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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 Jan 01 2017
Journal Name
البحوث التربوية والنفسية
the effect of an educational -learning programe according to the concepts of renewable energy and nanotechnology on technological enlightenment among students of the che chemistry department
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Publication Date
Fri Nov 04 2016
Journal Name
International Journal Of Renewable Energy Development
The Temperature Profile for The Innovative Design of the Perforated Fin
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The development of the perforated fin had proposed in many studies to enhance the heat transfer from electronic pieces. This paper presents a novel derivative method to find the temperature distribution of the new design (inclined perforated) of the pin fin. Perforated with rectangular section and different angles of inclination was considered. Signum Function is used for modeling the variable heat transfer area. Set of parameters to handle the conduction and convection area were calculated. Degenerate Hypergeometric Equation (DHE) was used for modeling the Complex energy differential equation and then solved by Kummer’s series. In the validation process, Ansys 16.0-Steady State Thermal was used. Two geometric models were consider

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
The position of the Egyptian public opinion on the Mibi revolution
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The study of the subject of (Egyptian public opinion on the Libyan revolution) came to reveal the role of Egyptian public opinion in mobilizing and solidarity for the masses. With the events witnessed by the Arab countries before the revolution, this was evident by the people 's attitudes towards the tripartite aggression against Egypt in 1956, and the June 1967 war, and the most recent what the Egyptian people showed towards the Libyan revolution. The Egyptian press followed the completion of the arms deal with France and revealed the ability of the Libyan negotiator to achieve moral gain, supported by Egyptian support to thwart the United States intentions to arm "Israel" similarly. The Egyptian people expressed a love for peace and su

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Publication Date
Tue Jan 12 2016
Journal Name
International Journal Of Advanced Engineering, Management And Science
Whole body, Arm-Hand Vibration and Performance Drivers Tractors during Conservation Tillage under different Velocity and Soils
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The Experiment was carried out to determine the level vibration transfer in three axes Horizontal X, Lateral Y and Vertical Z direction to seat driver tractor, Vector sum of vibration and Daily Vibration Exposure (8 hours) in seat driver tractor, and vibration in steering wheel tractor, Heart Rate, Systolic and Diastolic blood pressure and temperature were measure to all Drivers before and after used Chisel plow in operation tillage. Statistical analysis system was used, Split-Split Plot Design under Randomized Complete Block Design, Three factors were used in this experiment included Two types of Soil Moist and Dry soil which represented main plot, Three Velocity Tractor was second factor included 1.6,3.5 and 5.4 km/hr and Three Drivers Tr

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Integrated Framework for technologies to reduce costs and reengineering processes to develop strategies companyes An Empirical Study In some companies affiliated to the Ministry of Oil
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Began the process of re-engineering processes in the private sector as a way to assist organizations in re-thinking how to run the business in order to improve production processes and reduce operational cost, to get to compete on a global level. That was a major restructuring by further evolution in the use of technology to support innovative operations.

 Entered the technology in all areas of life and different regulations, This led to use as a change in all aspects The companies achieved success and progress today through the use of resources so as to ensure the wishes of the customers and their needs, and the requirements of the market primarily, Which is reflected on the basis of building strate

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Publication Date
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
The fundamentalists' position on the absolute prohibition and its impact          In different jurisprudence
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Praise be to God, who started his book with the praise of himself and prayers and peace be upon those who have no prophet after him and his family and companions and those who followed them with charity until the Day of Judgment.
     For it is known to every researcher in jurisprudence and its origins that the semantics in terms of formulas for assignment are divided into an order and a prohibition, and I have seen it necessary to write a small research on the prohibition, and since this topic is complex, and has a great impact on the difference of scholars, I decided to write on one issue of it And it is the absolute prohibition and its effect on the difference of jurists, and what is meant by the absolute p

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Publication Date
Thu Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Analyzing the relationship between stock market volatility and economic activity in the USA
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This study examines the dynamic relationship between stock market and economic activity in the United States to verify the possibility of using financial indicators to monitor the turning points in the expected path of future economic activity. Has been used methodology (Johansen - Juselius) for the Co-integration and causal (Granger) to test the relationship between the (S & P 500 , DJ) index  and gross domestic product (GDP) in the United States for the period
(1960-2009). The results of the analysis revealed the existence of a causal relationship duplex (two-way) between the variables mentioned. which means the possibility of the use stock market indicators to pre

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Publication Date
Thu Oct 30 2008
Journal Name
College Of Islamic Sciences
The will In the Islamic concept
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I often read in Islamic jurisprudence in all chapters as much as possible from divine success, time and health, and everything I read in any of the chapters of jurisprudence, I see divine light, eternal wisdom, and a constitution that does not accept error and alteration, as I looked at the great jurisprudential treasures and this enormous wealth, A person finds in himself helplessness in front of this law, how clear, easy, and accurate it is, and it contains permanent good for man, as it is a religion of mercy, benevolence, and goodness, and among these chapters of jurisprudence is the jurisprudence of the commandment. Of the reasons, in the will, the person has had the opportunity to make up for what he missed of doing good that a pers

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Publication Date
Tue Jan 29 2019
Journal Name
Journal Of The College Of Education For Women
The Similarity in the Holy Quran
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The method of Similarity of important topics in Arabic Rhetoric has ample evidence in the Qur'an and the Hadith and the words of the Arabs and this study is limited to only the Koran.
There have been Similarity in the Holy Quran on both types : investigative and discretion , but the verses are more Similarity investigative and in verse 49 Similarity investigative and in verse 25.
The rush of Albulageyen and many other examples of Quranic Vmtheloa on Similarity , with a linguistic analysis and return to the origins of the meanings are not properly counted Similarity , Kolvaz cunning , deception , and maliciousness , the bad and ridicule.
This study seeks as much as possible to the statement of this phenomenon and stand on these t

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Publication Date
Mon Feb 19 2018
Journal Name
Al-academy
The idea strategy in the theater
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There is an association between the signifier and the signifier. This association shows the eyeball, which acquires a direct presence and whose presence influences the level of production of the hidden connotation. Because the theatrical presentation is a series of auditory-visual functions, these signs are looking for the exploration of their meanings and their evocation to form a complete loop to achieve the association of the above. This is what made the researcher to monitor the abundance of semantic shifts in theatrical presentation as long as the implications of the strategy continue in the game of semantic production with multiple horizons, and the idea in theatrical presentation tolerates multiple readings according to the refere

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