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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 Sep 19 2017
Journal Name
Al-academy
The structure of design and technology in the contemporary design in the interior spaces
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The design of the interior spaces process the product of intellectual civilization expresses the prevailing thought, discoverers of principles and beliefs through the sheen reflects the present, and generating languages ​​graphical variety caused a different revolution in design mounting structure, and because of the complex nature of the interior spaces were and we have to be a reflection of cultural reality of being a form of cultural expression and true embodiment of scientific developments prevailing for each stage where she was born, the changes occurring in human thought and then extremism and the discrepancy tastes among individuals all communities factors have caused a change in the design structure involving modernization an

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Publication Date
Fri Mar 01 2024
Journal Name
Al-khwarizmi Engineering Journal
Quantitative Analysis of Isometric Ankle Torque and Muscle Activity during Dorsiflexion and Plantarflexion
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  Foot and ankle movements are essential in various activities like walking, running, and balance, where the mechanics of these movements are affected by the muscles around the ankle joint [1,2]. In this study, the correlations between isometric ankle torque and muscle activity of the tibialis anterior (TA) and gastrocnemius (GAS) in the course of dorsiflexion and plantarflexion was investigated. Eight healthy participants were enrolled for the study, where the ankle torque and surface Electromyography (sEMG) of the main flexors were measured and analyzed. The results showed that ankle torque is higher in plantarflexion than dorsiflexion. In addition, the TA has greater muscle activity during dorsiflexion, while the GAS presents higher ac

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Publication Date
Mon May 23 2022
Journal Name
The International Journal Of Artificial Organs
Quantitative analysis and control of the torque profile of the upper limb using a kinetic model and motion measurements
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This paper investigates a new approach to the rapid control of an upper limb exoskeleton actuator. We used a mathematical model and motion measurements of a human arm to estimate joint torque as a means to control the exoskeleton’s actuator. The proposed arm model is based on a two-pendulum configuration and is used to obtain instantaneous joint torques which are then passed into control law to regulate the actuator torque. Nine subjects volunteered to take part in the experimental protocol, in which inertial measurement units (IMUs) and a digital goniometer were used to measure and estimate the torque profiles. To validate the control law, a Simscape model was developed to simulate the arm model and control law in which measurem

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Publication Date
Thu Jun 28 2012
Journal Name
Journal Of Physical Education
The Study of the Motor coincidence and sensitive- Kinetic Perception and its Relation them with Artistic Performance Level in Gymnastics Skills for Women
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The aim of this study was Identifying the relation of coordination and kinesthetic perception with artistic performance level in gymnastics skills for students in second class from the college of physical education/ university of Baghdad/ Al - jadreia .The searchers have been used the descriptive method in scanning style .The subject of this search has been taken (45) female - student in second class from the college of physical education/ university of Baghdad . The searchers have reached into specific conclusions concerning with statistic analysis about immoral joint relation between sensitive- kinetic coincidence and realization and with Artistic Performance Level in Gymnastics Skills for Women for second class .The an important recommen

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Publication Date
Fri Apr 30 2021
Journal Name
МИР НАУКИ, КУЛЬТУРЫ, ОБРАЗОВАНИЯ
SIMILARITIES AND DIFFERENCES IN THE NAME OF BREAD IN THE GLUTONIC PICTURES OF THE WORLD IN THE RUSSIAN-LANGUAGE AND ARABIC-LANGUAGE NATIONAL-CULTURAL CODES
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The author’s research is dedicated to the actual problem of identifying the linguoculturological and translation features of the glutonic vocabulary both in Russian and in Arabic. It is noted that the vocabulary of the glutonic type is extremely rich and diverse, as it is part of the national and linguistic culture of the Russian and Arab people. In the gastronomic discourse of the Russian people and the Arab peoples, it is represented by various parts of speech. The study of the traditions of food consumption confirmed the rich stylistic possibilities of the glutonic vocabulary, the names of bread in Russian and Arabic languages. It has been established that in modern Russian gastronomic discourse, glutonic lexical units are involved

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Publication Date
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
Features of (Possible for Itself) in the (Alashaira) opinion – Spoken Study
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My study here is about the (possible for itself) features especially in the (Alashaira) opinion, also I touch to the other logicians opinions, I clarified these features concisely in the preface to be clear in front of the reader, I made it in two studies and five subjects.I talked about the meaning of the existence in the ((possible for itself) theme, and I clarified its types in the logicians and the philosophers' opinions, through which the existence and the nonexistence are equal in it, as it cannot be existed nor be nonsexist unless with a separated reason, and there is no necessity to oblige its existence, or its nonexistence is impossible.Then I talked about the outweighing of the (possible for itself) as one side  of the exi

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Publication Date
Tue Jun 18 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Effect of Corporate Goverment in Tax Planning: An Empirical Study
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The purpose of this study is discuss the effect of Corporate Governance in the Tax Planning, has been made in a sample of Iraqi Industrial contribution Companies listed in Iraqi Stock Exchange Market (ISE) , for the period from 2008 to 2012.The study used the" Experimental Research Approach" . Also used the (Modified Jones Model, 1995) in order to measure the corporate governance, to measure the extent of the practice of corporate governance in the samples companies. While it use to measure tax planning, the model that used by studies and researches of tax that adopted in discussions of tax reform, by analyzing the financial statements of companies  to reach  a measurement  for  the two variables of the study.  T

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Publication Date
Mon Aug 03 2015
Journal Name
International Journal Of Research Studies In Biosciences
Study the Histopathology of Immuno-Therapytrail in Mice Infected with Hydatidcysts
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The study was trail to treated secondary hydatid cysts in white micepost-infection with Echinococcosis of sheep origin, by immunization with a mixture of CFAgs/PSAgs prepared from haydatid Cyst Fluid antigens (CFAgs) and Proto scolices antigens (PSAgs) respectively, two concentrations (7.5 &15 mg/ml) in addition to two derivatives of benzimidazole; albendazole (A) and mebendazole (M) 10 and 40μg/gm body weight, respectively, one week after challenged dose with protoscolices. to determine the efficacy of immunization and chemotherapy simultaneously in reduction the number of growing cysts, then measured both humoral and cell-mediated immunity. Results: elevation the immune responses that reflected decrease number and diameter of hydatid cys

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Publication Date
Mon Dec 22 2025
Journal Name
Al–bahith Al–a'alami
Semiotics of Political Caricature in the Palestinian Newspapers An Analytical Study
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This study aims to study the political caricature and its indications in the Palestinian newspapers, to know its subjects, the active characters, the artistic styles, and the symbols the caricaturists use.

The study concluded that there is a variety of subjects that the political caricature handled in the studied newspapers and the degree of interest in every subject. The subjects related to the international subjects came first (% 24.5) and the other subjects came next (% 22.2).

The results showed the caricaturists relied on unnamed symbolic active characters that came first (% 62.3) and named symbolic characters (% 11.1). The positive characteristics of the Palestinian figures were higher than the negative ones, and the

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Publication Date
Tue Jul 21 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Numerical Study of the Heat Transfer Behavior in Helical Microcoil Tube
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