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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
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
The Minister Historian, The Granadian Ibnul Khateeb, The Sheikh of Granada scientists
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1- The Granadian, Lisan Ad-Din Ibn ul Khateeb, was a brilliant thinker and a great writer who filled Andalus and Morocco with literature and poetry and his genius emerged in different knowledge fields.
2- He was one of Andalus famous people, as he was a first class physician and philosopher, a great historian, a farsighted politician and had a strong cognition.
3- Ibnul Khateeb proved that his age, that he lived in, was a sophisticated in which arts, literatures and sciences thrived.
4- Ibnul Khateeb dedicated his life for the service of Granada Kingdom and that was clear in his writings, both prose and poetry.
5- Ibnul Khateeb witnessed a group of great Andalus scientists and writers, firstly the thinker Ibn Khaldun who sing

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Publication Date
Fri Jul 05 2024
Journal Name
Journal Of Applied Spectroscopy
Spectrophotometric Method Using the Derivative for the Determination of the Drug Losartan
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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The effect of external environment on the process of decision-making associated with the closing of private industrial firms: The Iraqi experiment, (1976-1985)
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Abstract
The research hypothesizes is that the external Environment
has the responsibility concerning decisions making and behavioral
upon industrial firms. It is, Furthermore, an attempt to review the
problem of closures of private industrial firms in the country, during
the period (1976-1985), i.e. prior to and during the Iraqian- Iranian
war.
The behavioral approach of industrial geography has been
adopted as a theoretical background and the statistical test has
been practiced for the applied purposes.
As result, the research comes out with suggestions,
depending upon previous trials in the field of direction and
formulation of the of the private industrial sector. The chief point
among th

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Publication Date
Mon Jun 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Experience of Kurdistan province of Iraq in light of the development of economic and social indicators for sustainable development
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Reflect the sustainable development of the interaction of three key elements are the economic component and the social component and the environmental component while focusing economic component to achieve economic growth and focuses social element to achieve social justice in the distribution of income and achieve prosperity, the environmental component related fields and including emphasizes the protection of the environment and to ensure the continuation and sustainability of resources physical, biological and form in which it believes the interaction required for development process real and effective and sustainable, and is considered the province of Kurdistan Iraq of important areas where the movement of developmental mount

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Publication Date
Sun Dec 01 2019
Journal Name
Saudi Medical Journal
The diagnostic power of circulating micro ribonucleic acid 34a in combination with cancer antigen 15-3 as a potential biomarker of breast cancer
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Publication Date
Mon Sep 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Strategic planning of taxes, and its effect in the investment: Applied research in Taxes General Board
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The current research seek to known the strategic planning for the taxes and its important , and its effect upon the investment , and this research was be in the general board of taxes, and the economical directorate of the ministry of finance , therefore this research started from the problem below: 

  • What level of the important and type of the research changeable of the research ( the strategic planning for the taxes and investment) in the research organization ?
  • Is there any relation of the join and effect of the changeable of the research (the strategic planning for the taxes and investment)in the research organization ?

Therefore this research depended a hypotheti

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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The reality of total quality management in educational institutions and its role in achieving excellence performance
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This study is concerned with the reality of total quality management and its role in achieving the excellence performance of the employees of the Institute of Technology / Baghdad, excellence performance is described by the extent to which the organization is able to invest the effort of the human resource to achieve its Objectives by adopting the principles of Total Quality Management (TQM) according to some of its basic dimensions in proportion to the reality and Possibilities Institute, the aim is to study to know the reality of total quality management ,and indicate the levels of excellence performance in the Institute of Technology / Baghdad,

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Publication Date
Sun Jun 12 2011
Journal Name
Baghdad Science Journal
The effect of Tilt Angle, Surface Azimuth and Mirror in Solar Cell Panel Output in Baghdad.
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In this research (100* 40* 4 cm) solar cell panel was used in Baghdad at autumn season (2010), to get best solar cell panel angles experimentally, and then a mirror (40*50 cm) is use to concentrate incident sunlight intensity on a panel. At first case we get (Tilt angle ?P =60°and Surface Azimuth angle ?P =36°E) is the best angles and other case, we add a mirror at angle = 120° at bottom of panel, then we get output power (27.48watt) is bigger than without using a mirror (25.16watt). We can benefit from these cases in variety applications.

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Publication Date
Thu Feb 13 2025
Journal Name
Technology In Agronomy
Challenges and innovations in potato harvester design: the role of artificial intelligence in improving crop sorting
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As population growth increases the demand for crops increases and their quality improves, and it becomes necessary to find innovative and modern solutions to enhance production. In this context, artificial intelligence plays a pivotal role in developing new technologies to improve crop sorting and increase agricultural yields. The present review discusses the main differences between manual and mechanical potato harvesting, explaining the advantages and disadvantages of each method. Manual harvesting is highlighted as a traditional method that allows for greater precision in handling the crop, but it requires more time and effort. In contrast, mechanical harvesting provides greater efficiency and speed in the process, but it may damage some

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Publication Date
Mon May 25 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
Strength Training and its Effect in Some Biochemical Variables in the High Jumping of Advanced Players
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The study of biomechanical indicators in the arc of the run and the upgrading stage is one of the important variables that affect the nature of the upgrading and thus affect the result of the race due to the importance of these stages and the consequent variables during the last steps. That’s why, the jump-trainings based on assistant means or body weight positively affect the step-time for each of the three steps in the acceleration arc. As well as, it focuses on the momentary strength of each step at this stage. It also significantly affects the speed of motor performance to suit the activity in which the runner needs to perform perfect steps with high flow in order to convert the horizontal speed to a vertical one. This is achieved thr

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