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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 Sep 25 2017
Journal Name
Biomedical And Pharmacology Journal
Comparative Study of the Effect of Incorporating SiO2 Nano-Particles on Properties of Poly methyl Methacrylate Denture Bases
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Publication Date
Fri Mar 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
An empirical Evaluation of the effect of service encounter on customer voluntary behavior: Exploration study of (TBI) customers
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Purpose: To determine the impact of service encounter in stimulating voluntary customer behaviors.

  • Approach / methodology: It was selected a sample of customers Bank Iraqi Trade (TBI) was (105) individual, using a questionnaire designed in the light of previous studies, was drafted scale and tested in the light of a group of statistical methods developed (reliability coefficient, reliability coefficient composite, convergence). Then test hypotheses through structural equation modeling.
  • Results: The behaviors and characteristics of the service provider in effect urged bank customers to perform voluntary extra, as the service environment service encounter

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
The Iranian –Sudanes Relations (1985-1989) Historical Study
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The Iranian-Sudanese relations during the era of the transitional government (1985-1986), and the era of the third democratic government, has seen a marked improvement, particularly since the transitional government, which was formed in Sudan following a popular uprising that toppled former President Jaafar Nimeiri followed based on balancing policy in international relations, which is the same policy adopted by the government of Sadiq al-Mahdi that, especially that Mr. Sadiq al-Mahdi had enjoyed close ties with the government in Tehran before he took office, and on the basis of the policy of diplomatic representation between the two countries returned since the time of the transitional government after relations were severed due to the

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Publication Date
Wed Mar 18 2020
Journal Name
International Journal Of Research In Social Sciences And Humanities
THE ROLE OF ELECTRONIC-PAYMENT SERVICE PROVIDERS IN THE DEVELOPMENT OF E-BANKING IN IRAQ - AN APPLIED RESEARCH IN CENTRAL BANK OF IRAQ
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THE ROLE OF ELECTRONIC-PAYMENT SERVICE PROVIDERS IN THE DEVELOPMENT OF E-BANKING IN IRAQ - AN APPLIED RESEARCH IN CENTRAL BANK OF IRAQ

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Publication Date
Sun Sep 04 2011
Journal Name
Baghdad Science Journal
A Mathematical Approach for Computing the Linear Equivalence of a Periodic Key-Stream Sequence Using Fourier Transform
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A mathematical method with a new algorithm with the aid of Matlab language is proposed to compute the linear equivalence (or the recursion length) of the pseudo-random key-stream periodic sequences using Fourier transform. The proposed method enables the computation of the linear equivalence to determine the degree of the complexity of any binary or real periodic sequences produced from linear or nonlinear key-stream generators. The procedure can be used with comparatively greater computational ease and efficiency. The results of this algorithm are compared with Berlekamp-Massey (BM) method and good results are obtained where the results of the Fourier transform are more accurate than those of (BM) method for computing the linear equivalenc

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Publication Date
Fri May 01 2015
Journal Name
Journal Of The Faculty Of Medicine
Gentamycin injection in disc space during lumbar discectomy (aiming to prevent post - operative discitis)
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AW Ali T, Journal of the Faculty of Medicine, 2015 - Cited by 3

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Publication Date
Mon Aug 01 2022
Journal Name
Nauchforum
METAPHOR AND THE FEMININE (ON THE EXAMPLE OF L. ULITSKAYA'S WORK "MEDEA AND HER СHILDREN")
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The article considers metaphors as one of the fundamental means used by L. Ulitskaya when writing the family chronicle "Medea and her Children" (1996), for the formation of images of heroines - representatives of the pronounced feminine principle in the work. Here I describe the results of the next stage of research related to the work of Lyudmila Evgenievna Ulitskaya as a representative of modern Russian prose.

Publication Date
Thu Feb 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of educational institutions and regulatory bodies to reduce the financial and administrative corruption
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This research seeks to clarify the regulatory and educational role of the regulatory and educational institutions in reducing the phenomenon of financial and administrative corruption as a dangerous phenomenon of the communities, as it touched search kinds of financial and administrative corruption and the causes and effects, as well as to the role of educational institutions in reducing this phenomenon, and finally between experiments some SAIs and accounting Arab and foreign countries on how to reduce the phenomenon of financial and administrative corruption.The research aims to several targets which shed light on the role of educational and supervisory institutions in reducing corruption, a statement origins and evolution of and justi

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Publication Date
Thu Sep 29 2022
Journal Name
Al–bahith Al–a'alami
Digital media and linguistic evaluation between the need to stay and the idea of dispensing
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In spite of the contemporary development over the world in pertaining of modernization and its differences about the transformation of the knowledge but, the important instrument to transfer the thoughts and information did not have change except the language. So the evolutionary process became as a torrent or fusillade above the cliff which drifted anything. So that the objective inquiry and impressed with varieties of development the casement to evaluate the linguistic or re - correction highlight article in order to preserve on the origins of the language and its sobriety.
Today, we have different correspondence and social media as

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Publication Date
Sun Jul 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The healthy personality and its relation to the academic achievement of school and university teacher
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Personality regard as one of the human soul pillars that has been built throughout the life of people, starting from the fertilizing process to different stages of people ages. Over time, numerous scientific studies have shown that fetus has the ability to hear and feel and he is being stereotyped since the first stages of formation. Accordingly, the process of forming human personality set up since that date. Besides, the socialization means that take different resources to enhance human personality such as holy Quran, school, social media, and social environment. The emergence of social media made the world as a small village which gives the chance for all people, over the world, to obtain the knowledge easily and limitless. Thus, the

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