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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 Dec 09 2018
Journal Name
Journal Of Education In Black Sea Region
Discriminatory and Racist Discourse in American TV Channels: The Image of Arab Immigrants
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The present study examines critically the discursive representation of Arab immigrants in selected American news channels. To achieve the aim of this study, twenty news subtitles have been exacted from ABC and NBC channels. The selected news subtitles have been analyzed within van Dijk’s (2000) critical discourse analysis framework. Ten discourse categories have been examined to uncover the image of Arab immigrants in the American news channels. The image of Arab immigrants has been examined in terms of five ideological assumptions including "us vs. them", "ingroup vs. outgroup", "victims vs. agents", "positive self-presentation vs. negative other-presentation", and "threat vs. non-threat". Analysis of data reveals that Arab immig

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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of Madenat Alelem College
Morphological description and Histological structure of the liver in Passer domesticus (House sparrow)
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This study showed that liver of Passer domesticus bilobed the right lobe is cardiac shape while the left is elliptical and the liver colour is brown. It is occupying most of anterior and middle parts of abdominal cavity. The liver is surrounded by Glison capsule which is represented by a thin layer of connective tissue with septum extend peripherally in liver tissue. The liver tissue is formed from polyhedral hepatocyte arrange as irregular hepatic cord surrounded the central vein. Each cell contains one or two nucleus with one or more nucleolus. The blood sinusoid appeared between the liver cells .The hepatic cord arranged radially around the central vein. The portal area is clear and surrounded by connective tissue. Gallbladder is almost

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Causality Analysis of the Nexus between Higher Education and Income Distribution in Iraq
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Abstract:

The achievement of economic and social welfare for individual is the main target to all policies that adopted by all countries worldwide either were economic, social, political or others. The obtaining of education by individuals and especially the higher education is one of the most important determinates in achieving the wellbeing and lasted economic development. This is because via the higher education new fields can be opened in front of individuals in order to get adequate jobs associated with their scientific specialization. This is allowing educated individuals gain higher income that can reduce the gap of income inequality.

Thus, this paper aims to analysis the n

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Publication Date
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
The role of environmental governance in maintaining environmental systems and achieving urban sustainability
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The solution to the problems and challenges of the twenty-first century requires the absorption of many transformations, such as demographic change, poverty reduction, the expansion of safe and clean energy without affecting the environment, as well as reducing health risks and other transitions. It also requires greater cooperation than is possible in the current global system, because both of these constraints and challenges, even if addressed locally or nationally, are because of the potential for their transnational impact, that is, their impact on the lives of people at the global level, Which is necessary to be fully addressed unless it is guided by a comprehensive global vision. This is what environmental governance provides in te

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Publication Date
Tue Dec 30 2014
Journal Name
College Of Islamic Sciences
Ibn Habib al-Maliki and his views     Jurisprudence      In the book of marriage
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Allah the Almighty has honored many of his slaves in the high houses for their efforts in building the scientific edifice of this nation, by demonstrating what is needed from the legal provisions for all the relations between them, and the actions that they emanate from. The tasks of the abbreviations and Almstsot, and deposited in the mabahith after various investigations and precious precious matters and showed all the human needs in his life and what is expected to happen, even on the rarest possibilities, and their efforts that left the nation on the cases of Goliath. , And Ask They are in Dar dignity with the best creatures and make us a share of those good things, and Odamna to obey Him and His pleasure until death, and forgive us

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Publication Date
Sun Jun 30 2019
Journal Name
Journal Of The College Of Education For Women
Intertextuality with Prophetic Hadith in the Poetry of Safiyaddin Alhilliyy (Tools and Implications)
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 تحقق القراءةُ التَّناصيَّة قيمة موضوعيَّة للدرسِ النَّقديّ المعاصر؛ بمؤثراتها الثَّقافيَّة، والمعرفيَّة، لأنَّ الإبداعَ من سمات التُّراث الشِّعري في العصر الوسيط، وهو مسرحٌ لتداخلات نصِّيَّة مع مصادر متعددة دينيَّة، وأدبيَّة، وتاريخيَّة أداء ومضامين؛ يأتي اختيارُ (التَّناص مع الحديث النَّبوي في شعر صفيّ الدِّين الحلّي)؛ بوصفه امتدادًا شعريَّا أصيلًا لحضارة راقية معطاء

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Publication Date
Sat Jun 04 2022
Journal Name
International Journal Of Language And Literary Studies
Investigating the Use of Google Meet and Face-to-Face in Teaching Conversation
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conversation is an oral skill in which two persons can exchange their ideas, thoughts and opinions to communicate with each other. Learners can work in pairs or groups to practice dialogues chosen by the teacher from their textbook materials or from additional resources. Nowadays, because of Corona virus infection, our college students are taught all the subjects including conversation course either via google classroom platform or any other platforms. Google meet is one of online meetings between the teacher and students, i.e., a video meet in which students and the teacher join the online meetings in a specified time to communicate, express their ideas, thoughts and feelings about what is mentioned above. In this study, the resea

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Publication Date
Thu Nov 09 2023
Journal Name
Beirut: Al-arif Publishing House
Arabic-English Dictionary of Euphemistic and Non-literal Expressions in the Glorious Qur’an
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Publication Date
Wed Mar 15 2023
Journal Name
Al-academy
Kinetic diversity and its effectiveness in the formal variables of industrial product design
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The formal diversity in designs is achieved by creating shapes and lines with a distinct movement pattern, which are preceded by mental processes. The greatest source of diversity in design in general and industrial design in particular is the creation of multiple directions for the completion of designs and the diversification of intellectual proposals for the design idea. The human activity that takes place around us in various fields of life takes place due to the diversity of movement in the form of the design product and its effectiveness through the dynamic diversity in the form, which differs in the methods of designing and showing it. He invents material value as a distinct artistic product that he owns A specific form or system

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Publication Date
Thu Sep 26 2013
Journal Name
Astronomy &amp; Astrophysics
High-resolution observations of SDSS J080800.99+483807.7 in the optical and radio domains
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