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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 Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Employing electronic supervision applications in developing the teaching performance of teachers in the Sultanate of Oman: a suggested vision
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The study aimed to investigate the employment of electronic supervision applications in developing the teaching performance of teachers in Oman. Based on the qualitative method and the study population consisted of all the teachers of the first cycle in the Governorate of Muscat. The study sample amounted to 24 female teachers. The interview was used as a tool for data collection. The study reached several results, including: There are difficulties in employing electronic supervision applications, which are weak network, density of curricula, lack of experience in applying technology, and the large number of tasks assigned to the teacher. These difficulties can also be overcome by strengthening the network, training teachers, reducing th

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Publication Date
Fri Mar 18 2022
Journal Name
International Journal Of Health Sciences
Histological and Immunohistochemical Study of the Protective Effect of Virgin Coconut Oil on Cyclophosphamide-induced Immunotoxicity of the Spleen and Peyer’s Patches
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Publication Date
Wed Aug 02 2023
Journal Name
Migration Letters
The Effectiveness of the Public Relations of the Sunni Endowment Diwan through Social Networking Sites: An Analytical Study of the official Facebook page of the Diwan
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The Internet has added another dimension to public relations in institutions and organisations, as it provided tools and communication channels, especially social networking sites, which provided information and data on public relations for the institution through these websites. In addition to its communication with its audience, and the audience's interaction with it, so our research tagged (the effectiveness of public relations of the Sunni Endowment Diwan through social networking sites): An analytical study of the official Facebook page of the Diwan that addresses the knowledge and monitoring of the contents of the official Facebook page that public relations adopt in providing information, data, and activities of the Sunni End

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Publication Date
Mon Jun 05 2023
Journal Name
Al-khwarizmi Engineering Journal
Fabrication and Analysis of Denture Plate Using Single Point Incremental Sheet Forming
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Incremental sheet forming (ISF) is a metal forming technology in which small incremental deformations determine the final shape. The sheet is deformed by a hemispherical tool that follows the required shape contour to deform the sheet into the desired geometry. In this study, single point incremental sheet forming (SPIF) has been implemented in dentistry to manufacture a denture plate using two types of stainless steel, 304 and 316L, with an initial thickness of 0.5mm and 0.8mm, respectively. Stainless steel was selected due to its biocompatibility and reasonable cost. A three-dimensional (3D) analysis procedure was conducted to evaluate the manufactured part's geometrical accuracy and thickness distribution. The obtained results confirm

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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
The impact of a practical treatment program in enabling victims of bullying in a sample of 6th graders
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This study was aimed to explore the impact of a practical program on supporting and reducing
symptoms of school bulling victims in a sample of student in the sixth grade. The study sample consisted of (18)
students that have been chosen from two schools (Al-Abass and Alataa’) it was an intended sample, because
there were enough student with high scores in bulling victims diagnostics test, the sample was divided into two
groups: the control group of (9) student from (Alataa’) school, and the experimental group consisted of (9)
student from Alabass) school keeping in mind to keep the two groups equivalent in maintaining equal controls.
The researcher applied the practical program which is based on cognitive behavioral

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Business Process Reengineering in the institutional performance : Research in the office of the General Inspector in the Ministry of Higher Education and Scientific Research
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Abstract

       This research is aimed at indicating the impact of business process reengineering on corporate performance in the Office of the Inspector General of the Ministry of Higher Education and Scientific Research of the Iraqi study has identified a problem in a number of the most important questions - what the impact of the Business Process Reengineering at the corporate office performance indicators respondent? What are the actual results of the analysis of paths Administrative Process Engineering and Corporate Performance respondent in the office? In order to achieve the goal of the research and answer the questions of the problem, the study applied to a sample of

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Publication Date
Sun Sep 01 2013
Journal Name
Baghdad Science Journal
Study Analytical of The Effect Magnesium ion Concentration to Determination the Total Hardness And Comparison Spectrophotometry
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The determination hardness in water raised to rivers caused several problem in the validity of the water used depends on where determination ions concentration calcium and magnesium in salts carbonate and sulfate , this possibility of separation between of these ions and the resulting impact on concentration and determination the degree of hardness water and appreciation between the insolvent water quality . It study the effect of the impact of concentration magnesium ion in determination the quality of the water has turned out to be Mg concentration more than 60% of the total content of hardness is borderline in hardness effect the determination. Adopted in this research determination the ions in two method titration by EDTA solution and

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Publication Date
Wed Dec 25 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Non-interest income and its impact on the profits of the Iraqi banking sector: (Comparative study)
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     In this study,  has been discussed the issue of non-interest income and its impact on the Iraqi banking sector profit for the period between (2008-2017) as it was the main objective of the study is to find the relationship between the non-interest income and the profits of the banking sector in order to know  the size of the sector's dependence on non-interest income As well as an analysis of its profitability compared to selected countries, And to test hypotheses, the financial ratios and some statistical tests to determine the stability of the time series such as the test (Correlegram , Dickey -Fuller (depending on the statistical program (E-Views V8) and a simple linear regression method by (Minitab

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Publication Date
Sun Jun 30 2024
Journal Name
Lark
The Image of the Arab in Hebrew Literature for Young Adults – A Reading of the Novel “Nadia” by Kalila Ron Feder
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يهدف هذا البحث الى التطرق الى صورة العربي كما يعرضها ادب اليافعين العبري في رواية " نادية " للكاتبة العبرية " كاليلا رون فيدر " . والتي تعد من الاديبات العبريات اللواتي تطرقن بصورة مباشرة الى موضوع ما خلف الجدار ، والصراع العربي – الإسرائيلي وانعكاساته على المجتمع الإسرائيلي بصورة عامة والمجتمع العربي بصورة خاصة . ينقسم هذا البحث إلى ثلاثة فصول، تطرق الفصل الأول  إلى "ادب اليافعين"، و تاريخه ، مميزاته والفئ

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Publication Date
Sun Dec 16 2018
Journal Name
Al-academy
The Overlap of Visions between the Scenographer and the Director in the Theatrical Show
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After the spread of the function of the scenographer in the modern theater, his vision has become present in most of the theatrical works and because the director is the master of the work and the owner of the vision that appears in front of the audience, the overlap between the visions of each of them was required. This research is an attempt to detect the overlap and disengagement in the work of each of them.
The research is divided into a methodological framework that included the research problem, importance, limits, and purpose, and then the definition of terms. In the theoretical framework, the research dealt with two theoretical sections that pave the way for raising ideas related to this subject: the first section (scenography

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