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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 Jan 01 2007
Journal Name
Al Mustansiriya Journal Of Pharmaceutical Sciences
Synthesis and study of the mixed ligand (phenylalanine and anthranilic acid) with some transition Ions
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This paper presents the synthesis and study of some new mixed-ligand complexes containing anthranilic acid and amino acid phenylalanine (phe) with some metals . The resulting products were found to be solid crystalline complexes which have been characterized by using (FT-IR,UV-Vis) spectra , melting point, elemental analysis (C.H.N) , molar conductivity . The proposed structure of the complexes using program , chem office 3D(2000) . The general formula have been given for the prepared complexes : [M(A-H)(phe-H)] M(II): Hg(II) , Mn(II) ,Co(II) , Ni(II) , Cu(II) , Zn(II) , Cd(II) . A = Anthranilic acid = C7H7NO2 Phe = phenylalanine = C9H11NO2

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
The Evaluation of Illustrations Images in the Content of the Computer Book for the Second Intermediate Grade from the Point of View of the Teachers of the Subject
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The research aims at evaluating the illustrations images and determining the availability of good image standards in the illustrations images of the content of the second intermediate stage computer's book for the academic year (2019-2020) as seen by computer teachers. The sample was randomly selected, (30) teachers who are actually teaching the subject in schools within the geographical area of the province of Baghdad (Karkh III). To achieve this goal, ten standards were identified: scientific accuracy, suitability for the level of students, image clarity, image freshness, quality of coloring, suitability of its location of the subject, Matching their content glimpsed, The subject matter is appropriate in terms of area, matching its tit

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Electonic management   And its role in the development of the Zakat Foundation
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The world is witnessing a remarkable development in the use of technology, which has made it an essential means of investment, especially in the field of management, which provided many of the facilities experienced by the institutions, including improving revenues, shortening time and saving labor. Islamic investment technology as a successful means of management and we touched on the Zakat Foundation as an application model.

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Publication Date
Thu Jan 14 2010
Journal Name
Bayt Alhekma
the problem of the relationship between phraseology and words in modern Russian
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Abstract The study aimed at reviewing translation theories proposed to address problems in translation studies. To the end, translation theories and their applications were reviewed in different studies with a focus on issues such as critical discourse analysis, cultural specific items and collocation translation.

Publication Date
Fri Dec 15 2023
Journal Name
Al-academy
The role of artificial intelligence in revolutionizing the clothing and textile industry
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 The integration of AI technologies is revolutionizing various aspects of the apparel and textile industry, from design and manufacturing to customer experience and sustainability. Through the use of artificial intelligence algorithms, workers in the apparel and textile industry can take advantage of a wealth of opportunities for innovation, efficiency and creativity.
The research aims to display the enormous potential of artificial intelligence in the clothing and textile industry through published articles related to the title of the research using the Google Scholar search engine. The research contributes to the development of the cultural thought of researchers, designers, merchants and the consumer with the importance of integ

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Test the effectiveness of transactional and transformational leadership in the Egyptian Environment
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       The present study aims to test a range of hypotheses about the effectiveness of each of the theory of transactional leadership, and the theory of transformational leadership in the Egyptian environment, and to identify any of them are better able to predict the effectiveness of leadership. And after the effect will be to identify the quality of the relationship between the leader and the subordinate in leadership , and what is the role of transformational leadership dimensions influencing the effectiveness of leadership. The field study was conducted on a sample of companies' public and private sector and the government in Egypt. The results of the study resulted in experimental that transacti

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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
The Redemptive Vision of the Heart and Mind in Margaret Edson's Wit
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Approaching the turning of the millennium, the American theatre witnessed an arousing
interest much shown in patients suffering of severe diseases as a subject matter to drama. In a
discussion of Margaret Edson's Wit, the light is shed on how far such patients, who were literally
involved in secular visions during their life-time, become apt to create a different one on their
death beds. The vision newly blossomed becomes much rooted in the spiritual life; it is a
redemptive vision that can amend what those patients' hearts and minds have long ignored.
Further, the human touch that has been ignored during man's healthy secular life is ultimately
needed for the time being. It helps to enhance man's vision towards the

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Publication Date
Mon Jan 01 2018
Journal Name
Proceedings Of The 2018 4th International Conference On Humanities And Social Science Research (ichssr 2018)
The Artistic directions in stalactites of the antiquarian and religious buildings minarets
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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The auditor's qualifications and their role in the quality of professional performance
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Abstract

The aim of the research is to clarify the requirements of the qualification of the external auditor in Iraq and the extent of their impact on the quality of the professional performance of the audit process. The research was based on analyzing the results of the questionnaire prepared for the impact of qualifications on the quality of professional performance. The researcher has reached a number of conclusions, the most important of which is that a highly qualified and unethical auditor has a greater negative impact on the quality of professional performance than those with low qualifications. The most important recommendations of the research were the need to pay

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Publication Date
Wed Sep 30 2015
Journal Name
College Of Islamic Sciences
Break in the bond And its impact on the difference of scholars
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Break in the bond and its impact on the difference of scholars

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