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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
Wed Mar 15 2023
Journal Name
Al-academy
Geometrical Foundations of Shape in Structural Design of Contemporary Ceramic Pots "The artist "IBRAHIM SAEED" is a model"
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Each era has advantages in terms of innovation and development in form, technology, style, and design in ceramic vessels, both at the level of functional and aesthetic performance, so this study aimed to demonstrate the importance of geometrical foundations in the design structure of contemporary ceramic vessels, and also to reveal the constructive skills in The structure of the ceramic figure.
The researchers used the descriptive analytical approach to suit the nature of the study, and they described and analyzed the ceramic works in terms of geometric shape systems, elements and foundations of design in construction, formal diversity in the general design of ceramic vessels, and references and sources of artwork. In addition to th

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Publication Date
Tue Dec 30 2014
Journal Name
College Of Islamic Sciences
Prayer sessions are the truth and the opinions of scholars
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The ritual is a Sunnah between the two prostrations, not as some of the worshipers do, where he made it in the last tashahhud when the tasleematin, and it may be in the last tashahhud.
The assumption is Sunnah and most of the scholars say that in the middle tashahhud session as we have shown through research.
The Turks are Sunnah as well, and it is at the end of the prayer, whether it is double, triple or quadruple, whether it is naval or NAFTA, whether it is urban or travel, which is the view of most scholars from the three imams and others.
If we say weighting, say the audience of the three imams (Malik, Shafi'i, and Ahmad) is the most correct, and it is also the son of values, and if we say the choice is as Ibn Rushd said: by

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The archaeological and religious sites on the city of Babylon
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The archaeological and religious sites play a prominent role in the rest of the other tourist activities as cultural and spiritual needs that can not be dispensed with. Archaeological sites represent cultural origins of the nation. Religious sites represent the state of man's orientation to God in places of worship . The focus was on the city of Babylon because it is an ancient city and tourist because of its characteristics and elements. The importance of the city of Babylon is illustrated by highlighting its archeological and religious status through its geographical distribution. This gives the subject special importance for the purpose of knowing the city's important sites. And come out with a number of results and a set of recommend

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Publication Date
Mon Jun 15 2009
Journal Name
Alustath Journal For Human And Social Sciences
THE SYNTACTIC AND SEMANTIC MANIFESTATIONS OF THE DETERMINER PHRASE (DP)
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Publication Date
Thu Jun 30 2022
Journal Name
Anbar Journal Of Agricultural Sciences
THE EFFECT OF PESTICIDES ON THE ENVIRONMENT AND LIVING ORGANISMS
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The current report dealt with the effect of pesticides on the ecosystem through their impact on soil, water, and microorganisms and their impact on human health. As well as this study dealt with the biodegradation process of pesticides and the organisms involved in this process, even some previous studies proved that Bacillus spp. And Pseudomonas sp. Bacteria is the most efficient in the biodegradation of pesticides, at the same time, other previous studies dealt with the environmental factors that affect the biodegradation process of pesticides. It proved that each of the incubation periods, pH, and temperature have different effects on biodegradation. Most of the studies indicated that the best incubation period for biodegradation is 7-8

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Publication Date
Fri Oct 28 2022
Journal Name
Political Sciences Journal
Security Intellectual Proposals of the Paris and the Wales Schools
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The study discusses ''The Security Intellectual Proposals of the Paris and the Welsh Schools'', which are considered one of the most important contemporary European monetary schools that emerged in the nineties  of the twentieth century, and how did it approach the concept of security, criticizing the traditional trend that prevailed during the Cold War period regarding limiting the concept of security to the state or to the military aspect (National Security), and an attempt to expand the concept to economic, social and environmental dimensions, as well as political and military dimensions. The most important proposals that the Wales School provided are “Security as an emancipation policy”, “ individual security”, and “The ro

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Publication Date
Wed Oct 12 2022
Journal Name
College Of Islamic Sciences
The Concept of the Text, its Divisions, Connotations, and Methodology
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The text has many connotations in the Arabic language, such as vowel points, designation, completion, etc., and the original meaning of the text is to show. The Western text has its owen independent semantic unit .The biblical texts are a mixture of what was reported by the Prophet Moses (peace be upon him) and what the authors described in terms of texts over many centuries.The meaning of the text is guidance and payment, and it is a natural connotation. The religious text for Muslims is divided into peremptory texts that are national proof. The evidence for the meaning of the text is proven by language, and it is not required that the researcher be a jurist. The approach is a factual questionnaire by the researcher according to a speci

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Publication Date
Mon Oct 23 2023
Journal Name
College Of Islamic Sciences
The concept of justice and its relationship to the law
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Any person, regardless of his location in the air, whether he was kidnapped or trained, and then he performs a certain work, believes that his work is in vain, and by God, his deeds. I wonder if those who hold him in the first place will be safe in good form. He said that the essence of justice in the story is the story:

These are given the meaning we have fought in the fact that each group of. He went beyond creating a group of blocs, sects, and parties. If justice indicated one meaning, these relationships between people and peace would diminish. In fact, justice has only one concept, but there are several associations with it in the field of divorced one of these synonyms. However, the variation in racist drums in the encounte

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Publication Date
Mon Feb 02 2026
Journal Name
Revista Iberoamericana De Psicología Del Ejercicio Y El Deporte, Issn 1886-8576, Vol. 17, Nº. 5, 2022, Págs. 275-278
The effect of therapeutic physical exercises in the rehabilitation of the knee joint injured partial rupture of the medial meniscal cartilage for football players
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Autorías: Ismael Saleem Abed, Imad Kadhim Khlaif, Salah Mahmood Salman. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 5, 2022. Artículo de Revista en Dialnet.

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Scopus
Publication Date
Fri Mar 25 2022
Journal Name
Asian Journal Of Biochemistry, Genetics And Molecular Biology
Evaluation of the Simple Sequence Repeats to Work as a Phase Variation with the Neisseria meningitidis Genome
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Background: The most crucial mechanism of genetic variation in N. meningitidis is the slipped strand mispairing, this mechanism generates Phase variation using simple sequence repeat (SSR) and is commonly used by the N. meningitidis to escape the immune system despite its function in eradicating the pathogenic and commensal bacteria. Some of simple sequence repeats (SSRs) that located within the genome works as phase variation while other SSRs have no role in generating phase variation mechanisms. Therefore, Aim: the main goal of the current in silico study was to detect the probability of SSR to enroll with phase variation for the entire N. meningitidis genome. Methods: Different criteria were used to judge SSR as

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