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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 Apr 03 2024
Journal Name
Al- Anbar Medical Journal
Hypervirulent and the Multi-Drug Resistant Klebsiella oxytoca: A New Emerging Pathogen in Baghdad Hospitals, Iraq
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Publication Date
Mon Jun 15 2020
Journal Name
Al-academy
Digitization is a contemporary reality and its importance in the Saudi plastic arts: ابتسام سعود الرشيد
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After completion of the artistic production, the artist plays the echo of this production upon the recipient. Whether this recipient is from the public, art connoisseurs, or private artists, critics and academics. In the past, the boundaries of Time and place had a great effect in limiting this echo or its quality, as the views of the recipients were largely influenced by the prevailing thought or the artistic trends that dominate the artistic scene in the surrounding environment in which the artist created. In order for the artist to show works for the widest segment of the recipient, he bears the burden of the costs of transporting the work, a keeper of damage on the move, and the material amounts that may hinder the publication of the

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Publication Date
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
Poverty and its Relations to Some Social Variables (Children in the Primary Stage as a Model)
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The phenomenon of poverty is one of the most important phenomena facing the world at large. Despite the tremendous technological progress witnessed by mankind and despite the unprecedented high levels of world economic production, poverty remains the greatest challenge facing the world. Statistics and studies have shown that poverty is caused by several problems: (health, social, economic, educational, etc.) These problems are obstacles to the ability to obtain employment opportunities, which leads in the beginning to the growth phenomenon of unemployment, and ultimately to the growth of poverty.

The results of a range of research in the field of psychology have confirmed that children from poor homes suffer from a high level of

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Publication Date
Thu Oct 01 2009
Journal Name
Journal Of The College Of Languages (jcl)
Male protagonists in Alice Walker's The Color Purple; a Voyage from Oppression to Maturity and Reconciliation
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Alice Walker's novel The Color Purple1983, whose events take place in the rural Georgia and addresses the most important issues in the early 20thcentury; like male dominant society and women submission to men, weaves a mosaic picture of male-female relationships. Black men like Alphonso, Albert and Harpo are portrayed as oppressors, cruel and they exercise power and violence over their wives and daughters. Through the negative portrayal of black male characters, Walker is accused to be a men hating writer because she ''Views oppression as an essentially masculine activity which springs from the male's aggressive need to dominate. In the novel, man is the premium mobile, the one by whom and t

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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of The College Of Languages (jcl)
Contrast in Matthew Arnold’s The Scholar Gipsy and Kahlil Gibran’s Al-Mawakib: A Contrastive Stylistic Analysis
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     Poetry is regarded an interesting area of inquiry in linguistic studies due to its eccentric and aesthetic use of language. A lot of studies have been carried out so far for the analysis of poetry, yet few have dealt with pastoral poetry. The present research attempts to investigate the language of pastoral poetry in two different languages i.e. English and Arabic with the aim of finding similarities and differences. The data of the study consists of one English and one Arabic pastoral poems. Leech and Short's (2007) checklist is used as a model for analysis. The findings of the study reveal that there are more similarities than differences between English and Arabic pastoral poems as the poems rely on contrast

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Accounting measurement of strategic storage in light of government support and its implications for presentation and disclosure / proposed model: an analytical study at the General Company for Grain Trade
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يؤدي عرض معلومات مضللة او محرفة ضمن القوائم المالية والتي تعد أهم مصادر المعلومات الموثوقة التي يُعول عليها لاتخاذ القرارات السليمة الى عدم قدرتها على عكس نتيجة النشاط والمركز المالي لها او اعمال الوحدة الاقتصادية لتلك الفترات الزمنية بصورة صادقة وعادلة نتيجة لنوعية المعلومات المفصح عنها في القوائم المالية لذلك زاد الاهتمام بتطوير الممارسات المحاسبية لتتضمن افصاحات كافية بغرض اعطائهم صورة صادقة وعادلة

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Publication Date
Thu Jun 15 2023
Journal Name
Bionatura
Effect of aqueous extracts of the sprouted seeds on the quantitative and qualitative yield of the coral lettuce cultured under the modified nutrient solution film NFT system
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The study was conducted at the fields of the Dept. of Horticulture and Garden Engineering, College of the Agricultural Engineering Sciences, Jadriyah in the fall season of 2020-2021 aiming to culture the coral lettuce with green and red leaves under the hydroponics system using the modified nutrient solution film NFT and study the effect of aqueous extracts of alfalfa and berseem sprouted seeds on the quantitative and qualitative yield of the lettuce crop. The research was conducted as an experiment of split plots within the Randomized Complete Block Design (RCBD) of three replicates. The seedlings of the green coral lettuce, Locarno RZ, and red coral lettuce, Locarno RZ, symbolized by A and B respectively, were transferred to the c

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Publication Date
Thu Jun 09 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The financial aid of the Central Bank of Iraq to the government and its reflection on indicators of banking stability/ Applied Research
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The research aims to define the images of financial aid that it provides within their tasks (central banks to governments) and how it can affect the indicators of banking stability, as well as monitoring the levels of banking stability in the Iraqi economy through the indicators used by the Central Bank of Iraq, and the importance of research in banking stability lies in Iraq, because any decrease in the movement of the aggregate banking stability index will reflect negatively on the financial sector in Iraq. Therefore, the Central Bank sought to provide financial aid to the government through a group of components, some of which are represented by initiatives that contribute to revitalizing the national economy and the other hel

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Publication Date
Tue Jun 15 2021
Journal Name
Al-academy
Listening to music and its reflection on the artistic output of the students of the Department of Art Education: سميعه فاضل كعود
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The relationship between music and plastic arts can be viewed as an interdependent relationship, as they both develop imagination, focus and sensory perception, as well as the presence of some artistic concepts that music shares with the art of drawing, on this basis the rationale for this research aimed at identifying (the influence of music) was dealt with On the artistic output (drawing) of students of the Department of Art Education - College of Fine Arts) In the first chapter the problem of research, importance, terminology, boundaries and goal was addressed, and in the second chapter the researcher dealt with in the first topic the relationship between music and painting, and in the second topic the use of music in education. As fo

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
The effect of usage two methods of garlic extraction( foliar and ground application) on the growth of the tomatoes (Solanum lycopersicum) plant
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Abstract<p>Garlic is rich in nutritional and medicinal value as it has been found that the water extract of garlic plant contains 31% carbohydrates and rich in elements calcium, phosphorus, magnesium, potassium, sodium, iron, zinc, manganese, vitamin C, thiamine, riboflavin, niacin and pyridoxine. The aim of this study was to investigate the effect of garlic extract (<italic>Allium sativum</italic> L.) on tomatoes (<italic>Solanum lycopersicum</italic> L.) plant. The trend is to use plant extracts in foliar and ground fertilization. Three levels of foliar application (4, 6, 8%), three levels of ground application (10, 20, 40%), one treatment 6% of foliar and 20% ground applic</p> ... Show More
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