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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 Feb 01 2018
Journal Name
Journal Of Us-china Public Administration
Victims of Terrorism between Compensation and Loss of Rights: A Comparative Study between Iraqi Law and French Law
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The problem of the damage caused by terrorist acts has raised many difficulties in many countries, including Iraq, which requires the existence of a law that sets out sufficient rules for compensating the victims of terrorist acts, in order to compensate them for the harm they have not suffered. It may be difficult or impossible for them to identify causing damage, and therefore unable to obtain compensation by applying the traditional rules of liability that require proof of fault and identify the culprit. The security funds come as an appropriate alternative that pays compensation in such cases for victims to reparation for the damage they suffered. Therefore, this problem remains one of the most problems that Iraq suffers from it, which

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Babis and Baha’is in Iran
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The person who wants to learn. The history of Bab’is will notice a very
starnge phenomenon that they (Babis and Baha’is) resort to visions to prove their
delusion.
The believers usually reach to each other by their visions. This phenomenon
are shared among them from Al- Ahsa’ai time till the last phase of their propaganda
which is the Baha’is propaganda, and this is due to their ignorance and under
development in doctrine of islam which was widespread in Iran and the Islamic world.
The whole secrets of Babis and Baha’is movement were restricted among
particular group, most of them were Al- Rashti’s students and knew the basic
principles of their movement which deperding or (the principles) declarati

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Publication Date
Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
STUDY OF SOME BIOLOGICAL ASPECTS OF MICE INFECTED WITH HYDATID CYST OF Echinococcus granulosus PARASITE AND THE THERAPEUTIC CAPACITY OF ETHANOLIC EXTRACT OF Cladophora glomerate ALGAE
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Publication Date
Mon Feb 13 2023
Journal Name
Journal Of Educational And Psychological Researches
A Proposed Strategy to Develop Postgraduate Studies at King Khalid University to Support the Achievement of the Kingdom's 2030 Vision
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Abstract

The aim of this research is to formulate a proposed strategy for developing graduate studies at King Khalid University to support the achievement of the Kingdom's vision (2030). The research used the descriptive survey approach. The research community consisted of all graduate students at King Khalid University. The research was conducted on a random sample included (623) Male and female students, this research relied on the questionnaire as the main tool for collecting its data. The results revealed that the research sample believes that all the proposals included in this research are very important for the development of postgraduate studies at King Khalid University to support the achievement of the K

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Publication Date
Wed Mar 30 2022
Journal Name
College Of Islamic Sciences
The grammatical approach to explain Bant Souad's poem (Explanation of Ibn Hisham as a model) a . M . Dr. Abdul Hamid Hamad shehatha Mustansiriya University Faculty of Basic Education the department of Arabic language
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This study is concerned with shedding light on the grammatical method of Ibn Hisham Al-Ansari (761 AH), in his explanation of Bant Souad’s poem by the poet Kaab bin Zuhair, and I included a brief description of Ibn Hisham’s life with a number of explanations of this poem, then clarified the most important features of this method The grammar represented by his reliance on hearing and presenting it to analogy with mention of types of analogy, as well as his attribution of opinions to their owners with weighting, selection and balancing, and his attention to reasoning and a number of grammatical ailments, and his approach is also distinguished by following the method of fractal.

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Publication Date
Wed Jun 10 2009
Journal Name
Iraqi Journal Of Laser
Simulation of passively Q-switched rate equation using saturable crystal Dy +2: CaF2 with ruby laser
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The simulation of passively Q-switching is four non – linear first order differential equations. The optimization of passively Q-switching simulation was carried out using the constrained Rosenbrock technique. The maximization option in this technique was utilized to the fourth equation as an objective function; the parameters, γa, γc and β as were dealt with as decision variables. A FORTRAN program was written to determine the optimum values of the decision variables through the simulation of the four coupled equations, for ruby laser Q–switched by Dy +2: CaF2.For different Dy +2:CaF2 molecules number, the values of decision variables was predicted using our written program. The relaxation time of Dy +2: CaF2, used with ruby was

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Publication Date
Fri Oct 11 2019
Journal Name
Journal Of The College Of Education For Women
The Symbolic Interaction of the Kindergarten
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The Symbolic Interaction of the Kindergarten

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
The communicative implications of the uniforms
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The costume is a language that has carved itself into a path that is transformed over time in line with the development of human thought. The child theater is a form of communication between the individual and his society. The costume in the child's theater is seen as a sign of personality and identity. It is a model of communication that uses many of the world systems to which it belongs. Directed to the child by invoking the creative and creative energies of the designer in the formation of the children's theater. The second topic was the communicative function of secondary signs of uniforms and patterns of their transformations. The theoretical framework of the indicators included the on the research community. And his tools in the an

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Crossref
Publication Date
Sat Jun 30 2018
Journal Name
College Of Islamic Sciences
The grammatical views of the Chalobini
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This research deals with the most important grammatical views of the science of the media of the Arab and Andalusian grammar is: Abu Ali al-Shloubini, who filled his name the pages of important grammatical books such as: (singer Al-Labib) Ibn Ibn Hisham, and the book (like and analogues), and (Hama Alhwama) for Suyuti, and other books The task, I have divided my research into the topics: I talked in the first section on his life and his biography and his works, and the second topic: it included his independent opinions and the third section contained the most prominent views selected The fourth and final topic, was his responses to grammarians, and concluded my research with the most prominent findings Research to them, which was the mos

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Publication Date
Wed Dec 13 2023
Journal Name
Journal Of Law And Interscience
The Consequences of the Researcher’s Liability
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The process of discovering pharmaceuticals is of great importance in our contemporary life, in a way that without life becomes almost impossible, as this process is the first building block in the field of pharmaceutical industries to search for new methods and means of treatment and treatment. This process results in the commitment of the discoverer to a set of obligations in the face of the volunteer. This responsibility or negation of intentional infliction of damage by means of what is known in the law as methods of paying liability

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