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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
Sun Jan 01 2012
Journal Name
Journal Of The College Of Languages (jcl)
A Phonological Study of English and Arabic Assimilation : A Contrastive Study
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        Assimilation is defined ,by many phoneticians like  Schane ,Roach ,and many others, as a phonological process when there is a change of one sound into another because of  neighboring sounds.This study investigates the  phoneme assimilation as a phonological process in English and Arabic  and it is concerned specifically with the differences and similarities in both languages.   Actually ,this study reflects the different terms which are used  in Arabic to refer to this phenomenon and in this way it  shows whether the term 'assimilation ' can have the same meaning of  'idgham' in Arabic or not . Besides, in Arabic , this phenomenon is discussed from&nb

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Importance of Effort and its Impact in Building the Society in the Light of the Holy Book and Sunna
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The Importance of Effort and its Impact in Building the Society in the Light of
the Holy Book and Sunna.
Thank for God and peace be upon Prophet Muhammad, His hose hold and
Companions.
This research is to refute a fault : that Islam as a religioncalls for laziness and
dependence and this in first, Second, to show the originality of the Islamic method in
building and construction.
This research Starts with an introduction in which I refer to the nature of the
Islamic method and its way of work in life: that it is a divine method that is achieved
by the effort of the people them selfves and not through a divine extraordinary power:
The research explains the shift in the peoples life who were addressed by this<

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Evaluation of Lands in Yusufiya County -study in the soil geographic
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This study has contributed to identify convenience of the land Usifiya of Mahmudiya district baghdad province for the cultivation of sensitive and salt resisting crops and growing pasture .The nine pedons (tracks) of the study have spread over three transects to cover the whole area the north, middle and south .
Depending on Visual Space tupe (TM) for 2007 which is super classified, samples are distributed on all classes of land cover
It is detected the presence of nine series soils namely
MM5- MW96- DM 115 for 1st transect
MF12- DM46 - DM96 for 2nd transect
DM56- DF56 - MW5 for 3rd transect
Soils are classified to the level of sub great group according to (soil Survey Staff) to :
*Typic Torri Fluvents , Typic Haplos

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Publication Date
Thu Dec 26 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The dimensions of Financial inclusion and its role in achieving competitive advantage: An exploratory research of the views of a sample of clients of the Algerian commercial Banks
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The research aims to identify the role of the dimensions of financial inclusion in achieving the competitive advantage by An exploratory research of the views of a sample of customers of the 20 Algerian commercial banks, And the relationship between its dimensions (Access dimension, Usage dimension, Quality) And competitive advantage. This research is based on the analytical descriptive approach. The questionnaire was adopted as a main tool in collecting data and information on the sample of 377.

The The research showed several results, the most important of which is a strong correlation between the dimensions of the three financial inclusion combined and the competitive advantage of the Algerian commercial banks, and explained t

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Role Of The economic And External Factors In Selecting Aggregate Planning Alternatives For Workforce Case Study In Yarmouk Teaching Hospital
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The research aimed to achieve many objectives represented in two variables, which are the impacted factors and the aggregate planning alternatives of workforce in Educational Al- yarmouk Hospital , This research started from a problem focused on finding solutions to the demand’s  fluctuation  or the energy limitation while the study importance is emerged from diagnosis the suitable strategy and adopt the suitable alternatives due to their importance in meeting the demand for the health service submitted by the hospital .This study  based on choosing assumptions of connection relationship and the impact among the mentioned variables in the(surgery and internal diseases) departments. The research is dependent on ch

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Publication Date
Wed Mar 30 2016
Journal Name
College Of Islamic Sciences
Message in detail what was said in the parents of the Prophet  Ibn Kamal Pasha (d. 940 e) study and investigation
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After Hamdallah and his success on the realization of this manuscript (a letter in detail what was said in the parents of the Prophet  Ibn Kamal Pasha (d. 940 e) study and investigation I will review some of the results reached in the realization of this manuscript:
1. The hadiths mentioned in this manuscript are mostly placed or weak.
2 - We are not entitled to speak about the silence of the law for saying Almighty ﭽ ﮮ ﮯ ﮰ ﮱ ﯓ ﯔ ﯕ ﯖ ﯗ ﯘ ﯙ ﭼ Table: 101.
3 in which harm to our Holy Prophet  وله تع ﮂ ﮃ ﮄ ﮅ ﮆ ﮈ ﮉ ﮊ ﮋ ﮌ ﮍ ﮎ ﭼ parties: 57.
4 Because the parents of the Prophet  of the people of the period ordered them to God for the Almighty ﭽ ﯨ ﯩ ﯪ ﯫ ﯬ

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Publication Date
Tue Jun 01 2021
Journal Name
Political Sciences Journal
The economic dimensions of the railway link between Iraq and Kuwait and the role of national alternatives (Faw port and the dry canal as a model(
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   Decision-makers in each country work to define a list of internal and external interests, goals and threats to their countries according to the nature of their awareness of these interests, goals and threats. 

  Hence, Iraq is not an exception to this rule, and the process of evaluating its interests and the objectives of its foreign policy is subject to the pattern of awareness of decision-makers and the influencing forces in defining its basic interests, which often witness some kind of difference in defining them, evaluating their importance and determining the size of the threats they face. And among these interests and threats that have witnessed a difference in the assessment of their

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Publication Date
Tue Aug 02 2022
Journal Name
International Journal Of Research In Social Sciences &amp; Humanities
The Making of a Heroine: A Female Character as Portrayed in The English Patient By Michael OndaatjE
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This article discusses how women have significant abilities to cope with the difficulties of war times. They are not the weak and vulnerable victims who are thought to be. On the contrary, they have the power to control over many-sided fronts, like participating in the battlefield as nurses or activists for peace, or even fighters, as well as through the tasks and responsibilities assigned to them to protect and support their families during wartime. The researcher will examine the impact of war upon women. Like men, women suffer during wartime. They are being injured, tortured and killed. Yet, they are able to give examples of love and courage even in the difficult times of war. Hana is one of those women who lived during wartimes,

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Publication Date
Sun Jul 17 2022
Journal Name
Al–bahith Al–a'alami
The Pocessing of Extremism’s Manifestations in the T.V Talk Shows : A Paper Extracted from A Masters Thesis
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This study aims to know how and what is the media processing presented by the television talk shows for the religious extremism topics in terms of topics, hosted personalities, and ways to address this global phenomenon.

The study is based on descriptive research, and the researcher used the analytical-survey method, analyzing the episodes of (Awkar Al Dhalam) T.V Show which was presented on Al-Iraqiya News Channel, and (Islam Hur) T.V Show which was presented on Al-Hurra in 2019 with 25 episodes from each Show, The sample and research community was chosen with the intent to cover the research problem and its

The study reached several conclusions, including:

  • The various dialogs in the episo

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The risks of derivatives contracts and their reflections on the global financial crisis Analytical study in (Toronto – Dominion) bank
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The research tacklets the role of risks arising from the excessive use of derivative contracts for trading in financial crises, including the recent global financial crisis in (2008) which is known the mortgage crisis.

   In order to prove the hypothesis of the research, the risk index of derivative contracts has been chosed as expressed in the measure of (value at risk) to be the main field for testing the hypothesis of research. The duration of the contract  has been also chased  for (15) years between the years (2001- 2015), the period preceding the global financial crisis, while the second represents the period of time that followed. The research reached a number of conclusions, bu

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