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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 Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Human capital and its role in achieving the underwriting policy: Applied research in the National Insurance Company
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The insurance companies are one of the organizations that rely mainly on human capital to underwriting to insurable risks because most of risks have many variables, so the aim of the research is to show the level of interest of the researched company in human capital, the reality of the underwriting policy in it, and the relationships of correlation and effect between them, and the approach has been used Analytical descriptive, as books, research and other related sources were used for the purpose of completing the theoretical side, on the practical side, a questionnaire was prepared, which represents the main tool for collecting data and distributed to a random sample of 64 people from underwriting managers and employees in spec

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Publication Date
Wed Jan 01 2020
Journal Name
International Journal Of Innovation, Creativity And Change (ijicc)
The relationship between conceptual knowledge and procedural knowledge among students of the mathematics department at the faculty of education for pure sciences/IBn Al-Haitham, university of Baghdad
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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of The College Of Languages (jcl)
Peculiarity of Colloquial and Popular Vocabulary in a Collection of the Poet Alexi Kaltsof's Letters: Varonech Bazars: Специфика просторечной и диалектной лексики в эпистолярном дискурсе «воронежского прасола» Алексея кольцова
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The paper studies the description of the colloquial and popular vocabulary  used by wholesales tradesmen in Varonech before the Bolshevik Revolution . The vocabulary were used in the personal letters written by the poet and sent to famous poets and critics like Belenisky, kryvesky and Malsheve. And some were sent to his father and his sister. Not only did these letter bear the personal taste, but they represented a literary product reflecting on the poet's impressions, views, ambitions, and opinion in arts, poetry, prose, and theatre. The researcher used about thirty instances of various levels of grammar, style and phonology, all representing colloquial vocabulary used commonly at the time of Alexi&nbsp

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The trend to Joint Audit as an approach to Improve the Financial Reports Quality - An Applied Study –
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This study aimed at identifying the trend to applying the Joint Audit as an approach to improve the financial reports quality with all their characteristics (Relevance, Reliability, Comparability, Consistency), as well as enclose the difficulties that faced the auditors in the Gaza Strip in implementing the Joint Audit. In order to achieve the study aims, a measure was used to identify the trend to apply the Joint Audit and it was distributed to the study sample which is consisting of (119) individuals and retrieved thereof (99) valid for analysis, approximately (83.2%), (69) of them are Auditors, (30) financial managers and accountants. The researcher used the analytical descriptive method, and after analyzing the results, the s

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Publication Date
Tue Feb 16 2016
Journal Name
The Iraqi Journal Of Agricultural Sciences
MEASURING VIBRATION AT TRACTOR PLATFORM , STEERING WHEEL AND SEAT EFFECTIVE AMPLITUDE TRANSMISSIBILITY FACTOR DURING OPERATION TILLAGE
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Field experiment conducted to measure vibrations on three axes longitudinal X, lateral Y and vertical Z on steering wheel, platform tractor and vertical vibration in seat tractor and seat effective amplitude transmissibility (SEAT) factor during operation tillage in silt clay loam soil with depth 18 cm in Baghdad. Split – split plot design under randomized complete block design with three replications least significant design 5 % used. Three factor were used in this experiment included two types of plows included chisel and disc plows which represented main plot, three tires inflation pressure was second factor included 1.1 ,1.8 and 2.7 bar, and three forward speeds of the tillage was third factor included 2.35 , 4.25 and 6.50 km/hr. Resu

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Publication Date
Wed May 01 2024
Journal Name
Journal Of Madenat Alelem College
Study 1,4- Naphthoquinone Derivative and Biological Activity: A Review
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In this work, we focused on studying 1,4-naphthoquinones and their derivatives, and knowing the methods of preparing them using different auxiliary agents and forming derivatives containing heterocyclic rings, active groups and saturated rings containing heterogeneous elements . In addition, due to their strong antibacterial, antifungal and anticancer activity, 1,4-naphthoquinone compounds biological importance and are considered a source of various pharmaceutical compounds.

Publication Date
Mon Jan 01 2024
Journal Name
Aip Conference Proceedings
Negative skin friction evaluation and mitigation: A review study
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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Using Regression Analysis as Analytical Procedure to Facilitate the Decision-Making Process in The Tax Audit: An Applied Research in the General Commission of Taxes
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This research aims to clarify the advantages of using the regression method as analytical procedure in the tax audit to reducing the examination cost , time, effort, human and material resources, and represents an applied study in the General Commission of taxes. In order to achieve its objectives the research has used in the theoretical side the descriptive approach (analytical), and in the practical side regression method has been applied to the research sample represented by the soft drinks company that is subject to the tax settlement for the year 2014, where the value of sales has been verified by using the regression method without conductinga comprehensive examination. The most important results of the research indicate that the r

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Publication Date
Wed Oct 02 2024
Journal Name
Journal Of International Crisis And Risk Communication Research
Manufacturing Consent: A Critical Discourse Analysis of Benjamin Netanyahu's Speech to the United States Congress in 2024” has been accepted for publication in
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In this paper, the researchers investigate Prime Minister Benjamin Netanyahu's speech before a joint session of the US Congress on July 25, 2024. The researchers primarily aim at highlighting the ideology behind Netanyahu's speech by using qualitative research through the application of critical discourse analysis (CDA), which is employed here in in order to show how certain linguistic choices can manipulate and determine concepts related to power and ideology. The CDA method used is Discourse Historical Approach with the main focus on argumentation management through discursive strategies. The researchers adopt DHA by Wodak (2009) with focusing on the taxonomy of social actor representation by Van Leeuwen (2008). The study reveals th

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Publication Date
Tue May 01 2018
Journal Name
Journal Of Physics: Conference Series
Synthesis, Characterization and the Corrosion Inhibition Study of Two Schiff Base Ligands Derived From Urea and Thiourea and Their Complexes with Cu(II) and Hg(II) Ions
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