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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
Sun Dec 16 2018
Journal Name
Al-academy
Reflection of political variables in the design of the Journal cover
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the political changeable is important reflection in areas of life and the designers tried to high light it in the cover of Journal promised time Journal a fertile square to show reflection of political changeable, and triad  to  search  the  current  path. The  first  chapter organized according to axes, problem of  research formulated according to question:- what are reflections of political changeable in magazine cover?

    The importance of research depth of specialized approach on level of technical and stylistic as ago al ago as in: the baring of political changeable in design of journal's cover. The research moves in cognitive border from 2013 to 2017 and selection of t

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Role of inherited occupations in cohesion of the family system
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This study aims to study the inherited occupations which are considered to be a cultural, civilized and social legacy that effected by the Prevailing social and economic circumstances in the Iraqi society .
The study aimed to achieve several goals, including:
Identify the relationship between the urbanization and inherited occupations in the old city Al-Karkh.
Identify the relationship between the ecological construction and inherited occupations in the old city Al-Karkh.
Recognize the factors and motives inherited occupations in the study area .Identify the role of inherited occupations in promoting opportunities cohesion of the family system in the study area.
The field of the study had concentrated on a sample of famili

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Publication Date
Fri Dec 15 2023
Journal Name
Al-academy
Representations of the Metaverse in the Works of Potter Jason Walker
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The current research studies (representations of metaphysics in the works of potter Jason Walker) a concept that refers to To a large extent, by conveying a sense of reality to the recipient by conveying ideas, contents, and connotations. A variety of center hit, dispersion, and rejection of everything that prevails, so our position on the closed text has shifted To the open text, through the role played by cross-pollination in the works of the potter (Jason Walker), which established a clear hypothetical vision of the image represented in the construction of the ceramic work and the thought that was embodied in that image represented by the nature of its unrealistic formations for those ceramic artworks. It is thus considered a logical

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Publication Date
Sat Jan 12 2019
Journal Name
Journal Of The College Of Education For Women
The geomorphological associated of Sebkha in the Mesopotamia- plain of Iraq
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The Sebkha of geomorphological aspects of evaporative where climate leads active role, which forms part of the earth's surface in the form of Iraqi Mesopotamia plain who of the most fertile land, and because of natural factors and human Common turned most of the arable land to the territory of Sebkha. It was to determine the exact geomorphological associated of Sebkha formats by field work such as: Alnbaka, lakes, salt flats, and other forms of Small is: bridges salt, mud cracks, salt ponds, Rectangles and polygons salt, Sahaf salt, salt domes, salt gravel, bumps saline (salt points), Ash salt, salt bows, in detail and accurately documented Terrestrial Photogrammetry field and were compared to the levels and standards varieties have been

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Publication Date
Thu Oct 10 2024
Journal Name
Pakistan Journal Of Criminology
The Role of Environmental Bonds in the Settlement of Environmental Debts
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The concept of environmental debt, which has several dimensions, emerged in the nineties. One of these dimensions is spatial, referring to the debts that southern countries sustain due to the extraction of natural resources and environmental damage inflicted upon northern countries. Another dimension, the temporal dimension, concerns the environmental debts that current generations owe to their predecessors. That means past generations are culpable for overuse of natural resources and mismanagement. The debt issue is complex, despite many mechanisms to resolve it. Most important are the recently introduced environmental bonds, an important step forward in the field of sustainable financing of environmental debts.

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
Educational Implications of the Concept of Desertion in the Holy Quran
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The purpose of the present study is to identify the comprehensive concept of desertion through the Holy Qur’an and to derive some educational implications related to the concept of desertion and its editing. The also aims to explain the images and forms of desertion. The researcher used the qualitative analytical method. The study concluded that the comprehensive concept of desertion was represented in moving from the country of polytheism to the country of Islam, singularity, alienation, and isolation, leaving, repelling and showing off, abandoning the wife in bed, and reciting from the Qur’an recitation, action, and arbitration, insulting, abandoning, delirium, intersection, and manipulation. The researcher has drawn many education

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Publication Date
Tue Jan 30 2024
Journal Name
Iraqi Journal Of Science
A Study of Drinking Water Properties in Some Hospitals in Baghdad City
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One of the bigger problems in drinking water is disinfection by-products (DBPs) that come from chlorinated disinfection. This study’s goal was to evaluate the drinking water in Al-Yarmouk Teaching Hospital, Ibn Sina Hospital and Ibn-Al-Nafis Hospital.  Samples were collected between October 2018 and September 2019. Physical and chemical characteristics of the water were studied, including (temperature, hydrogen ion (pH), total dissolved solids (TDS), electrical conductivity (EC), turbidity, free residual chlorine, total organic carbon (TOC), total trihalomethanes (THMs), total halo acetic acid (THAAs)). Data analysis showed the highest value of study temperature, pH, TDS, EC, turbidity, free residual chlorine and TOC which was

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Al-qadisiyah For Computer Science And Mathematics
A General Overview on the Categories of Image Features Extraction Techniques: A Survey
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In the image processing’s field and computer vision it’s important to represent the image by its information. Image information comes from the image’s features that extracted from it using feature detection/extraction techniques and features description. Features in computer vision define informative data. For human eye its perfect to extract information from raw image, but computer cannot recognize image information. This is why various feature extraction techniques have been presented and progressed rapidly. This paper presents a general overview of the feature extraction categories for image.

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
A new vision inspired by the school of geometric abstraction to enrich the field of Saudi plastic painting
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Art is a language in which the artist expresses himself, his society, and the events he lives in, so new artistic trends emerged, so the artist no longer practices his art as required by any previous artistic rules. And the thoughts wandering inside him, which led him to the abstract method in which the artist tries to employ the elements of the artwork in a plastic construction through which he achieves the relationships of the abstract form through the rhythms of lines, colors, spaces, shapes and textures without these plastic elements having any connection with the visual reality.
The research aims to find a new vision inspired by the school of geometric abstraction to enrich the field of Saudi plastic painting. And to take advan

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Publication Date
Thu Mar 31 2022
Journal Name
Journal Of The College Of Education For Women
The Phonetic Connotation of the Appending Letter Alef in the Holy Qur’an
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Appending is a morphological term which means the addition of one or two letters to a structure to be similar to other structures of well-known abstractor additional nouns and verbs constructions. The goal of appending is to organize what have been expanded linguistically and collect similarities to reduce the syntactic rules. This is because the appended word exists for expanding purposes; however, it has no construction of its own. An appending was included with another construction with mentioning the additional letter. This by itself means that appending as a process is a term that helps organize rather than expand language. Scholars further noticed that the appending letter is not semantically significant, and so it differs from the

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