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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 Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Providence of the Rosaly's family to the Intellectual Movement in Yemen
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The Providence of the Rosaly's family to the Intellectual Movement in Yemen

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Publication Date
Thu Dec 15 2022
Journal Name
Al-academy
The deliberative dimension of the visual sign in the contemporary Iraqi poster
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The current research dealt with (the deliberative dimension of the visual sign in the contemporary Iraqi poster) in an attempt to identify the importance of the contemporary poster and the role of the international dimension of the visual sign of exceptional importance.
What is the international dimension of the visual mark?
- What is the effect of the visual label on the contemporary Iraqi poster?

The current research aims to identify the pragmatic dimension in the contemporary Iraqi poster.
Across the temporal and spatial research boundaries of the year (2000-2020) in Iraq. The limits of the objective research The limits of this study on the pragmatics in the visual sign and the determination of the relationship betwee

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Publication Date
Sat Oct 01 2016
Journal Name
Al–bahith Al–a'alami
The Absence of the Applied Semiotic Approach in Analyzing the Media Phenomenon
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the contemporary Arab scholars deal with semiotics as an approach that helps them understand the texts, its meaning, and its structural functionalism . that’s why every now and then we find some
studies and researches using semiotics as an approach in study and comparatives, some of them even used the semiotic approach in analyzing old and new texts, while others think that semiotic holds and important place in critical approaches .
even though some of them considers semiotic just a trend of fashion this really didn’t lessen the value of semiotic as a scientific and procedural approach in literary and media studies as well as in analyzing literary and journalistic texts. for this reason it is considered as an important approa

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Publication Date
Wed Oct 05 2016
Journal Name
Al-academy
The Stylistic Development in the Crafts of the Sculptor Mohammed Ghani Hikmat
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The present study aims at examining the stylistic development in the crafts of the sculptor Mohammed Ghani Hikmat. It gives answers to the following two questions: what is the nature of the stylistic development? And what are these principles and techniques led him to this development? The researcher has used the descriptive, analytic approach in examining the selected five samples out of the sculptor’s displayed crafts. The observational technique is used as a tool of examination. Among the main findings are: integrating space in the cubic crafts, represented by the existence of holes within this general construction of that space; the evident influence of critical contemporary orientations through the direct insertion of recipients i

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Publication Date
Wed Sep 07 2022
Journal Name
International Journal Of Asia Pacific Studies(ijaps)
Investigating the Aesthetic Effect in the Arabic Translations of Gibran’s the Prophet
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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Commitment of Public Companies in disclosure requirement of Financial Statement: Analysis Study in State Company for Leather Industries (SCLI)
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It has been an increase concern of scientific and professional accounting sides on disclosure especially after appearance of business firms and accounting development with its relationship to financial statements which are considered to be outputs of the activity results.  The preparing of financial statements and auditing of those accounts according to normal principles and standards of accounting on both local and international levels. Accounting disclosure can be seen an importance through discover all fundamental and necessary information for proper supply. Therefore, the research will highlight on public companies commitment in Iraq for basis and standards which have taken disclosure in financial data. The conceptual frame of t

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Sealing Depth of Q-Switched Nd:YAG 1064nm Laser in the Treatment of Patients with Hypersensitive Teeth: An In Vitro Study
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The purpose of this work was to study the effects of the Nd:YAG laser on exposed dentinal
tubules of human extracted teeth using a scanning electron microscope (SEM). Eighty 2.5mm-thick
slices were cut at the cementoenamel junction from 20 extracted human teeth with an electric saw. A
diamond bur was used to remove the cementum layer to expose the dentinal tubules. Each slice was
sectioned into four equal quadrants and the specimens were randomly divided into four groups (A to D ).
Groups B to D were lased for 2 mins using an Nd:YAG laser at 6 pulses per second at energy outputs of
80 , 100 and 120 mJ. Group A served as control. Under SEM observation, nonlased specimens showed
numerous exposed dentinal tubules. SEM o

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Publication Date
Thu Jan 01 2015
Journal Name
Al–bahith Al–a'alami
News coverage of Arab revolutions in satellite channels An analytical study of the news bulletins in Al - Tijah satellite channel
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The news media material to any means of mass media, and increasingly

 important in TV; what the associated word and image effects, which do different cover events (political, economic, sports, and social .... etc.) directly from the event site and gather the news and do prepared formulation and arranged within the framework provided by the newsletter, as it requires the viewer to provide the public with information about this news correlated; to achieve the greatest gravity following the shapes and styles and technical fees (Alkraveks) during the submission. What we are witnessing today from technological developments help existing staff to cover the news activity quickly and efficiently prohibitivel

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Publication Date
Thu Jun 29 2017
Journal Name
College Of Islamic Sciences
Balance and moderation in dealing with the oppressor and the oppressed in the Sunnah - "Applied models")
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Research Summary

In The Name of Allah Most Gracious Most Merciful

The word injustice and its derivatives were repeated in the Holy Qur’an in several places, approximately (154) times. This is due to the severity of its danger, and that the most dangerous thing that our Islamic nation suffers from in our time is; It is injustice in all its forms and types, so we should all have an honest review of the sincere change in the right direction, and uncover cases of injustice and explain their causes and causes, and work to treat them and rid the wrongdoers of their injustice, and help them to correct their condition. To reveal their grievances and explain their causes and causes, and work to remedy them, and support them and mi

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Publication Date
Fri Oct 07 2022
Journal Name
Texas Journal Of Engineering And Technology
Estimation of Pore Pressure and In-Situ Stresses for Halfaya Oil Field: A Case Study
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