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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
Mon Feb 14 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of S.N.I.P.S Strategy on the Achievement of Fifth Grade Students in Geography
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The present research aims at identifying the impact of S.N.I.P.S strategy on the achievement of fifth grade students in natural geography

For the purpose of verifying the objective of the research, the researcher put the following zero hypothesis: There is no statistically significant difference at the level of (0.05) between the mean score of experimental group who study according to the (S.N.I.P.S) strategy, and the mean score of control group who study according to the traditional method in the achievement test.

In order to verify the validity of this null hypothesis, the researcher adopted the experimental method. Two groups of (60) fifth grade literary students were collecte

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Publication Date
Wed Nov 21 2018
Journal Name
Al–bahith Al–a'alami
Remediation of the Administrative Corruption Issues in accordance to the Theory of News Frames
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Media, especially press plays an important role in fighting corruption and tackling this phenomenon, which has become widespread in our society, through its effective role in raising awareness of the seriousness of spreading of corruption of all its forms in society.
All international conventions and agreements stress the necessity of the role of media and its importance in the light of corruption. All countries also commit themselves to the necessity of guaranteeing the freedom of media and the circulation of information and preparing it as a prerequisite for activating the People’s Control Mechanism and supporting measures and means to prevent and combat financial and administrative corruption more actively and effectively.
Co

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The use of management principles to Fayol in the implementation of competitive strategies Porter
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This paper aims to review the intellectual to the most important thought leaders administrative and strategic They both (Henry Fayol and Michelle Porter), who forward a lot of ideas that have helped countries in the advancement and progress their economies , has been drawing literature theoretical common border in Contributions ( Fayol ) philosophical and between applications ( Porter ), which reversed strategies of the three ( the leadership of the cost, differentiation, and focus ), so browse search how to apply and use the principles of Fayol in the implementation of strategies competitiveness of Porter, and stems from a problem ( ( to what extent a reflection of the principles ( Fayol) fourteen strategies (Porter ) competitiv

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Publication Date
Fri Sep 30 2022
Journal Name
College Of Islamic Sciences
Infrastructure components Reading in selected texts from the letters of the Brothers of Purity
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Absract

The letters of the Al-Safa Brothers contain many tales, in which each story is a literary text that is independent from the other texts, but it constitutes a unified entity in its entirety, because these stories contain recurring structural elements that go into building each one of them. The stories - the subject of the analysis - were not keen on something that was keen on adhering to the Sufi vision and its apparent effect on the tales of the messages, starting with the announcement of the narration to the narrator and his attempt to persuade the recipient of the truth of what is being told and its realism, and made him believe it. The stories correspond to the formal construction of the ideal style defined by th

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Publication Date
Wed Jun 28 2023
Journal Name
Al–bahith Al–a'alami
The Value of News in the Websites of Regional News Agencies Regarding Iraqi Affairs
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This study examines the news values employed by regional news agencies in the selection and dissemination of news concerning Iraqi affairs. Content analysis was conducted on a purposive sample of 596 news articles sourced from official websites of news agencies, including Iraqi, Turkish, and Iranian agencies. The research aims to identify the underlying criteria used by these agencies in determining news suitability for publication.

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Publication Date
Thu Aug 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The role of Electronic human resources management practices in the sustainability of knowledge capital
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Abstract:

The aim of the research is to highlight the role of electronic human resources management practices in the sustainability of knowledge capital as one of its success factors, as well as the diagnosis and interpretation of the relationship between research variables and their dimensions. The research problem is that the University of Babil implements some electronic human resources management practices not in a complete way, The level of its application and the problems it faces, as well as the extent to which these practices reflect the knowledge capital and sustainability in the university, and highlights the importance of research as it is concerned with the electronic aspects and achieve the competitive advant

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Publication Date
Sat Aug 01 2020
Journal Name
Journal Of Engineering
The Effect of Staggered porous fins on the performance of Photovoltaic panel in Baghdad
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The performance of photovoltaic (PV) panel having staggered metal foam fins was examined experimentally in Baghdad, Iraq. Three staggered metal foam fin configurations attached to the backside of the PV panel were studied. The measured parameters were front and back surfaces temperature, open voltage and current circuits, maximum power, and PV efficiency. It was noted that the maximum electrical efficiency enhancement was 4.7% for staggered metal foam fins (case III) than the reference PV panel. The operating temperature of the cell was increased when the value of solar intensity was high. Thereby, the electrical efficiency was decreased. It was found that the metal foam fins decreased the PV temperature by 2-3 o

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Publication Date
Sun Feb 08 2026
Journal Name
Al–bahith Al–a'alami
The problem of defining the vocabulary of teaching Arabic language methodology in media colleges
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This study examined the problem of identifying the vocabulary of the methodology of teaching Arabic language in the faculties of Media. The researcher noticed the existence of an overlap between the syllabuses of the general specialization of the Arabic language and its Media sections in the universities with the special professional vocabulary that suits the study of the media student. Thus ,this study is regarded as a real attempt to present a methodological model of media language that concerns with fillfuling students ‘linguistic and knowledgeable needs relying on measuring their benefits from the methodological Arabic curriculum .  Key words:problem,  teaching’ methodology of Arabic language, media language.

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Crossref
Publication Date
Tue Jun 30 2015
Journal Name
College Of Islamic Sciences
The phenomenon of advertising In the poetry of Ali bin Abdul Rahman Balnopi Sicilian
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The phenomenon of advertising In the poetry of Ali bin Abdul Rahman Balnopi Sicilian

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Publication Date
Thu Dec 04 2014
Journal Name
Engineering And Technology Journal
Optimization of the Time Required for Determination of the Total Dissolved Salts in Soil ‫
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