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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
Sat Apr 13 2019
Journal Name
Journal Of The College Of Languages (jcl)
A Study of Collocation in English
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We used to think of grammar as the bones of the language and vocabulary as the flesh to be added given that language consisted largely of life generated chunks of lexis. This “skeleton image” has been proverbially used to refer to that central feature of lexis named collocation- an idea that for the first 15 years of language study and analysis gave a moment‟s thought to English classroom material and methodology.
The work of John Sinclair, Dave Willis, Ron Carter, Michael McCarthy, Michael Lewis, and many others have all contributed to the way teachers today approach the area of lexis and what it means in the teaching/learning process of the language. This also seems to have incorporated lexical ideas into the teaching mechanis

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Engineering
Using of Constructed Wetlands in The Treatment of Wastewater: A Review for Operation and Performance: Review for Using of Constructed Wetlands in The Treatment of Wastewater: Operation and Performance
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Wastewater recycling for non-potable uses has gained significant attention to mitigate the high pressure on freshwater resources. This requires using a sustainable technique to treat natural municipal wastewater as an alternative to conventional methods, especially in arid and semi-arid rural areas. One of the promising techniques applied to satisfy the objective of wastewater reuse is the constructed wetlands (CWs) which have been used extensively in most countries worldwide through the last decades. The present study introduces a significant review of the definition, classification, and components of CWs, identifying the mechanisms controlling the removal process within such units. Vertical, horizontal, and hybrid CWs

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Publication Date
Thu Dec 01 2011
Journal Name
Journal Of Engineering
EFFECT OF COOLING RATE ON MECHANICAL PROPERTIES OF EUTECTIC AND HYPOEUTECTIC Al-Si ALLOYS
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In this research the effect of cooling rate and mold type on mechanical properties of the eutectic
and hypoeutectic (Al-Si) alloys has been studied. The alloys used in this research work were (Al- 12.6%Si
alloy) and (Al- 7%Si alloy).The two alloys have been melted and poured in two types of molds with
different cooling rates. One of them was a sand mold and the other was metal mold. Mechanical tests
(hardness, tensile test and impact test) were carried out on the specimens. Also the metallographic
examination was performed.
It has been found that the values of hardness for the alloys(Al-12.6%Si and Al-7%Si) which poured in
metal mold is greater than the values of hardness for the same alloy when it poured in a heated

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Publication Date
Sat Oct 01 2016
Journal Name
Al–bahith Al–a'alami
Semiotics of Joseph Curtis… A Study in Perspective and Concept
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Joseph Curtis wrote in his book (Introduction to Semiotics narrative and rhetoric) on the development of a semiotic project in exploring the meaning of communion. The book is rich in theoretical and analytical benefits both in the approach of texts and in the pursuit of letters in search of mechanisms of scriptural and scriptural generation and mechanics in narrative production, especially as the book offers exercises that help to assess the distance separating the narrative spread from the sin of the text, for the semiotics, Refers to the theoretical developments of the science of relations, through the combination of conventional definitions and the representative and comparative limitations, to provide an approach to the application o

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Publication Date
Mon Dec 22 2025
Journal Name
Al–bahith Al–a'alami
The extent of Concern of the University Press in Students’ Issues (Journal of the University of Technology as a Model) for the Period from 2009 to 2012
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The university press is an essential pillar in building an academic community to achieve its objectives in the service of society. Since the university press is a means of university media, which is issued by the departments or units of media in Iraqi universities as academic governmental-institutions, so it highlights the activities of the university and link them to its internal society in the first place as the university press is a mirror of the university and its voice is sincerely expressed. This research comes to know the extent of interest of the university press in various student issues.

