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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
Sun Jul 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The Family’s Role in Inculcating the Moral Values of Voluntary Work among Adults
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The study aims to identify the role of family in inculcating the moral values of voluntary work among adults, as it constitutes the basic social institution that is responsible for raising and control children. It has regarded as the first phase of constituting societies, where family plays a significant role in changing the behavior of individuals positively or negatively through provided patterns. The moral values act as organizer of human relationship in which misusing of these values would affect the interaction between people. This study focuses on how to employ the moral values in voluntary work as a civilized behavior helps in developing and strengthening societies. The researcher adopted the analytical-descriptive approach as mor

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Publication Date
Fri Sep 08 2023
Journal Name
Hammurabi Journal For Studies
The Impact of the Political Process on Government Stability in Iraq After 2003
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The research in the variables of the political process and government stability tried to show the impact of the political process on political stability first, and then on government stability second, given that the political process that was established in 2005 was aimed at achieving legitimacy, and its most prominent tools are elections, leading to achieving political stability, including government stability. The issue of governmental stability is one of the important issues in Iraq, but it has not been achieved, as a result of several factors, including problems in political action, as the political process has not succeeded in leading Iraq to stability.

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Publication Date
Mon Feb 18 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Control Over The Medical Evacuation Program in light of the Government's Accounting System
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The accounting system of government is considered an important tool to follow up the financial transactions that reflect the activities of governmental units and by which the useful information for estimating governmental annual revenues and expenditures are provided through the state public budget because it is an information system that provides detailed past performance, as well as measures the efficiency of the governmental agencies performance in implementing the budget, and the of success governmental units is measured through the type of services and programs offered, their size and the possibility of achieving the objectives assigned to them. The medical evacuation program is one of the medical and curative health services provid

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Publication Date
Tue May 01 2018
Journal Name
Journal Of Physics: Conference Series
The Effects of micro Aluminum fillers In Epoxy resin on the thermal conductivity
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Publication Date
Tue Sep 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Determine the optimal decision in the process of production planning usingDynamic programming style
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The operation of production planning is a difficult operation and it's required High effect and large time especially it is dynamic activity which it's basic variables change in continuous with the time, for this reason it needs using one of the operation research manner (Dynamic programming) which has a force in the decision making process in the planning and control on the production and its direct affect on the cost of production operation and control on the inventory.

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Publication Date
Mon Dec 30 2019
Journal Name
College Of Islamic Sciences
Military incidental messages In Andalusia until the end of the sixth century AH
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The Arab literature in Andalusia was distinguished by its special nature, in addition to the distinction of its influencing rhythm in our souls, it represents the natural extension of the Arab-Islamic civilization in Morocco, that civilization that collapsed with insecurity and stability and the exit of Muslim Arabs from those countries and the defeat of Muslims, their civilization has ceased, and only remains of them witnessing For its leaders in a safe and stable life, but literature in Andalusia underwent many experiences that express the lives of Arab Muslims there, especially what distinguished the Andalusian Muslims from their many battles and conquests, but they did not suffer as their support during the fall of Andalusia and the

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Scheduling of Leaching Requirements to Prevent the Secondary Salinisation in the Root Zone
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Leaching scheduling techniques are one of the suggested solutions for water scarcity problems .The aim of the study is to show the possibility of using leaching scheduling, when applying the irrigation scheduling program for a certain irrigation project, which was prepare by Water Resources Engineering –University of Baghdad with some modifications to generalized it and it make applicable to various climatic zone and different soil types.
The objectives of this research is to build a system that concerns the prediction of the leaching scheduling (depth and date of leaching water), illustrating the main problems (soil salinity, save the amount of leaching requirement, and to maintain crops growth).The other objective is to compare be

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Publication Date
Sun Mar 05 2017
Journal Name
Baghdad Science Journal
The Effect of Organic Matter Application on Phosphorus Status in the Calcareous Soil
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A field experiment is conducted to study the effect of different levels of peat (0, 25, 50, 75, and 100 Mg ha-1 to uncropped and cropped soil to wheat. Soil samples are taken in different period of time (0, 3, 30, 60, 90, 120, and 180 days after cultivation to determine (NaHCO3-Exteractable P at 3 different depths (0-10, 10-20, and 20-30 cm). Field Experiment is conducted in a randomized complete block design (RCBD) with four replicates. Wheat, Al-Rasheed variety, is cultivated as a testing crop. The entire field is equally dived in two divisions. One of the two divisions is cultivated to wheat and the second is left uncropped. The effect of five levels of peat namely 0, 25, 50, 75, 100 Mg ha-1 is investigated. Soils are fully analyzed

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Educational And Psychological Researches
The socio-psychological implications on the investigators of police directorate in Hebron district
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The present study aims to identify the socio-psychological implications that police investigators experience regarding the variable of gender, age, place of residence, qualification, military rank, and work experience. The study included 6 individuals who were working in investigation department in Hebron district as a sample. The results demonstrated that the targeted sample had a dump attitude toward the socio-psychological implications. The psychological implications reflected 2.8739, the social side represents 3.2956.

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Publication Date
Wed Dec 01 2021
Journal Name
Civil And Environmental Engineering
Prediction of the Delay in the Portfolio Construction Using Naïve Bayesian Classification Algorithms
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Abstract<p>Projects suspensions are between the most insistent tasks confronted by the construction field accredited to the sector’s difficulty and its essential delay risk foundations’ interdependence. Machine learning provides a perfect group of techniques, which can attack those complex systems. The study aimed to recognize and progress a wellorganized predictive data tool to examine and learn from delay sources depend on preceding data of construction projects by using decision trees and naïve Bayesian classification algorithms. An intensive review of available data has been conducted to explore the real reasons and causes of construction project delays. The results show that the postpo</p> ... Show More
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