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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 Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measuring the impact of the financial value of human resources on investor decisions: (An Empirical Study)
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The aim of the research is to clarify the measurement of the impact regarding financial value of human resources on investors' decisions by considering that the human element is one of the assets of the company. Therefore, a set of criteria must be available to determine the applicability of these standards in the human resource because it has an effective role in the success for the company. Is to measure the value of human resources in a financial format according to the first two methods depends on the value and the second depends on the cost.

In order to achieve the objectives of the study, a questionnaire was designed to survey the views of a number of employees of the General Company for Leather Industries in order to arriv

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Publication Date
Mon Mar 11 2019
Journal Name
Baghdad Science Journal
Study the Effect of Cold Plasma on the Nonlinear Properties of Polymeric Membranes Rod Amine (R3Go)
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The nonlinear optical properties for polymeric (PMMA) doping with dye Rhodmine (R3Go) has been studied .The samples are prepared by normal polymerization method with concentrations of 5x10-5mol/l and a thickness of 272.5µm.

                         Plasma effect was studied on samples prepared before and after exposure to the Nd: YAG laser for three times 5, 10 and 15 minutes. Z-Scan technique is used to determine the nonlinear optical properties such as; refractive index (n2) and the coefficient of nonlinear absorption (β). It was found that the nonlinear properties is change by increasi

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Publication Date
Wed Sep 01 2021
Journal Name
Journal Of Ecological Engineering
Study of The Fermentation Conditions of the Bacillus Cereus Strain ARY73 to Produce Polyhydroxyalkanoate from Glucose
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Polyhydroxyalkanoates (PHAs) have gained much attention as biodegradable polymers, many efforts are being made to minimize the cost of PHAs by finding cheap carbon source depending on the type of microorganism and fermentation conditions. The aims of this study were to evaluate the effects of different glucose concentrations and other important conditions on the PHA production by Bacillus cereus isolated from soil. Polyhydroxyalkanoates PHAs accumulated by soil microorganisms were examined by screening the isolated bacteria using Sudan B Black and Nile Blue staining process. A Gram positive strain was identified using the 16s rRNA gene, deposited in the NCBI GenBank sequence database. Different growth conditions (favorite glucose concentrat

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Publication Date
Mon Jul 17 2023
Journal Name
Journal Of The Iraqi University
Analysis of the Content of the Physics Textbook of the 3rd Intermediate Grade According to the Criteria for Designing and Producing in Fographics
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In this study, the researcher aims to analyze the content of the physics textbook for the 3rd intermediate grade according to the criteria for designing and producing infographics, and the research community consists of the content of the physics textbook for the 3rd intermediate grade intermediate grade for the academic year 2021-2022. The researcher adopted the analysis instruments with a number of the criteria for designing and producing infographics. The results revealed randomness in the percentage of the criteria included in the content of the physics textbook for the 3rd intermediate grade, and they are not compatible with the proposed criteria by the experts also.

Publication Date
Wed May 14 2025
Journal Name
Journal Of Applied Mathematics
Role of Wind and Fear on the Dynamic of a Prey and Two Competing Predators
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An essential tool for studying the web is its ability to show how energy moves through an ecosystem. Understanding and elucidating the relationship between species variety and their placement within the inclusive trophic dynamics is also beneficial. A food web ecological model with prey and two rival predators under fear and wind flow conditions is developed in this article. The boundedness and positivity of the system’s solution are established mathematically. The stability and existence constraints of the system’s equilibria are examined. The proposed system’s persistence limitations are established. Additionally, the bifurcation analysis of every potential equilibrium is examined using the Sotomayor theorem. To describe the

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Establishment of method and the development of the teaching methods in the late abbissid period and it s impact on the contemporary leading methods
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Every researcher must say that the world in continually progress toward the best and that
the Arab and Islamic civilization had produced much of systems and virtuous educational
practices which raised from Islamic heritage. This nation was not isolated from external
world, but it was made a clear active for promote the banner of other nations which entered
under her influence to promote Islamic banner and Muslims. Consequently also Muslims are
affected and influenced, this resulted a clear impact in the civilization and educational
ideology especially in the contemporary teaching methods.

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Publication Date
Wed Jun 01 2022
Journal Name
International Journal Of Research In Social Sciences And Humanities
THE EFFECT OF SPECIAL EXERCISES IN THE DEVELOPMENT OF THE MOMENTARY BIOMECHANICAL STRENGTH OF THE SKILL OF THE TWO REAR AIR CORES ON THE PARALLEL DEVICE IN THE TECHNICAL GYMNASTICS OF THE EMERGING PLAYERS
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Gymnastics is one of the most interesting games in terms of organizing various world championships and tournaments. Their basic skills and their technical development, especially those with high difficulty levels that rely on basic and complex skills, are the basic skills of gymnastics are the main pillar to be developed and therefore high-difficulty skills will not depend on basic skills, which should reach the stage of the automatic mechanism. Retention) in order to move on to training and developing another skill for the difficulty of movements as well as the smooth flow of performance, ie the degrees of difficulty of each skill specific to your gym and The researcher used the experimental method and The research community determin

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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
Perceptual for enrolled and not enrolled the puplis in kindergartens (comparative study)
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Enrollment in kindergarten child accomplishes many positive aspects, that’s what Im sure a lot of modern educational trends in child education preschool in the importance of exposing children to a variety of sensory stimuli that contribute to impart a range of sound concepts.

Current research aims to know:

1.the level of sensory perception in the first primary grade students a sample search.

2.differences in perception of elementary first-graders with variable gender male, female))   3.differences in perception of the first primary grade students attending and not attending kindergarten in accordance with variable attendance (attending, not attending).

school students (first grade) from attendi

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Legend between reality and its future Treatment in threatre analytics study
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The Legend between reality and its future Treatment in threatre analytics study

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of the method of partial least squares and the algorithm of singular values decomposion to estimate the parameters of the logistic regression model in the case of the problem of linear multiplicity by using the simulation
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The logistic regression model is an important statistical model showing the relationship between the binary variable and the explanatory variables.                                                        The large number of explanations that are usually used to illustrate the response led to the emergence of the problem of linear multiplicity between the explanatory variables that make estimating the parameters of the model not accurate.    

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