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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 Jun 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Use sensitivity analysis in evaluating projects Investment under the conditions of risk and uncertainty Case study of glass bottles project in Anbar province
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This paper studies the investment project evaluation under the condition of uncertainty. Evaluation of investment project under risk and uncertainty is possible to be carried out through application of various methods and techniques. The best known methods are : Risk-adjusted discount rate , certainty equivalent method , Sensitivity analysis and Simulation method The objective of this study is using the sensitivity analysis in evaluation Glass Bottles project  in Anbar province under the condition of risk and uncertainty.

After applying sensitivity analysis we found that the glass bottles project  sensitive to the following factors (cash flow, the cost of investment, and the pro

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Publication Date
Wed Sep 15 2021
Journal Name
Al-academy
The Communicative Functions in The Speech of The UAE National Anthem in The Light of The Eloquence of The Audience: زينب دريانورد (الغيصي) - رسول بلاوي - أحمد موسى البطاينة
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  The national anthem is one of the most eloquent communicative discourses that the language establishes due to its deep impact on the audience and forms a broad mass base that interacts with the chanting of the national anthem. Moreover, communication is the cornerstone in building social and educational relations. From this point of view, the communicative approach studies language in the communicative context and its six important functions identified by linguist Roman Jacobson. The official UAE national anthem is considered as a model for expressing the enthusiasm of the Emirati Arab public, who is proud of their Arabism, loyalty and love of the homeland, because of the expressions that this anthem carries, urging the public to

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Constants of blood money in the Koran   And its variables in the custom prevailing in Iraq
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Praise be to Allah, the Lord of the Worlds.
          Because it has a prominent role in the life of the Muslim person in particular, and in the stability, security, and safety of society in general, I found it appropriate to participate even a little in solving some of the problems that arise in the nation, and that Adello Badawi in this important issue that concerns everyone without exception And that I show that there are constants in the Koran, from which the scholars of the Ummah derived their evidence on this subject, and that there have been variables have occurred in some Islamic societies, in the issue of blood money that deserves the victim and his family, has allocated talk

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The relationship between the dimensions of the strategic recovery and achieving the company's strategic goals: Applied research in the National Insurance Company
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The aim of the research is to explain the nature of the relationship between the dimensions of the strategic recovery of the service represented by (compensation, speed of response, apology, initiative (defining the problem) and the strategic goals of the company represented in (profitability, growth, community service, employee satisfaction) in the National Insurance Company, it has been approved The questionnaire as a tool to collect data and information from the sample of (58) who are in (department manager, M. department director, division official, unit official) and the statistical program (spss) was used in calculating (arithmetic mean, standard deviation, coefficient of variation, coefficient of Correlation, t-test, varia

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Publication Date
Sun Oct 21 2018
Journal Name
Al–bahith Al–a'alami
“Usages of the Youth in the Emirati Society for the Dubbed Turkish Series on the Arab Satellite Channels and the Satisfactions Achieved”
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The research topic is summarized in the importance of studying the measuring the extent of the university youth’s exposure in the Emirati Society to those series and the resulting achieved satisfaction. The most important results and recommendations of the study are as follows: a high rate of the respondents’, sample individuals, exposure to the dubbed Turkish series since it is evident that almost three-fourths of the study individuals watch the dubbed Turkish series,.”. The most significant positive aspects of the dubbed Turkish series are: “they focus on the most important tourist attractions in Turkey” and “ improving the audience›s knowledge and information on the traditions of the Turkish society”. The most apparent

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Publication Date
Sat Jul 02 2022
Journal Name
Journal Of Positive School Psychology
Morphological structures and their significance for the triple verb " The abstract and more in the Diwan of Al Yassin
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Verbs are an important material in the construction of the sentence, as they are among the requirements of every sophisticated language, and in this regard, Ibn Al-Gothic (d. 367 AH): “Know that verbs are the origins of the buildings of most speech, and thus scholars called them buildings.” Verbs are the source of expression of the speakers’ ideas to represent the element of activity and movement, and with their knowledge We infer the meanings of Arabic words, and Ibn Al-Sarraj (d. 316 AH) defined it: “The verb denotes a meaning and a time, and that time is either past, present, or future.” Its letters are original and does not drop from its construction a letter in the conjugation of its conjugations, and it is in Arabic two type

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The role of Rabi’a tribe in the history of Iraq in the rightly guided caliph’s period Prof. Dr.: The role of Rabi’a tribe in the history of Iraq in the rightly guided caliph’s period Prof. Dr.
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Abstract:
Rabi’a tribe lived on the land of Euphrates since the first century of the
Christ. Then that land becomes her homeland. The Persians tried many times
to drive her away from that land, but with out result.
In the course of time Rabi’a become more knowledgeable of Persia.
This tribe proved her love and sanctification to the land of Euphrates, in the
battle of Dhyqar.
Rabi’a converted to Islam quickly and helped the Muslims to conquer
Iraq with a big number of fighters in many battles like al- Qadisyyah. That
influenced the anger of Mudriat Arab tribes who were their old enemies.
Mudriat tribes did their efforts to reduce the importance of Rabi’a because of
some its branches were among of t

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of Educational And Psychological Researches
The effect of the differences in the correlation pattern of the micro blogging in the educational attainment of computer science curriculum for 12th grade students
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The object of this research is to determine the effect in the differences of the correlation pattern of the micro blogging on the educational attainment of computer science curriculum for 12th grade students. I will try to test the best suited correlation and I might use the demo curriculum as well to achieve its objectives , The research method that will be used in this research is the quantitative method where we will use a sample of 60 students divided into two groups ( correlate the micro blogging - adopted the sequence pattern of relating the micro blogging) As a result, we found out that there are quantitative differences among the two groups' median , The differences goes back to the main effect of the correlation pattern of the m

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Publication Date
Tue Sep 07 2021
Journal Name
Nanomaterials
Transformation of Silver Nanoparticles (AgNPs) during Lime Treatment of Wastewater Sludge and Their Impact on Soil Bacteria
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This study investigated the impact of lime stabilization on the fate and transformation of AgNPs. It also evaluated the changes in the population and diversity of the five most relevant bacterial phyla in soil after applying lime-stabilized sludge containing AgNPs. The study was performed by spiking an environmentally relevant concentration of AgNPs (2 mg AgNPs/g TS) in sludge, applying lime stabilization to increase pH to above 12 for two hours, and applying lime-treated sludge to soil samples. Transmission electron microscopy (TEM) and energy-dispersive X-ray spectroscopy (EDS) were used to investigate the morphological and compositional changes of AgNPs during lime stabilization. After the application of lime stabilized sludge to

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Publication Date
Tue Feb 18 2020
Journal Name
Modelling And Simulation In Engineering
Temperature and Stress Evaluation during Three Different Phases of Friction Stir Welding of AA 7075-T651 Alloy
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The current study performs an explicit nonlinear finite element simulation to predict temperature distribution and consequent stresses during the friction stir welding (FSW) of AA 7075-T651 alloy. The ABAQUS® finite element software was used to model and analyze the process steps that involve plunging, dwelling, and traverse stages. Techniques such as Arbitrary Lagrangian–Eulerian (ALE) formulation, adaptive meshing, and computational feature of mass scaling were utilized to simulate sequence events during the friction stir welding process. The contact between the welding tool and workpiece was modelled through applying Coulomb’s friction model with a nonlinear friction coefficient value. Also, the model considered the effect of nonlin

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