In order to identify the problem of the research, the method of content analysis was adopted within the survey method

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Publication Date
Mon Oct 01 2018
Journal Name
Al–bahith Al–a'alami
International News Agencies Treatment of the Great Return Marches A Case Study of Agence France Presse “AFP”
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This study examines Agence France Presse’s (AFP) media treatment of the Great Return Marches in order to identify its contents, the issues it gave attention to, its sources, attitude, techniques, objectives, the journalistic forms used in covering events and the typographic elements used to highlight them.

This descriptive study employed the survey methodology through the use of content analysis method, and the methodology of mutual relations through the use of the case study method. The data was collected by means of a content analysis form. The study was based on the Agenda Setting Theory in the analysis of the study results.
The study sample included (116) news texts from AFP collected during the period from 20/3/2018 to

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Publication Date
Tue Feb 12 2019
Journal Name
Iraqi Journal Of Physics
A Study of the generation of laser soliton from spontaneous emission by ring cavity with carbon nanotube
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We demonstrate a behavior of laser pulse grows through fiber laser inside and output cavity with a soliton fiber laser based on the multi-wall carbon nanotube saturable absorber (SA), we investigate the effects of a saturable absorber parameter on the mode-locking of a realistic Erbium fiber ring laser. Generalized nonlinear Schrodinger equation including the nonlinear effects as gain dispersion, second anomalous group velocity dispersion (GVD), self phase modulation (SPM), and two photon absorption used to describe pulse evolution. An analytical method has been used to understand and to quantify the role of the SA parameter on the propagation dynamics of pulse laser. We compute the chirp, power, width and phase of the soliton for range

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Publication Date
Wed Jan 01 2020
Journal Name
Plant Archives
STUDY OF THE EFFECT OF COLD PLASMA ON THE REPRODUCTIVE ENDOCRINOLOGY OF MALE RATS
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Cold atmospheric plasma (CAP) is used widely in medical and biological fields because of non-thermal effected. Direct application of plasma is preferred in medical functions, so, direct application of cold plasma has obtained by the floating electrode dielectric barrier discharge (FE-DBD) system. The purpose of this paper to review the effect of (CAP) on the reproductive hormones (testosterone, LH, E2, progesterone, for male rats. The study appeared that no significant effect on E2 and progesterone hormone for all time of exposure, besides this significant difference in LH hormone (P<0.05) at 15 sec, (P<0.0001) at 30, 90 sec and (P<0.001) at 60 sec of exposure to plasma. Added to that significant difference (P<0.01) at 15, 30, 60 sec and no

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Publication Date
Tue Dec 06 2011
Journal Name
Journal Of Planner And Development
The Development of the planning and architectural thought of the holy city of Kadhimia in line with the spirit of the time
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The evolution of thought, planning for Urban Communities in the second half of the twentieth century, through several successive stages. He was thought of planning urban communities depends on identifying the general plan for land uses of the project area as a basis for drawing charts the physical, social, economic, and put the general plan for land uses based on the terms of reference set by the number of experts in the ministries and agencies. I have lived cities in the Arab-Muslim region, during the transition period the natural and historic environment, urban, sophisticated balanced ways mentioned in the cultural, social, inspired by the teachings of Islam and the customs and traditions of the Arab social, put forth a set of

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Publication Date
Fri Mar 31 2017
Journal Name
Al-khwarizmi Engineering Journal
Study the Catalytic Activity of CeO2 Catalyst for the Oxidative Degradation of Orange G Dye in Aqueous Solution
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The oxidative degradation of Orange G dye by nanosized CeO2 catalyst has been performed in this study. The catalyst was prepared by precipitation method. Various characterization techniques were carried out to study the physical and chemical properties of the synthesized catalyst. The XRD result confirms well the formation of CeO2 cubic phase.  The FTIR result showed the effect of calcination temperature for CeO2 was clearly observed due to reduction in band intensity compared to uncalcined Ce nitrate sample. Meanwhile, the diffused reflection spectra recorded reflection spectra at 414 nm with an energy gap of 3.2 ev. The decolorization of Orange G dye by oxidation process were carried out  unde

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