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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 Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
Experimental Study of Mixed Convection in an Enclosure with a Cold Movable Top Wall and Hot Bottom Wall
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Mixed convection heat transfer to air inside an enclosure is investigated experimentally. The bottom wall of the enclosure is maintained at higher temperature than that of the top wall which keeps in oscillation motion, whereas the left and right walls are well insulated. The differential temperature of the bottom and top walls changed several times in order to accurately characterize the temperature distribution over a considerable range of Richardson number. Adjustable aspect ratio box was built as a test rig to determine the effects of Richardson number and aspect ratio on the flow behavior of the air inside the enclosure. The flow fields and the average Nusselt number profiles were presented in this wo

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Publication Date
Fri Feb 13 2026
Journal Name
Sciences Journal Of Physical Education
Individual analysis of kinetic response variables according to the measurement of the H7 system for the best jumping players in the national basketball team 2021
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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Achieving the rule of tax justice\Adopting the application of the international standard IFRS 15: Applied research in the General Authority for Taxes - Companies Department
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Abstract:

                The research aims to achieve the basis of tax justice by making a comparison between the tax accounting process according to the application of the International Financial Reporting Standard IFRS15 and the tax accounting procedures currently used in the General Authority for Taxes to determine the annual and total tax differences, to give credibility and enhance transparency in the reports and financial statements of companies Long-term contracts when prepared in accordance with the requirements of applying the international standard IFRS15 “Revenue from Contracts with Customers”, which increases the possibility of relying on them when calculating taxes. Thus, the resea

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Publication Date
Sat Sep 23 2023
Journal Name
Sciences Journal Of Physical Education
Individual analysis of kinetic response variables according to the measurement of the H7 system for the best jumping players in the national basketball team 2021
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The skill scale in most of sport activity monitoring a lot of dynamic behaviours conducted with playing situations that help the excerpt's in sport field to evaluate and put right solutions ,soccer one of games that studies in third stage in college and take skills ,dribbling , passing, shooting these skills helps to execute the plans in game ,the researchers notice that there is no test measure the skills of the game in the beginning of the first semester especially in the method of soccer in physical education college and the problem of the research were by answering the question that is there test connect between one or more that one of skill to measure the ability of students to execute the plans in soccer and the conclusion was the bui

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Publication Date
Fri Apr 01 2022
Journal Name
Chemical Engineering Science
Numerical modelling of flow through nodes in foams within the “dry” limit in the presence of solid particles
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Publication Date
Sun Jun 11 1989
Journal Name
مجلة متحف التاريخ الطبيعي
The Role of Specific Amino Acids in the Protection of Escherichia coli Against B-Lactam Antibiotics In Vitro
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ABSTRACT The role of specific amino acids namely cysteine, methionine, threonine and asparagine in the protection provided by vamin solution against B-lactam inhibition to E. coli was evaluated in vitro. In minimal medium, Cells were treated with 32 ug/ml of penicillin G, carbencillin, hostacillin, cloxacillin and cephalotin in the presence of specific amino acid supplementations. Deletion of specific amino acids from the media abolished the protection provided by vamin. Threonine was essential for the protection of cells against all tested antibiotics, while cysteine was essential for protection against carbencillin and cephalotin Deletion of methionine or asparagine abolished the protec- tion against carbencillin and to a less extent ce

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The role of drinking water quality in achieving customer satisfaction Applied research in the Directorate of water Diwaniyah
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ABSTRACT    

The purpose of the research is to identify the role of drinking water quality in achieving customer satisfaction in one of the formations of the Ministry of Construction, Housing and Public Municipalities (Diwaniyah Water Directorate), as they are important service organizations that have a fundamental role in serving the community. Faced many administrative challenges, as a result of the continuous and accelerating environmental changes, environmental pollution and immaturity of social awareness and social responsibility, as these contributed to and affected the quality of drinking water, Therefore, it is necessary to know the role of quality, specifically "drinking water and its effect o

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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Effectiveness of Quantitative Instruments in Controlling Money Supply: An Applied Research in the Central Bank of Iraq
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This research deals with the role of quantitative (indirect) tools of monetary policy that used by the Central Bank of Iraq in order to control and manage the size of the money supply that intermediate goal through which monetary policy is able to achieve its final goals, foremost among which is to reduce inflation and raise the value of the local currency in front of foreign currency rates. The research is based on a major hypothesis stating that quantitative tools have a direct and strong influence on the money supply, especially under the circumstances of the shift towards a market economy. There has been a branching relationship with this statistically significant relationship between the money supply and the quantitative tools used

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Publication Date
Sun Jul 01 1990
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
THE ROLE OF SPECIFIC AMINO ACIDS IN THE PROTECTION OF E. COLI AGAINST B-LACTAM ANTIBIOTICS IN VITRO
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The role of specific amino acids namely cysteine, methionine, threonine and asparagine in the protection provided by vamin solution against B-lactam inhibition to E. coli was evaluated in vitro In minimal medium, cells were treated with 32 ug/ml of penicillin G, carbenciLlin, hostacillin, cloxacillin and cephalotin in the presence of specific amino acid supplementation. Deletion of specific amino acids from the media abolished the protection provided by vamin. Threonine was essential for the protection of cells against all tested antibiotics, while cysteine was essential for protection against carbencillin and sephalotin. Deletion of methionine or asparagine abolished the protection against carbencillin and to a less extent cephalotin.

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Publication Date
Mon Feb 14 2022
Journal Name
Journal Of Educational And Psychological Researches
Psychological alienation in relation to the motivation of achievement among incoming teachers in the schools of Dhofar Governorate
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The present study aimed at identifying the level of psychological alienation and motivation of achievement among the incoming teachers in the schools of Dhofar Governorate in the Sultanate of Oman a well as to explore the correlation relationship between psychological alienation and motivation of achievement. The sample of the study consisted of (238) expatriated teachers from Al- Dhofar Governorate in Oman who were selected randomly. The psychological alienation scale and the motivation of achievement scale for teachers were used by researchers and were conducted electronically by google forms. The data were processed statistically using the Statistical Package for Social Sciences (SPSS). The results showed that the level of psy

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