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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
Thu Apr 23 2020
Journal Name
International Journal Of Innovation, Creativity And Change
A PRAGATIC STUDY OF APOLOGY STRATEGIES IN ONLINE ENGLISH LETTERS
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DBN Rashid, International Journal of Innovation, Creativity and Change, 2020

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Publication Date
Thu Mar 31 2022
Journal Name
Journal Of The College Of Education For Women
A Pragmatic Study of Identity Representation in American Political Speeches
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Identity is an influential and flexible concept in social sciences and political studies. The basic sense of identity is looking for uniqueness. In one sense, it is a sign of identification with those we assume they are similar to us or at least in some significant ways they are so. Globalization, migration, modern technologies, media and political conflicts are argued to have a crucial effect on identity representation in terms of the political perspectives specifically in the United States of America. This paper endeavors to investigate how American politicians represent their identities in speeches delivered in different periods of time namely from 2015 to 2018 in terms of the pragmatic paradigm. Three randomly selected speeches by fa

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Publication Date
Tue Dec 09 2025
Journal Name
Discourse And Interaction
A discursive pragmatic study of emotional blackmail in American movies
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This study examines emotional blackmail from a discursive pragmatic standpoint to gain insights into how this psychologically manipulative phenomenon is revealed in the discourse of some American movies. Five extracts from five American movies are purposely selected and analyzed using an eclectic model based on a discursive pragmatic approach to navigate this unexplored study area. The model incorporates Halliday’s (2014) transitivity system, Martin and White’s (2005) attitude system, Forward and Frazier’s (1997) types and tools of emotional blackmail, and Mayfield’s (2010) informal fallacies. The present study is guided by four research questions that identify the types and tools of emotional blackmail employed in the selec

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The possibility of the application of international accounting standards to strengthen the role of oil companies in the region environment
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Abstract:

 The underlying objective of the international standard No. (6) to assist in accounting applications for the extractive industries, taking into consideration the goals and objectives contained in the sixteenth of the private International Accounting Standards criterion accounting for land, machinery and equipment, as well as Standard No. axes (38) relating to intangible assets, and in order to create a vision of a comprehensive development needs oil in order to exact evaluation of policies related to the particular needs and draw a comprehensive frameworks with respect to treatment of expenditures and revenues in the oil production industry, is also interested in Standard No. (6) within the primary objectiv

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Publication Date
Thu May 18 2023
Journal Name
College Of Islamic Sciences
ascetic And the pleasures of the worldly life
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Because asceticism has a great impact on educating the human soul properly, according to what was mentioned in the Book and the Sunnah of the Prophet, and keeping it away from vices and what is devolving into it, and this world and its adornments keep the Muslim away from virtues and work with them in order to reach the Hereafter in which is the eternal bliss that God, peace be upon him, has prepared for the obedient. The two pious obedient ones. And because of the impact of this topic on the Islamic community and adorn it with good qualities. Likewise, I saw many Muslims who do not prefer the life of this world over the hereafter, and they began to fight over the world and enjoy its adornments, and they took pride in money, building, an

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
The question of demand: definition, divisions, and examples from the controversy of the scholars of jurisprudence.
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research summary

Praise be to Allah، and prayers and peace be upon His Messenger and His chosen one، his family، companions and his family and his family.

After that، this is a study on the question of the claim، as one of the controversial questions that are the mainstay of debates، and I looked at it: the limit of the question of the claim، its importance، its impact، its aspects of corruption، its sections، and the representation of its sections of the fundamentalist controversy;

The research was according to the following plan:

Introduction، in which she mentioned: the importance of the research topic and the reason for its selection، its questions، its l

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Publication Date
Wed Sep 15 2021
Journal Name
Al-academy
Contemporary experimental currents and its impact on the structure of the contemporary Iraqi theatrical text "The epic theater as a model": هيثم حمزة سلمان الحمداني
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  In this research study, I tried to trace the epic effect to learn how it was understood and how it was used. Following the descriptive and analytical approach in the research, the first chapter dealt with a presentation of the methodological framework of the problem, the goal, the limits of the research, the importance and the need for it and the definition of terms, as well as the theoretical framework which consisted of two topics, including the impact of the epic theater on the world theater and the second the effect of the epic theater on the Arab theater, This came by tracing the epic impact on the world stage of the Greeks, the Middle Ages, the Renaissance, and the Arab theater of the twentieth century.
As for the second

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Publication Date
Sat Apr 01 2023
Journal Name
Baghdad Science Journal
Development and Validation of a Simple and Sensitive Reverse-Phase High Performance Liquid Chromatographic Method for the Determination of Ibuprofen in Pharmaceutical Suspensions
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The aim of this work was to develop and validate a rapid and low cost method for estimation of ibuprofen in pharmaceutical suspensions using Reverse-Phase High Performance Liquid Chromatography. The proposed method was conducted and validated according to International Conference on Harmonization (ICH) requirements. The chromatographic parameters were as follows: column of octyldecylsilyl C18 with dimensions (150 × 4.6) mm, mobile phase composed of acetonitrile with phosphoric acid with a ratio of 50 to 50 each using isocratic mode, flow rate of 1.5 mL/min and injection volume of 5 μL. The detection was carried out using UV detector at 220 nm. The method was validated and showed short retention time for ibuprofen peak at 7.651 min, wit

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Publication Date
Fri Aug 25 2023
Journal Name
Plos One
Organizational and behavioral attributes’ roles in adopting cloud services: An empirical study in the healthcare industry
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The need for cloud services has been raised globally to provide a platform for healthcare providers to efficiently manage their citizens’ health records and thus provide treatment remotely. In Iraq, the healthcare records of public hospitals are increasing progressively with poor digital management. While recent works indicate cloud computing as a platform for all sectors globally, a lack of empirical evidence demands a comprehensive investigation to identify the significant factors that influence the utilization of cloud health computing. Here we provide a cost-effective, modular, and computationally efficient model of utilizing cloud computing based on the organization theory and the theory of reasoned action perspectives. A tot

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Publication Date
Tue Jan 01 2019
Journal Name
Iraqi Journal Of Agricultural Sciences
Effect of welding heat input on corrosion rate of sprinkler irrigation piping joints by tig welding used in South of Iraq
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