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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
Thu Jan 16 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Suggested Model for activating the role of the regulators for the auditing profession in achieving quality audit
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The concept of quality of auditing profession comes on top of the concerns of the international business community and international institutions particularly now following the impact of the several failures and financial hardships suffered by the major companies in the recent collapse of money markets in some countries of the world and fear of their recurrence in the future.An observer of the local and international rules and standards (or principles) finds that these include such implications have direct or indirect effects on the performance of the service of the accountant and auditor, which should upgrade their professional performance in these services to a high level of quality so as to be in line with the requirements, principles

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Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Using Cluster Analysis In Determining The Variables Affecting The Evaluation The Growth Of Children At Different Levels
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In light of the increasing interest in Child-rearing in nurseries and kindergartens and the most important experiences gained by the child at this stage that form the basis for the subsequent stages of her/his physical mental and social growth.

The significance of the research concentrates the need to asses the affecting variables on the child growth to create opportunities for her/him to have intact rearing.

The research also aims to classify these variables at each age level and highlight its moral role.

The problem of the research is the lack of clarity of different variables impact of the child growth in different age levels in nurseries and kindergart

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Publication Date
Mon Jun 15 2020
Journal Name
Al-academy
Constructing the audio format in the performance of the theater actor: يــاسين إسماعيل خلـف - فائـــــز طـــــــــــــه ســــــــالم
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The science of (- - Semiology) comes in the introduction to language sciences and linguistics that addressed the levels of language building and its phonemic signs, through which we can monitor and analyze the data of the phoneme of the actor, and the ways to build his linguistic speech, especially since (the linguist Saussure - He emphasized that linguistque is only part of the science of signs, which is particularly advanced within logic, social psychology, and general psychology, and since language is in the origin - whatever language, and at what level - it is not A separate, single and unified language, in fact, they are intertwined, multiple, varied and renewed languages due to their influence The times and its development and the

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Publication Date
Mon Dec 28 2020
Journal Name
Journal Of The College Of Education For Women
Penalty of Semi-Intentional Killing Offence according to the Egyptian and Algerian Penal Law: An Evaluative Study from the Islamic Viewpoint: محمد جبر السيد عبد الله جميل
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The study aims at  evaluating  the penalty of  semi- intentional killing felony in the Egyptian and Algerian criminal law following the Islamic Law (Shari'a). The  study used the descriptive, evalutive and analytical  methodology  to  reach the topic in question. To meet the theoretical significance of the study, much data has been collected to give a comprehensive picture about the topic under examination. As for the practical significance of the study, it helps the juridical power to reconsider and phrase the legal materials of the semi-intentional killing penalty based on the Islamic law. The study has come to the conclusions that the Islamic Law (Shari'a) imposes a compensation (blood-money) to be g

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Publication Date
Sun Mar 20 2016
Journal Name
Al-academy
The Impact of using the strategy of shape (V) on the Achievement of the students of the Department of Artistic Education: كريم حواس علي، نجلاء خضير حسان
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This research aim at finding out the impact of using the strategy of shape V on the achievement of the students of the Department of Artistic Education in the subject of "Principles of scientific Research ". This strategy is one of the cognitive strategies used in this topic . To verify the aim of the research ,the two researchers have put the following null hypothesis:-There are no significant differences on the level of 0,05 among the average degrees of the students of the experimental group in their answers on the topics of the pre and post cognitive achievement tests of the subject of "principles of scientific Research " . The two researchers have adopted the experimental approach which consists of one group . the population of the r

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Thu Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Financial Depth Measurements / Analytical Study in Selected Countries for the Period 1980-2008
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Therefore, this research has sought to put forward alternative indicators, is the structural indicators, and financial prices, and availability of financial instruments, and cost of transactions concluded, in order to measure the phenomenon of financial depth.

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Some Robust methods for Estimates the power Spectrum in ARMA Models Simulation Study
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Abstract:

Robust statistics Known as, resistance to errors caused by deviation from the stability hypotheses of the statistical operations (Reasonable, Approximately Met, Asymptotically Unbiased, Reasonably Small Bias, Efficient ) in the data selected in a wide range of probability distributions whether they follow a normal distribution or a mixture of other distributions deviations different standard .

power spectrum function lead to, President role in the analysis of Stationary random processes, form stable random variables organized according to time, may be discrete random variables or continuous. It can be described by measuring its total capacity as function in frequency.

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Publication Date
Wed Dec 01 2010
Journal Name
Iraqi Journal Of Physics
Study of electron energy distribution function and transport parameters for CF4 and Ar gases discharge by using the solution of Boltzmann equation-Part I
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The Boltzmann transport equation is solved by using two- terms approximation for pure gases . This method of solution is used to calculate the electron energy distribution function and electric transport parameters were evaluated in the range of E/N varying from . 172152110./510.VcmENVcm
From the results we can conclude that the electron energy distribution function of CF4 gas is nearly Maxwellian at (1,2)Td, and when E/N increase the distribution function is non Maxwellian. Behavior of electrons transport parameters is nearly from the experimental results in references. The drift velocity of electron in carbon tetraflouride is large compared with other gases

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Publication Date
Thu Aug 13 2020
Journal Name
International Journal Of Innovation, Creativity And Change
Aspects Affecting the Public Service Motivation: Empirical Study in Some Public Service Organizations in Iraq
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Public service motivation in public service organisations is one of the main problems that many developing countries have begun to experience, including Iraq. The public agenda is increasingly complex with reduced financial resources. In addition, these organisations have increased responsibilities with respect to the achievement of public goals and objectives as they are responsible for providing key services to members of the community (education, health and social work). This research is based on the degree of public service motivation among those working in health education and social work in public organisations, and aims to show the extent of the difference in the public service motivation of these employees according to di

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of College Of Education
An Investigative Study on the Electron Energy Distribution Function and Electron Transport Coefficients in SF6 -- Ne Gas Mixtures
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