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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
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Impact Of Application Of Jit In The Banking Sector On The Quality Of Banking Service
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Abstract 

          The research the impact of the application of some of the production system tools in the specified time, which can be adapted in the service sectors (banking sector) over the improvement and increase the quality of banking services, and highlights the research problem in the low quality of banking services provided to customers because of the reliance on traditional banking systems in the provision of services Because of the lack keep pace with global developments in the banking industry, and the goal of research is to clarify the applicability of the production system in the time specified in the service sector and th

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Publication Date
Mon Feb 14 2022
Journal Name
Journal Of Educational And Psychological Researches
The Educational dimensions of children's television programs in the light of the universal rights of child
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The research aims at determining the type of educational dimensions to be broadcasted in children's television programs, clarifying the technical forms used in children's TV programs, analyzing the educational dimensions provided by children's television programs, and studying the educational dimensions of children's television programs. The researcher used a sample of children's programs: all of us heroes, which is a daily program on the mbc3 channel as well as the program of Tel flowers on the Algerian channel. The researcher designed an analysis content form included categories of analysis. Spss program was used to process the collected data. The research reached several results; the concentration of educational dimensions in

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Publication Date
Thu Mar 19 2015
Journal Name
Al-academy
THE SIGN READING OF THE STRUCTRE OF UNIFICATION IN THE CIVILIZATION OF MESOPOTAMIA: جهينة حامد حساني
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The Mesopotamian artist conversed the functions of idols with multi-formation, varied pictured and structural significances sign momentum. Each phenomenon had an idol and each event had an idol. So multiplicity contributes in the enrichment of the Mesopotamian thought by the full and comprehensive familiarity of the characterization of the religious space which reached up to realize the start point of creation and formation and specify the concept of unification in such a way that considered as pagan multiplicity and Atheism according to what brought by most of the previous studies.Such a research as ( The Sign Reading of the Structure of Unification in the Civilization of Mesopotamia) aims to clarify this confusion through decoding the

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Publication Date
Tue Nov 03 2020
Journal Name
Modern Sport
The effect of using multimedia in learning the skill of passing from the bottom of volleyball
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The aim of the research is to:. Preparation and implementation of special educational units using multimedia to learn the skill of scrolling from below. 2 to recognize the impact of the use of multimedia in learning the skill of scrolling from below. 3 to identify the differences between the tests after the two groups research in learning the skill of passing from the bottom volleyball. The research represented the students of the first stage and the sample of the research was drawn randomly and the number of (50) students were divided into two experimental and control groups and each group (25) students were used standardized tests and conducting pre-tests and the implementation of the main exp

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Prediction of the number of births in the Governorate of Basra for the period (1998-2050)
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The adoption of many mathematical concepts contributes to the construction of models of sports and the population can be interpreted to explain the movement and growth of the population lead to proper planning to manage the requirements of the population and meet their needs of providing education or providing medical services, health and others. In this study, the number of births in the Governorate of Basrah for the period (1998-2050) is estimated to be based on the assumption that the population of the visually impaired is a stable society. If the rate of growth is (0.0492), some demographic indicators are important for maintaining the average age of women at pregnancy (27.817). Each woman will give birth (3.74) female birth d

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Publication Date
Wed Feb 26 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Cost and Quality of Documentary Credit in achieving the Competitive Advantage in Banks: An Applied Research in North Bank for Finance and Investment and The United Bank for Investment
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Documentary Credit passes through many practical phases starting from Opening credit and matching documents and payment of the amount of credit……etc.  It is worthy to mention that there are several aspects that are varied and differed from Bank to another one which can offer Competitive Advantage for the bank …This will be shown in this research.

For the purpose of achieving the objective of this research within the theoretical aspect, the researcher had seen and briefed several books and researches which are mainly related to the subject of the research.

As for the practical aspect, has included Questionnaire which included many questions that are fit and suitable to the hypotheses.

Research sample has

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Publication Date
Sat Jun 15 2024
Journal Name
Iraqi Journal Of Laser
Estimation of mean photon number based on single photon detection of weak coherent pulses
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The demand for single photon sources in quantum key distribution (QKD) systems has necessitated the use of weak coherent pulses (WCPs) characterized by a Poissonian distribution. Ensuring security against eavesdropping attacks requires keeping the mean photon number (µ) small and known to legitimate partners. However, accurately determining µ poses challenges due to discrepancies between theoretical calculations and practical implementation. This paper introduces two experiments. The first experiment involves theoretical calculations of µ using several filters to generate the WCPs. The second experiment utilizes a variable attenuator to generate the WCPs, and the value of µ was estimated from the photons detected by the BB

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Publication Date
Sun Dec 01 2024
Journal Name
Iraqi Journal Of Physics
Study of the Sensitivity of Carbon Quantum Dots for NO2 Gas Sensor and improve it using Graphene
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Gas sensors are essential for detecting noxious gases that have a detrimental effect on people's health and welfare. Carbon quantum dots (CQDs) are the fundamental component of gas detectors. CQDs and graphene (Gr) were prepared using the electrochemical method. The gas sensitivity of these materials was evaluated at different temperatures (150, 200, 250 °C) to assess their effectiveness. Subsequently, experiments were conducted at different temperatures to ascertain that the combination of CQDs and Gr, with various percentages of Gr and CQDs, exhibited superior gas sensitization properties compared to CQDs alone. This was evaluated based on criteria such as sensitivity, recovery time, and reaction time. Interestingly, the combination was

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Publication Date
Fri Jan 23 2026
Journal Name
Sciences Journal Of Physical Education
Analytical study of the causes of winning and losing according to some technical indicators among young boxers
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Publication Date
Fri Apr 21 2023
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees22fr
Study of the x-ray diffraction lines of calcium titanate nanoparticle using SSP method and Scherrer method
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In this study, the modified size-strain plot (SSP) method was used to analyze the x-ray diffraction lines pattern of diffraction lines (1 0 1), (1 2 1), (2 0 2), (0 4 2), (2 4 2) for the calcium titanate(CaTiO3) nanoparticles, and to calculate lattice strain, crystallite size, stress, and energy density, using three models: uniform (USDM). With a lattice strain of (2.147201889), a stress of (0.267452615X10), and an energy density of (2.900651X10-3 KJ/m3), the crystallite was 32.29477611 nm in size, and to calculate lattice strain of Scherrer (4.1644598X10−3), and (1.509066023X10−6 KJ/m3), a stress of(6.403949183X10−4MPa) and (26.019894 nm).

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