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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
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
The role of organizational learning ability to improve the performance of hospital organizations under the accumulation of intellectual capital Study hospital enterprise sector in Algeria
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        This study aims to identify the amount of the effect of the ability to learn the individuals within the organization on the accumulation of intellectual capital and the role it plays in improving the performance of the organization, and to achieve that, the researcher designed a questionnaire to collect data and information from the surveyed respondents and analyzed using SPSS software, the study concluded after testing hypotheses to have a direct impact between the capacity for organizational learning and the accumulation of intellectual capital, which in turn affects the accumulation of intellectual capital as a positive and direct impact on the performance of the organization, al

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Publication Date
Tue Sep 28 2021
Journal Name
Journal Of The College Of Education For Women
Lying in Arthur Miller's The Crucible: A Pragmatic Study: هديل محمود إبراهيم , جمعه قادر حسين
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Lying is a controversial issue as it is closely related to one's intended meaning to achieve certain pragmatic functions. The use of lying in literary works is closely related to the characters’ pragmatic functions as in the case of Miller's The Crucible where it is used as a deceptive complex phenomenon that cannot be observed out of context. That is, the use of lying as a deceptive phenomenon represents a violation to Grices's Maxims. Thus, the study aims to qualitatively examine the kinds of maxims being violated, the kinds of violations conducted, the strategies followed in the violations, and the pragmatic functions behind such violations across the different categories of lies. To this end, the (30) extracts fou

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Publication Date
Sat Apr 01 2017
Journal Name
Al–bahith Al–a'alami
Palestinian Media Elite Attitudes towards Recording Cinemas in Addressing the Internal Situations: A Field Study
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The follower of the history of cinema in the world notes that cinema started recording one and these films are varied in their subjects, while the life of man was the material of these films to be in a creative artistic style.
If the Palestinian films produced by Palestinian directors do not have an impact on the local, Arab and international levels, this is due to the weakness in several technical fields or with the intention to make them bad or negligence of those who produce these films.
This research deals with the role played by Palestinian films in dealing with the internal situation from the point of view of the Palestinian media elite in terms of their exposure to films and the motives of this exposure and the expectation

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Publication Date
Sat Jun 24 2023
Journal Name
Arab World English Journal
Humor in The Stand-Up Comedy You Wanna Hear Something Crazy?: A Universal Pragmatic Study
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Humor is an interesting phenomenon that has been studied widely, yet it is considered a universal trait that cannot be an old subject for a study. This study is conducted to investigate humor from a universal pragmatic lens in a stand-up comedy show, namely, You Wanna Hear Something Crazy?. It aims to study humor as a coin with two sides, the production side and the understanding side. To achieve the aim of the study, the researchers use an eclectic contains Grice’s CP model (1975) and Habermas’s UP model (1979, 1984, 1987, 1998). The study has noted that while using the observance and the non-observance of the cooperative maxims to produce humor, the universal validity claims of truth, sincerity, and normative rightness for rea

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The contribution of the tax authorities to increase the tax revenues: An applied research on a sample of the supporting bodies in the health sector for the period 1998-2008
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the research was exposed to a study the importance of the role of the supportive entities in providing the useful information to the tax administration and their ability to extend the level of the tax base of taxpayers, through the improvement of the tax payers determination and their tax settle for the purpose of increasing the tax revenue, and shed light on the legal evidence through which these entities become officially assigned to perform a supplementary task to the General Committee for Taxes GCT, to help it to perform its task efficiently, and to study the reasons of the weak cooperation of the supportive entities and their reluctance to provide useful information which leads to limiting the tax base.

The research data hav

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Crossref
Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
AComparative Qualitative and Quantitative Study of Anthraquinone Derivatives in the Roots of Rheum ribes and Rheum emodi by HPLC
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High performance liquid chromatography was applied for the separation and identification of four antharquinone derivatives, aloe emodin, emodin, chrysophanol and physcion. The separation was carried out using Eurospher 100, C18 column (4.6 mm i.d. x 250 mm, 5 µm) under the following conditions: acetonitile (solvent A) and water: acetic acid (99.9: 0.1 v/v, pH 3.5)( solvent B) as a mobile phase with isocratic elution with 30% solvent B at flow rate 0.8 ml/min. The detection wavelength was set at 254 nm. The four antharquinone derivatives were isolated from the Iraqi rhubarb, Rheum ribes root by preparative TLC, their structures were identified by 1H NMR and used as standards for HPLC analysis. The percentages of alo

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Publication Date
Wed May 01 2024
Journal Name
Journal Of Physics: Conference Series
Study of The Effect of Concentration on The Efficiency of The Sensitive N749-TiO<sub>2</sub> Solar Cell
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Abstract<p>In this research, we studied the effect of concentration carriers on the efficiency of the N749-TiO<sub>2</sub> heterogeneous solar cell based on quantum electron transfer theory using a donor-acceptor scenario. The photoelectric properties of the N749-TiO<sub>2</sub> interfaces in dye sensitized solar cells DSSCs are calculated using the J-V curves. For the (CH3)3COH solvent, the N749-TiO<sub>2</sub> heterogeneous solar cell shows that the concentration carrier together with the strength coupling are the main factors affecting the current density, fill factor and efficiency. The current density and current increase as the concentration increases and the </p> ... Show More
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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Takir some study of environmental factors on the weight of some phases of the screwworm fly the ancient world
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The weight of larvae virgins and Alcamlat for males more than the weight of females of the roles themselves that the highest rate of loss in weight of larvae developed to virgins when field conditions were (21.5,22,21.3) mg during June and July and August respectively, recorded the highest degrees of heat and less attributed to moisture

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Post-evaluation of the strategic projects of the Directorate of Public Municipalities - Case study for the period (2004-2015
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The research aims at conducting a follow-up evaluation of a number of strategic projects implemented by the Directorate of Public Municipalities, one of the Ministry of Construction, Housing and Municipalities and Public Works. The sample included (35) varied strategic projects implemented in most Iraqi governorates. Buildings, municipal buildings, minarets, massacres, multi-story parking, paving and rehabilitation of streets and residential neighborhoods. The difference between the actual and planned times and costs of these projects was then measured and analyzed. These projects were used as a tool for collecting data and information. The questionnaire included four axes, each representing one of the parties to the project, whi

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Crossref
Publication Date
Mon Dec 22 2025
Journal Name
Journal Of The College Of Basic Education
The impact of cross-training in the development of the skills of the crushing blow and the blow-to-blow stroke under the age of 17
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