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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
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
P the commercial activity of the city of Ghana in the fif
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The city of Ghana is one of the important commercial cities in the country of Sudan, as it was a major source of commercial exchanges, and a commercial mediator across the countries of the Maghreb and the metropolises of the countries of Sudan. Many, and most of them take the desert road,    Which traders had to endure the hardships of these roads from the insecurity, high winds and dust that sometimes destroyed the trade convoys, in order to obtain gold, which is one of the most important minerals that Ghana traded with various countries, in addition to the different goods that the merchants carried In particular, salt and its trade with Ghana, and also taxes, which were an important financial resource imposed by some gov

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Publication Date
Fri Sep 08 2023
Journal Name
International Journal Of Scientific Trends
The Role of Renewable Energy in the Protection of the Iraqi Environment
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In this article, the types of renewable energies and the environmental effects of consuming these energies are studied. Energy is one of the things necessary for economic and social development and improving the quality of life, and the presence of continuous and sustainable economic energy is essential for any economic development and growth. Humankind has been aware of renewable energies such as biomass and geothermal energy for a long time and has used these energies as heat sources for shelter. With the beginning of the extraction of fossil fuels such as oil and coal and unlimited access to these products, the use of renewable energy sources, except in remote places and forest areas, has become limited and forgotten. Currently in Iraq,

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
האלמנטים המשותפים בשיריהם של משה בן עזרא ואבו פיראס אלחמדני (מחקר השוואתי) Elements common in the poems of Musa son of Izra and Abu Firas al-Hamdani (A comparative study)
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Abstract:

     Musa son of Yaqoob son of Izra, the Spanish poet, linguist, and  philosopher, was born in Granada. He has many poems representing  types of poetry. Also, he had important books, such as "the Poetry of Israel" and "Contemplative Research". He is knowledgeable in both Hebrew and Arabic, because most of his books were written in Arabic and the then translated to Hebrew. It seemed that he was influenced by Arab poets, specifically Abo Firas, and borrowed many issues, such as comparison, repetition, exaggeration, etc. and included them in his poetry.

     All know that Arabic literature clearly influenced Hebrew literature in the Spanish era. Ara

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Experimental Study of the Effect of Fuel Type on the Emitted Emissions from SIE at Idle Period
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The present study investigated the impact of fuel kind on the emitted emissions at the idling period. Three types of available fuels in Iraq were tested. The tests conducted on ordinary gasoline with an octane number of 82, premium gasoline with an octane number of 92, and M20 (consist of 20% methanol and 80% regular gasoline). The 2 liters Mercedes-Benz engine was used in the experiments.

The results showed that engine operation at idle speed emits high levels of CO, CO2, HC, NOx and noise. The produced emission levels depend highly on fuel type. The premium gasoline (ON=92) represents the lower emissions level except for noise at all idling speed. Adding methanol to ordinary gasoline (ON=82) showed high levels of emi

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Degree of Academic Leaders Practice at the University of Northern Border for Creative Leadership "Empirical Study"
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The study aimed to identify the degree of academic leaders practices at the University of Northern Border for creative leadership, which attribute to different variables (nature of work, employer, gender, years of experience in administrative work at the university). To achieve the goal of the study, the researcher used the descriptive approach survey. Therefore, the researcher used a questionnaire as a study tool, which consisted of (40) items that included dimensions (sensitivity to problems, initiative, originality, flexibility). The study sample consisted of (240) participants included (agents of colleges, and supporting deanships, and their employees) during the second semester of the academic year 1439/1440 AH. The results showed t

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Publication Date
Wed Apr 01 2020
Journal Name
Iop Conference Series: Earth And Environmental Science
The Effect of Urban Form on Temperature for Hot Arid Zones. The Case Study of Baghdad, Iraq
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The research aims to determine optimal urban planning and design indicators of the urban clusters form in hot arid zones through studying of three urban areas in Baghdad, analyzing their urban indicators which include floor area ratio (FAR), urban clusters height, building density or land coverage, green areas, paved areas, shading ratio and how they affect urban temperature. The research reached the conclusion that air outdoor temperature on urban areas affected primarily by shadows casted on the ground, the effect of shaded area equals (5) times the effect of paved areas and (3.7) times the effect of green areas, this means that increasing urban clusters height in hot arid zones could minimize air outdoor temperature, building

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Publication Date
Sun Jun 12 2011
Journal Name
Baghdad Science Journal
Study The effect of central ion to the dithene complexes on spectral shifting of saturable absorber band
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In this work dithine complexes prepared from dithiol benzil ligand and central ion to the Ni,Pd,Pt, element the ligand and complexes have been investigated using FTIR spectrophotometer and uv-vis-NIR spectral reigns show higher intensity represents the ?-?* transition in the chromopher cycle .These absorption which appear in visible and near IR spectral regions ,According to the complexes of one group ,the spectral shifting due to the change of central ion has been found to be related to atomic number of central ion .This shifting is increased while decreasing the central ion atom number These complexes have been implemented in Nd+2:YAG cavity because each posses resonant absorption band near Nd+2:YAG, Nd+2:Glass emitting at (106

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Publication Date
Sat Mar 26 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the marketing intelligence system in the quality of the insurance service : Applied research in the National Insurance Company
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The current research seeks to identify the role of the marketing intelligence system in its dimensions (customer intelligence, market intelligence, competitor intelligence, insurance product intelligence, sales representatives) and its reflection on improving the quality of the insurance service provided by the National Insurance Company represented in its dimensions (reliability, response, tangibility, Safety, the spirit of empathy, communication) adopted in the current research, and based on that, the research came as an attempt to find out the extent to which the research sample company can apply the approach of the marketing intelligence system and its impact on improving the quality of the insurance service provided to custo

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of The College Of Education For Women
Verbal Antonyms: A research in the relationship in meaning Between the words in Arabic language
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Verbal Antonyms: A research in the relationship in meaning Between the words in Arabic language

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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Using the Strategy of Roundhouse in the Achievement of Fourth Grade Students of Computer and Their Attitudes towards It
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The research aims to identify the effect of using the strategy of Roundhouse on the achievement of fourth-grade students of computer and their Attitudes towards it. The research sample consisted of (61) fourth-grade secondary school students distributed into the experimental group consisted of (31) students study computer according to the Roundhouse strategy, and the control group consisted of (30) students follow the traditional method. The researcher designed an achievement test consisting of (30) items of multiple choice. To measure the attitudes of students towards the computer, a questionnaire of (32) paragraphs with three alternatives was designed by the researcher. The results showed that there is a statistically significant diffe

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