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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
Sat Jun 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Rationalization the costs and improve seed quality under the application of biotechnology: An Applied Research in Ministry of Agriculture - the Directorate of Inspection &Certification of Seeds
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The importance of this research has been to rationalize the cost of producing maize seeds through the followers of modern techniques and methods in agricultural activities such as genetic engineering for the purpose of increasing production efficiency of maize seeds as well as the importance of calculating seed cost rationalization through the ABC system and thus rationalizing government spending. The research is based on a single hypothesis that the use of genetic engineering on corn seeds works to:increase production efficiency of seeds and savings in agricultural inputs, calculation of rationalization through the cost system on the basis of activity ABC The research reached a number of conclus

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of Educational And Psychological Researches
The impact of discrete realization strategy in the development of reflective thinking among students of Qur'an and Islamic education departments for the course of Islamic jurisprudence
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The paper aims to identify the impact of discrete realization strategy in the development of reflective thinking among students: (males/females) of Qur'an and Islamic education departments for the course of Islamic jurisprudence according to the variability of sex. The researcher used the experimental approach and adopted an experimental determination with a set part of the two groups (experimental and controlled). He selected the sample deliberately which consists of (147) students spread over four classes (experimental males/ experimental females/ controlled males/ controlled females), and it took last for an academic year of (2010-2011). He, then, prepared a post test to measure the reflective thinking with his five skills (skill of o

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Publication Date
Sat Oct 26 2024
Journal Name
Zac Conference Series: Social Sciences And Humanities
A Comparative Study of Postwar Literature (Iranian Defense and Vietnam’s War) a Komunyakaa’s and Aminpour’s Poems
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The comparative study tries to find the common points in two different authors’ works and in this kind of studying so many other common but the hidden points may be revealed. Postwar literature is somehow one of the best literary genres for finding the common factors and features that the poets have tried to present in their works elements such as desire to be winner, cruelty, inhumanity, and absurdity of the war.  The Iranian poet late Qaisar Aminpour(1961-2007)  and Yusef Komunyakaa ( 1947) from  Bogalusa, Louisiana, are among the great American and Iranian  poets whose works so many times have been  interpreted and analyzed. The finding the outstanding and the most important points and themes in the postwar poems of these

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
Polygamy in light of societal changes in Iraq (A Field Study in Baghdad)
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The polygamy as a social was known before Islam, has kept Islam on this system after it organized and put his controls and conditions, as justice between wives and the ability to alimony, it was not the purpose of satisfying the instinct of man and enjoyment, but his goal nominal than that, because it addresses problems humanity has goals noble, so the pluralism overlap of the fabric of families belonging to governance and benefits for women and men and society, which leads to increased ties of love between people of the same society and thus increases the cohesion and importance of the topic and its association with financial conditions have emerged as needed so you viewed in the second scientific Conference of the Department social Ser

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Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
The moral dimension of generating and destroying value Through the implementation of the Balanced Scorecard
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يسعى المجتمع من خلال الوحدات الإقتصادية إلى الوصول إلى تحقيق أفضل الإنجازات التي لا تتمثل بالسلع والخدمات حسب وإنما بما يتحقق من مردود لكافة الاطراف المعنية بالوحدات الإقتصادية على ان لايتم ذلك على حساب قيم المجتمع وأخلاقياته وآدابه العامة. وعليه تصبح الوحدات الإقتصادية مسرحاً لصراعات قوى متعددة كل منها له قيمه الأخلاقية سواء كان فرداً أومجموعة افراد أو وحدة إقتصادية أو أي جهة أُخرى، وبحكم مسؤولياته

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Publication Date
Thu Oct 31 2013
Journal Name
Al-khwarizmi Engineering Journal
Influence of the Applied Potential and Temperature on the Electrode position of the Lead Dioxide
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The excellent specifications of electrodes coated with lead dioxide material make it of great importance in the industry. So it was suggested this study, which includes electrodeposition of lead dioxide on graphite substrate, knowing that the electrodeposition of lead dioxide on graphite studied earlier in different ways.

In this work the deposition process for lead dioxide conducted using electrolytic solution containing lead nitrate concentration 0.72 M with the addition of some other material to the solution, such as copper nitrate, nickel nitrate, sodium fluoride and cetyl trimethyl ammonium bromide, but only in very small concentrations. As for the operating conditions, the effect of change potential and temperature as well

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
The Relations Of Design And The Role Of It Making The Idea For Fashion Design
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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
The preoccupations of the compressive references and their impact on the formations of postmodern art
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The artistic process operates whether in general in all arts or specifically in one type of arts or one of the genres of arts types on the preoccupations of the pressing artistic references as the founder of the artistic work in the material formulations on the one hand and on the other hand as a translator to understand the artistic achievement in general and plastic art in particular and for the importance The researcher chose the title of her research tagged (the preoccupations of the pressing reference and its impact on the formations of postmodern arts).
The first chapter of the methodological framework deals with the problem of research, importance, objective, limits, and then terminology and its definition, and then the secon

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Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
Value system and its impact on the morals of the public job of the individual
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         Values ​​are penetrating or interfering in the lives of individuals and groups and are connected to them in the sense of life itself, because they are closely linked to the motives of behavior, hopes and goals, and can be said that values ​​are everything. The concept of values ​​is one of the concepts that have received the attention of researchers from different disciplines. This has resulted in a kind of confusion and variation in use from one specialization to the other, and uses multiple uses within one specialization. Therefore, there is no uniform definition of values ​​because they relate to individuals. Individuals differ in many things, such as perception,

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Publication Date
Sun May 08 2011
Journal Name
Journal Of Planner And Development
The Effect of the Natural and Cultural Environments Factors on the Architectural and Planning Characteristics of Sulaymaniyah Mosques
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Most of the mosques in the Islamic world fall under specific and known forms and patterns to a large extent, and such patterns have grown and evolved from the few basic and uniform models, but they changed slowly due to the impact with a mixture of changing functional requirements and cultural landscapes because of the variables of time and place to form patterns known and famous in this day across parts of the Islamic world and its borders. There was no exception to these patterns, but small numbers of mosques that were probably the result of personal experiences or improvisational resolutions, or in response to specific or temporary stimuli. However, the emergence of a specific pattern which does not belong to any of these patt

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