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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
Mon Jun 19 2023
Journal Name
Journal Of Engineering
The Effect of Hydraulic Accumulator on the Performance of Hydraulic System
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The purpose of this paper is to depict the effect of adding a hydraulic accumulator to a hydraulic system. The experimental work includes using measuring devices with interface to measure the pressure and the vibration of the system directly by computer so as to show the effect of accumulator graphically for real conditions, also the effects of hydraulic accumulator for different applications
have been tested. A simulation analysis of the hydraulic control system using MATLAB.R2010b to study was made to study the stability of the system depending on the transfer function, to estimate the effect of adding the accumulator on stability of the system. A physical simulation test was made for the hydraulic system using MATLAB to show the ef

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Publication Date
Sun Apr 03 2011
Journal Name
Journal Of Educational And Psychological Researches
Constructing The Psychological Tranquility Scale of the University of Baghdad Students
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Constructing The Psychological Tranquility Scale of the University of Baghdad Students
The research aimed to :
- Constructing the Psychological Tranquility Scale of the University of Baghdad Students.
- Appointing the psychological content standard for the accepting Answer of student about the scale.
The research Sample was (414) boy and girl from Baghdad University Students for the Studying year (2008-2009), So the Scale of the Psychological Tranquility Scale was bilt on them in good psychometric properties from truth Factor analyzing which was its super saturation was reached to (50) item from its items a value more than the super sutution norm (0,30) for kaizer, also the firm value was Relaibility for the scale by the way

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Publication Date
Sun Dec 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Influence of the Industrial Buyer Behavior on channels of distribution
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Abstract:

This study deals with the influence of the industrial buyer behavior in Channels of distribution. It concentrates on one section of management levels in the company. Which is that of administrative managers The research problem is attempt to study and analysis the influence of industrial buyer behavior in channels of distribution.. The aiming at achieving a number of applicable goals depending on one major hypotheses I set a questionnaire in collecting the data and information relating to the study، which was distributed to sample of ( 30) department manager heads of section states company .  In order to process the data resorted to many statistical methods such as arithmetic means the sta

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Publication Date
Wed Dec 14 2022
Journal Name
Nasaq Journal
The Effect of Co-text on the Comprehensibility of World Englishes
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MR Younus, Nasaq Journal, 2022

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Publication Date
Mon Jan 01 2024
Journal Name
E3s Web Of Conferences
History of the impact of radiation on the environment: Hiroshima bomb
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The history of the impact of nuclear radiation on the environment, as illustrated by the Hiroshima bombing, reveals a multifaceted interplay of scientific, ecological, and ethical dimensions. From the historical context and immediate environmental consequences to long-term ecological effects and human health implications, the effects of nuclear radiation are pervasive. Comparatively analyzed with other nuclear incidents, case studies of affected ecosystems, and through education, ongoing challenges and opportunities toward nuclear technology are revealed. Moreover, it is through the echoes of past nuclear events that lessons were learned which until today guide current efforts on striking a balance between technological advancement

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Publication Date
Tue May 16 2023
Journal Name
Political Sciences Journal
Criticism of the Green Political Thought of the Modernist Intellectual Output
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In the last decades of the twentieth century, ideas emerged that were increasingly being floated, stating that the planet is suffering from a population explosion, depletion of resources, and environmental problems that require action to be addressed. Although these problems in practice need scientific solutions, the problem is that these solutions collide with ideologies. Here the green political thought emerges, based on the criticism of many ideological axioms. The owners of green thinking agree that most environmental damage is due to the humanist doctrine. It criticizes modernity accompanied by a scientific revolution, where this criticism centered around (the rationality of the scientific and technological mind), here the green pol

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Publication Date
Sat Aug 30 2025
Journal Name
مجلة منوال للدراسات التربوية والنفسية
The Negative Impact of Media on the Educational Identity of Society
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This research aims the effects of negative media on the educational identity of community. Whereas display the concept of educational identity and its basic components, as well as the role of educational institutions for example the school and the family in form it and reinforcing this identity to individuals. The study showcasing the harmful impact of both traditional and modern media on identity and values, spotlight several examples like the promotion of consumerism and materialism through television programs. which results in the young people to adopt materialistic values like simplicity. The study concludes that media is a double-edged weapon: it can instill virtues and support education if used duly, but it can also weaken the educat

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Publication Date
Sun Mar 30 2008
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Effect of Promoters on the Catalytic Activity of the Iosmerization Catalyst
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The crystalline zeolite, namely faujasite type Y with SiO2/Al2O3 mole ratio of 5 was used as raw material for preparation of isomerization catalysts. A 0.5 wt % Pt/HY-zeolite catalyst was prepared by impregnation of the decationized HY-zeolite with chloroplatinic acid. The dectionized HY-zeolite was treated with HCl, HNO3 and HI promoters using different normalities and with different concentrations of Sn, Ni and Ti promoters by impregnation method to obtain acidic and metallic promoters' catalysts, respectively. A 0.5 wt% of Pt was added to above catalysts using impregnation method. Isomerization of n-hexane was carried out at different prepared catalysts. The isomerization temperature varied from 250–325° C over weight hourly space

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Identifying the Phenomenon of monopoly according to the vision of Accounting
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The research seeks to identify the factors affecting the monopoly and the possibility of measuring the phenomenon of economic ( monopolistic profit) accounted for and that the importance of research topic arising from the transformation of the majority of developing countries to the market economy, which represents the image of the capitalist economy, which is a monopoly, a stages that economy in its various forms, whether Market Worldwide sales monopoly or monopoly, which generates absolute monopolistic profits, which more or less affect on the overall economy of those countries than they should study the phenomenon of monopoly and its impact on the economies of those countries that still love to find her site reinforces its pos

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Publication Date
Fri Feb 13 2026
Journal Name
Hammurabi Journal For Studies
(The impact of legislative drafting on the achievement of electoral justice)
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