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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
Sun Dec 30 2012
Journal Name
College Of Islamic Sciences
Interpretation of opinion At the rational school Descriptive study
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Praise be to God, Lord of the worlds, and prayers and peace be upon our master Muhammad and his family and companions until the Day of Judgment.
      The words of God Almighty are for the sake of the greatest and greatest speech, and the scholars, may God have mercy on them, raced.
To dive into knowing the word of God and what he intended, so they wrote in it the literature and collected works in it, and explained it to those after them.
      And when the noble companions, were extremely eloquent and eloquent, because the Holy Qur’an was revealed in the language of the Quraysh, and all the Arabs knew their language, they understood the Holy Qur’an and applied it p

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Publication Date
Fri May 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
Building and codifying a scale of the level of tactical performance of advanced volleyball players
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The research objectives, to build a measure of the level of tactical performance of volleyball players applying for the Iraqi Premier League for the 2018-2019 season. The nature of the research problem, then the researchers determined the research sample in the deliberate manner of the players of the Iraqi clubs for the Premier League (B, A). The researchers adopted the entire community as a sample for the research, and the number (156) players distributed over (13) clubs and divided the sample into (12)players an exploratory experiment player representing (the police club) and (100) player representing the construction sample and after a maximum period of two months has passed since applying the scale to the construction sample the researc

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Publication Date
Thu Jul 18 2024
Journal Name
Herança
Heresy and Hypocrisy of the Church: A Marxist Analysis of Okezie Nwoka's God of Mercy
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Hypocrisy is found in various aspects of life, whether in religion, politics, or social parts. Hence, some of the church's hypocrisy is an outcome of different ups and downs in life. Starting with the problem in the novel, some of the hypocritical pastors engaged in an immense role in affecting the folk's lives because they persuaded people that God ordered them to do so. To accomplish their personal interests, the abusive monks disguise their verbal speech, smiles, and fine clothes like mild sheep to delusional followers, leaving them with guilt, shame, and spiritual scars. The present study aims to examine the hypocrisy and heresy of the church as portrayed in Okezie Nwoka's novel entitled God of Mercy. It reflects the source of

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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of The College Of Languages (jcl)
A Stylistic Study of English Aphorisms of “Life and Death”
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In this paper , some of lexical stylistic , syntactical stylistic  devices , and one phonetic stylistic device are going to be illustrated in the study of the aphorisms of “life and death” . These stylistic  devices are parallelism , hyperbole , alliteration , meiosis , irony , oxymoron , cliché , litotes , metalepsis , and loose sentences.  This paper aims at identifying the functions and the  frequencies of these devices. These stylistic devices make one speech and writing more interesting and help to get the attention of readers/ listeners

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Dynamic Behavior of Pb(II) and Cr(III) Biosorption onto Dead Anaerobic Biomass in Fixed-Bed Column, Single and Binary Systems
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The biosorption of lead (II) and chromium (III) onto dead anaerobic biomass (DAB) in single and binary systems has been studied using fixed bed adsorber. A general rate multi- component model (GRM) has been utilized to predict the fixed bed breakthrough curves for single and dual- component system. This model considers both external and internal mass transfer resistances as well as axial dispersion with non-liner multi-component isotherm (Langmuir model). The effects of important parameters, such as flow rate, initial concentration and bed height on the behavior of breakthrough curves have been studied. The equilibrium isotherm model parameters such as maximum uptake capacities for lead (II) and chromium (III) were found to be 35.12 and

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Publication Date
Sun Jul 01 2018
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
KEY TO THE SPECIES OF THE ORTHETRUM NEWMAN, 1833 (ODONATA, LIBELLULIDAE) WITH A NEW RECORD SPECIES IN IRAQ
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This paper provides an identification key to the species of Orthetrum Newman, 1833 (Odonata, Libellulidae), including six species that were collected from different localities in Iraq.

 

    The species of O. anceps (Schneider, 1845) is registered as a new record in Iraq; the most important characters which are used in diagnostic key are included

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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Percentage of Availability of the Elements of Citizenship Concept in the Guides for Teachers of Musical Skills in the Sultanate of Oman
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Abstract

This research aims to identify the availability of the elements of the concept of citizenship, to identify the distribution ratios of the outputs of the musical skills curriculum at the levels of educational goals associated with the elements of the concept of citizenship in the guides of teachers of musical skills for grades (12-1) in the Sultanate of Oman. A content analysis card was designed to include the teacher’s guides of musical skills for grades (12-1), which included the outputs, according to the grades with the identification of the elements of citizenship (identity, belonging, rights, participation). The results of the research revealed that the percentage of inclusion of citizenship values

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Publication Date
Fri Jan 02 2026
Journal Name
Journal Of The College Of Basic Education
The impact of compound exercises in the development of some of the skills of the players football halls
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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
Assessing English Language Knowledge of the Scholarship Students in the Scientific Colleges and the Preparatory Year at the Islamic University of Madinah.
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This research aimed to identify the level of English language knowledge among the students of scientific colleges and the preparatory year (scholarship students) at the Islamic University of Madinah. The research was limited to identifying students at the meanings of vocabulary and grammar of the English language. The researcher used a descriptive approach to achieve study goals. It applied three tools to collect information from the targeted sample; first, a test for determining the level of students in the achievement of vocabulary which applied to (69) students. Second, a test to determine the level of students in the English language grammar, (73) students took part. Third, a survey to get students’ opinions about the program of te

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Publication Date
Thu Aug 21 2025
Journal Name
Journal Of Health And Biology
Distribution and Species Diversity of the Dove Genus Streptopelia: A Systematic Review
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Some species, such as the Eurasian Collared-Dove (S. decaocto) are fast expanding around the planet, while others, such as the European Turtle-Dove (S. turtur), are experiencing precipitous population declines. Climate change, habitat loss, greater cultivated areas, and hunting pressure are the major threats to the diversity of Streptopelia. A few species require urgent conservation action. Priority for subsequent research should be to redress outstanding taxonomic uncertainties, ascertain the effect of climate change on distributions, and put in place conservation measures for declining taxa. We provide here a detailed review on how it is possible to understand the diversity of Streptopelia and how such an understanding can con

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