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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 Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of insurance policy in facing banking risks
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The concept of insurance policy is one of the concepts that expresses a way to face the risks that a person is exposed to in the field of his life. It is a system that involves a prior agreement between two parties through which the risk is transferred from the second party (the insured) to the first party (the insurer) in return for paying an amount Calculated was able to cover the potential loss according to certain percentages agreed upon between the two parties, and that the main goal of any scientific analysis of the risk is to choose the most appropriate policy or method to confront it, by identifying the risks and ways to address them, and the main goal is to reduce losses and limit the possibility of their occurrence.

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Publication Date
Fri Nov 30 2018
Journal Name
Iop Conference Series: Materials Science And Engineering
Strengthening Aspects to Improve Serviceability of Open Web Expanded Steel-Concrete Composite Beams in Combined Bending and Torsion
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Publication Date
Tue Jan 08 2019
Journal Name
Iraqi Journal Of Physics
Simulation and experimental study of Pin-Plate DC discharge plasma technique
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The present work intends to study of dc glow discharge were generated between pin (cathode) and a plate (anode) in Ar gas is performed using COMSOL were used to study electric field distribution along the axis of the discharge and also the distribution of electron density and electron temperature at constant pressure (P=.0.0mbar) and inter electrode distance (d=4 cm) at different applied voltage for both pin cathode system and plate anode and comparison with experimental results.

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Publication Date
Thu Apr 29 2021
Journal Name
Egyptian Journal Of Chemistry
Fabrication and Study of ZnO thin Films using Thermal Evaporation Technique
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Pure SnSe thin film and doped with S at different percentage (0,3,5,7)% were deposited from alloy by thermal evaporation technique on glass substrate at room temperature with 400±20nm thickness .The influences of S dopant ratio on characterization of SnSe thin film Nano crystalline was investigated by using Atomic force microscopy(AFM), X-ray diffraction (XRD), energy dispersive spectroscopy (EDS), Hall Effect measurement, UV-Vis absorption spectroscopy to study morphological, structural, electrical and optical properties respectively .The XRD showed that all the films have polycrystalline in nature with orthorhombic structure, with preferred orientation along (111)plane .These films was manufactured of very fine crystalline size in the ra

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Publication Date
Fri Jun 01 2007
Journal Name
Journal Of The College Of Languages (jcl)
Evaluating the Proposed Curriculum of TEFL for First Intermediate Class Students in AL-Muthannah Governorate for the Second Semester/2007-2008
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During the 1970s, communicative view of language teaching began to be incorporated into syllabus design. The central question for the proponents of this view was: what does the learner want/need to do with the target language? This lead to the emergence of a teaching method (or approach) called communicative language teaching (CLT) during the late 1970s and early 1980s focusing on the functions that must be incorporated into a classroom. According to Brown (2001:43) CLT is a unified but broadly based, theoretically well informed set of tenets about the nature of language and of language learning and teaching. Harmer (2001:84) states that the communicative approach is the name which was given to a set of beliefs which included not only a

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Publication Date
Wed Mar 01 2017
Journal Name
International Journal Of Science And Research (ijsr)
The Effect of the Five Fingers Strategy and Traffic Signals Strategy on Physics First Grade Intermediate School Students' Achievement and Personal Intelligence
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The aim of this research is to know the effect of two strategies of active learning, the five fingers and traffic signals, on the first grade intermediate level student's achievement and personal intelligence. The research sample was chosen from the Al- Mansour intermediate school for boys, including (101) students divided into three groups chosen randomly which represented the first experimental group (32) students, the second experimental group (34) students, and the control group (33) students. To achieve the research aims, the research prepared a physics achievement test containing (26) items, and a personal intelligence test containing (20) items. The psychometric characteristics, of the tests were checked up the following results were

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Publication Date
Fri Jan 01 2021
Journal Name
Revista Latinoamericana De Hipertensión
Iatrogenic atrial septal defect post radiofrequency ablation in patients with left atrial SVT: Predictors and outcomes
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atrogenic atrial septal defect (IASD), post Catheter ablation during electrophysiological study simply can be assess with Echocardiography nowadays ablation consider the main line in the managements of patients with various type of arrhythmia. This study aims to de-termine the outcomes of Iatrogenic Atrial Septal Defect (IASD) six months post radiofrequency ablation (RF) procedure of left atrial arrhythmia using non-invasive Transtho-racic Echocardiography (TTE) parameters (LVEF, E/e` and ASD size) with sheath size as predictors of atrial septal defect closure. Patients and methods: A prospective study was con-ducted in Iraqi Centre for Heart Diseases included 47 patients post Electrophysiology procedure and ablation of left atrial SVT were

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Publication Date
Wed Mar 09 2022
Journal Name
Journal Of Craniofacial Surgery
The Use of Osseodensification for Ridge Expansion and Dental Implant Placement in Narrow Alveolar Ridges: A Prospective Observational Clinical Study
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The osseodensification (OD) drilling technique was suggested as an alveolar ridge expansion technique, so the aim of this prospective clinical study was to evaluate the amount of bone expansion obtained by the OD drilling technique and its effect on implant stability in patients with narrow alveolar ridges. The width of the alveolar ridge was measured at the crest before and after implant site preparation, whereas the implant stability was measured using Osstell Beacon implant stability quotient (ISQ). The ISQ values were recorded immediately postoperatively and after 16 weeks. Twenty-three patients were included; they received 40 implants. The mean (± standard deviation [SD]) amount of expansion was 1.29 (± 0.41) mm, and the difference b

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
Hiding the Type of Skin Texture in Mice based on Fuzzy Clustering Technique
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A substantial matter to confidential messages' interchange through the internet is transmission of information safely. For example, digital products' consumers and producers are keen for knowing those products are genuine and must be distinguished from worthless products. Encryption's science can be defined as the technique to embed the data in an images file, audio or videos in a style which should be met the safety requirements. Steganography is a portion of data concealment science that aiming to be reached a coveted security scale in the interchange of private not clear commercial and military data. This research offers a novel technique for steganography based on hiding data inside the clusters that resulted from fuzzy clustering. T

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Publication Date
Fri Apr 14 2017
Journal Name
Mechanical Engineering
Testing a Locally Assembled Combine Implement Used for Open Furrow, Planting and Fertilizing under Different Machinery Unit Speeds
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