativain microbial quality, sensing and extending storage time of minced cold poultry meat. Duplex volaticle oil was added at 25, 50 and 75 mg/kg to minced poultry meat , these treatments were stored individually for (0 ,4 and 7) days at( 4-7) C0 . After making several microbial and sensing test. The following results were obtained:- The process of adding duplex volaticle oil of Rosmarinus officinolis and Nigella sativa to minced poultry meat led to significant reduced (P<0.01) in total arobic count, psychrophilic count and coliform bacteria during refrigerated storage periods. The results showed asignificant sens

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Publication Date
Fri May 19 2023
Journal Name
Revista Iberoamericana De PsicologÍa Del Ejercicio Y El Deporte
The Effect of a Training Curriculum According To the Physiological Index and the Transitional Speed of the 100m Hurdles Runner
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Recently, that there has been a decline in the levels of female players for this event in recent years compared to developments in the world, as this activity depends to achieve the highest level of performance on the physical capabilities and physiological indicators of the player who It is reflected in the achievement, which results in the loss of time for Iraqi female runners compared to the world champions in the (100) meter hurdles competition, which reflects on the level of achievement. The two researchers used the experimental approach in addressing the research problem, and the experimental design used the method of the two equal groups, the two experiments with the pre and post-tests. Female runner and second experimental group (4)

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Scopus
Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
African landlocked countries problems and outlets in the study and classification of geo-political
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Landlocked countries are displayed geopolitical new geo-political and intended to
countries that do not have sea views, a phenomenon present in four continents of the world
are: Africa, Europe, and Asia, and South America and the number arrived at the present time
to the (44) state the largest number of them in the continent it arrived in Africa (16) countries
in Asia (13) countries and Europe (13) In the State of South America two. This phenomenon
emerged due to the division of federations and empires and colonial treaties and others. But
the negative effects suffered by these countries may vary from one country to another, since
these countries in the continent of Europe, for example, is different from the same cou

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Publication Date
Thu Mar 01 2012
Journal Name
Advances In Materials Physics And Chemistry
Study the Effect of Irradiation Time and HF Concentration on Porosity of Porous Silicon and Study Some of the Electrical Properties of Its Based Device
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ABSTRACT Porous silicon has been produced in this work by photochemical etching process (PC). The irradiation has been achieved using ordinary light source (150250 W) power and (875 nm) wavelength. The influence of various irradiation times and HF concentration on porosity of PSi material was investigated by depending on gravimetric measurements. The I-V and C-V characteristics for CdS/PSi structure have been investigated in this work too.

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
A specimen of the internal control system on the stock in light of the application JIT system In construction companies
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Suffer most of the facilities of the high cost of inventory , which affects the high cost of the product and thus affects many administrative decisions , as well as suffer the facilities of the systems developed by the provisions of inventory control , and this problem is exacerbated in the construction sector where the inventory in the form of Construction spin of the Year for another it becomes difficult to control the cost effectively , and is the research problem in question follows: What are the implications of the use of the system in time inventory accounting system for the contracting company does kills Alrkaah to the provisions of the cost of inventory and what is the optimal approach to inventory control ? Find assumed

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Forced displacement in Iraq its causes and its effects on displaced families (A field study of displaced families to the city of Baghdad)
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After a temporary halt to forced thghebr in different cities of Iraq this methodlogy
opeations returned directiy in the areas of political conflict on the ground which are translated
operations and forced displacement violence es they operations aimed at completing the
forced displacement that occurred after the occupation in(2003)which took an upward curve
publicly after these events and some of which are aimed at the liquidation of some provinces
than any demographic diversity of religious or sectarian or alhens and others aimed at
redemographic distribution within the province itself to produce a net sectarian zones as is the
case in Diyala Nineveh and Babylon Baghdad has the epicenter of sectarian violence and th

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Publication Date
Tue Jan 19 2021
Journal Name
Isprs International Journal Of Geo-information
The Potential of LiDAR and UAV-Photogrammetric Data Analysis to Interpret Archaeological Sites: A Case Study of Chun Castle in South-West England
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With the increasing demands to use remote sensing approaches, such as aerial photography, satellite imagery, and LiDAR in archaeological applications, there is still a limited number of studies assessing the differences between remote sensing methods in extracting new archaeological finds. Therefore, this work aims to critically compare two types of fine-scale remotely sensed data: LiDAR and an Unmanned Aerial Vehicle (UAV) derived Structure from Motion (SfM) photogrammetry. To achieve this, aerial imagery and airborne LiDAR datasets of Chun Castle were acquired, processed, analyzed, and interpreted. Chun Castle is one of the most remarkable ancient sites in Cornwall County (Southwest England) that had not been surveyed and explored

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