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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
Tue Jan 20 2026
Journal Name
Journal Of Babylon Center For Humanities Studies
The motives of pain in the play (Bells and Trains) by Yehuda Amichai
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The upbringing of Yehuda Amichai and the conditions he lived in had a great influence on his deep sense of pain, which made him think of death and suicide. Especially after the Nazis came to power in Germany, and his emigration with his family. Amichai searched for love throughout his life, and his failure was one of the most important factors affecting his psyche, which is A deep influence that made him live in harsh and painful pains that broke him, and prevented her from achieving his ambitions in life.Dramatic texts are characterized by repetition in writing and presentation. It is a textual discourse that has two advantages, first, that it can be read as a literary text like all other literary texts, and second, that it can be consider

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Publication Date
Sun Dec 31 2023
Journal Name
College Of Islamic Sciences
Hadiths about fasting at the beginning of the months, in compilation and criticism
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This research included the hadiths in which the urge to fast the month of the month, or the beginning of the month, and followed the inductive approach to collecting hadiths, and the critical approach in their studies, and in the weighting of the right from the faces contained in it, and one of the most important results of the research is the agreement of the words of the people On the whiteness, whether it is a little or a lot, the rush of the month will be the first three nights, where the moon white is a little, and they also agreed that the middle three are called the white days, and that the release of the rage on them for the whiteness of its nights, where the moon is complete, and the Prophet has been proven. May God bless him an

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Rooting non-violence in the Holy Quran And models of the Prophet application
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The term “non-violence” is a means of political, social, and advocacy that excludes force in reaching its objectives, and lacks infringement of the rights of non-violence. The policy of non-violence is a beautiful logic of the whole of Islamic creation, in that it is an integral part of the whole structure of Islam and it is a policy of brilliant and brilliant saying in the Almighty: `` Neither level nor good or bad, pay what is better, If that between you and him enmity as if he were intimate guardian (Suratvsalat, verse: 34. Has According to the prophet of Islam, it means that God gives to kindness (kindness) what does not give to violence (Sunan Abu Dawood, 4/255). These terms accurately communicate what is meant by violence and n

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
The General Principles of The Curriculum In Some Manuscripts Arab And Muslim Scholars
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Our scientists Arabs old efforts in achieving texts that led to the foundations of general
rules they have set for this work in accordance with the systematic context is based on the
study, analysis and precision in dealing with this work, which became the basis for each
investigator to the present day, which was to them careful consideration manuscripts and
work to be closer to the image by its author, so produced their efforts in this area several
books provided the technical wizards of this science, which did not leave a gap in which only
gave her treatments and suggestions each and every one of the point made by and gave her
what produced the expertise in this direction in accordance with the formulations
meth

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Publication Date
Tue Apr 19 2022
Journal Name
Ishraqat Tanmawia
The reality of the divorce problem in Iraqi society Reasons, solutions and results
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Praise be to God, who created people from one soul, and made her husband, and prayers and peace be upon His Messenger, Mercy given and the grace given, and on a machine and companions pure. Divorce cases have increased in recent years in a worrying manner, especially since divorce has unforeseen consequences at the individual and social levels. The source of concern stems from the fact that the cohesion and integrity of society starts from a family as it is the cornerstone of the social structure, which is the foundation upon which the large society is based. Marital life may suffer from problems and obstacles that are difficult to solve, so the man presents the divorce of his wife and that the phenomenon of divorce is not a result of it, b

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Publication Date
Mon Aug 01 2016
Journal Name
The Astrophysical Journal
MATTER IN THE BEAM: WEAK LENSING, SUBSTRUCTURES, AND THE TEMPERATURE OF DARK MATTER
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ABSTRACT<p>Warm dark matter (WDM) models offer an attractive alternative to the current cold dark matter (CDM) cosmological model. We present a novel method to differentiate between WDM and CDM cosmologies, namely, using weak lensing; this provides a unique probe as it is sensitive to all of the “matter in the beam,” not just dark matter haloes and the galaxies that reside in them, but also the diffuse material between haloes. We compare the weak lensing maps of CDM clusters to those in a WDM model corresponding to a thermally produced 0.5 keV dark matter particle. Our analysis clearly shows that the weak lensing magnification, convergence, and shear distributions can be used to distinguish</p> ... Show More
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Publication Date
Sun Mar 12 2017
Journal Name
Al-academy
The Origins of Chinese Influence on Pottery in the Tang and Song Dynasties
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This research study of influence of Chinese thought on porcelain in the tang and song period, the study came into four sections, which are:
* First section contains general framework of the research, which include the problem, which is represented by following of questions:
1- Is there intellectual and ideological dimensions in Chinese porcelain?
2-What are the mechanisms and techniques of Chinese porcelain?
.the importance of this research and the need counted as a study providing cognitive addition into the Chinese arts field, especially ceramics of the Chinese. The aim of the research included of areas of artistic creativity in Chinese pottery and ceramics according to the bases of construction and composition. As the impo

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Publication Date
Mon Oct 31 2022
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
The adoption of green management in Iraqi construction industry: The challenges and benefits
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Publication Date
Mon Jan 01 2024
Journal Name
Communications In Mathematical Biology And Neuroscience
The contribution of amensalism and parasitism in the three-species ecological system's dynamic
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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
Degree of Practicing the Professional Leadership of the Faculties’ Deans, Their Deputies and Heads of the Scientific Divisions in Al-Qaseem University
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Abstract

The study aims to find out the degree of practicing professional leadership of the faculty’s deans, deputies, and heads of the scientific divisions at Al-Qaseem University. The study has adopted the descriptive analytical method. To achieve the objective of the study, the researcher developed a questionnaire consisting of (45) items distributed to six fields that were applied to a sample of (116) faculty deans, deputies, and the head of division at Al-Qaseem University. The results showed there is a high practicing degree of the study sample individuals of the professional leadership on the questionnaire’s fields as a whole, strategic thinking field came at the first rank, while the innovation, creat

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