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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
Tue Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Reflection of the community participation in enhancing organizational excellence
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The research aims to identify the role of community participation in achieving organizational distinction in the Dhulia's municipality, which is one of the formations of the Ministry of Construction, Housing, Municipalities and Public Works in Salah al-Din Governorate, which is one of the service organizations that have a fundamental role in providing service to the community, which has faced many administrative challenges and many problems caused by the rapid and continuous changes in the environment, therefore modern management concepts must be adopted, such as community participation and the knowledge of its role To achieve its goals, which helps it in facing changes as well as achieving organizational excelle

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Publication Date
Mon Jan 11 2021
Journal Name
Journal Of Planner And Development
The Social Aspect of Vertical Landscape in Residential Buildings
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The great raise and development of residential buildings in modern cities worldwide as a result of urban extends leads to environmental and social problems, that make the designers looking for more complicated and innovative solutions. To encounter these, most advanced technologies in construction had been used resulting buildings had become higher, which was moved away from the land called residential housing. And with the development of these buildings, increase in the inhabitants inside; generate distant from nature, which increased the need for interactive outdoor recreational spaces open green in its high sections, was an alternative or complementary option to outer space at the ground level. Therefore, the research problem has emer

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Publication Date
Wed Jun 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The role of modern manufacturing systems in process Design
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The aim of the research to measure the correlation relationship between modern manufacturing systems and process design and measure the effect by adopting the regression; the research consists of two main variables, which are modern manufacturing systems and process design; it was applied in the production lines of the General Company for Construction Industries, There is a sample of managers, engineers, technicians, administrators, and some workers were selected to fill the special questionnaire with (70) forms which distributed and (65) were approved suitable for use, For data analysis the correlation coefficient was adopted to measure the relationship and regression analysis to find out the effect, Using (SPSS), So the first h

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
The Impact of Dialect Difference in Multifaceted Grammatical Rules
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Among the issues that preoccupied ancient and modern grammarians is the phenomenon of grammatical disagreement among grammarians and their differences in many grammatical issues that many of them go back to the phenomenon of dialectical difference, so this filled our thinking with a lot of things that led us to look at the side of the reasons for this grammatical difference, and here lies the significance of research to know that it is a linguistic phenomenon dealing with the living language used among the Arabs and linguistic phenomena that reflect linguistic reality as well. Thus our chagrin determination in research and investigation in this issue is the scarcity of dialectical studies at the compositional grammar side, and the lack o

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Publication Date
Sun Jul 07 2013
Journal Name
Journal Of Educational And Psychological Researches
Environmental reality for kindergarten in the city of Baghdad
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Before the unit environmental problems serious the issues of the environment and conservation of contemporary issues important in the developed and developing worlds, it was natural that leads increasing global awareness to alert a group of intellectuals, scientists and politicians to the seriousness of this problem and the call to take steps deeper and more comprehensive with respect to the environment humanitarian based on the study of the various elements of this environment and a greater understanding of the relationships among them, and on this basis, steps have been taken to target the environment and to identify problems and make efforts to achieve the goals I: stop the deterioration of the environment and the second impro

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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Behavioral Approach In Financial Reporting Enhancement
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 This study seeks to highlights on the behavioral approach in organization theory as modern and effective entrance in constructing this theory and reflection extent on the behavior of both the product and the information user (accountant and financial information).

 The study also focus on behavioral approach role in consolidating accounting concepts through making harmony between them so that the accountant can influence the user behavior with the concepts and principles of accounting in an effort to provide quality characteristic of accounting information produced by him in consistent with his behavior and information user and its impact on the decision making process by the latter.

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Publication Date
Tue Sep 19 2017
Journal Name
Al-academy
Avatar connotations in the works of sculptor Morteza Haddad
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Me researcher in this research study and discover the symbolic indications in the work of the Iraqi sculptor Morteza Haddad, has corrupted search of four chapters first chapter contains research problem and its significance and objectives of the research, which was to detect signs symbolism in works of contemporary Iraqi sculptor Morteza Haddad and terminology, which included significant the GTA and idiomatically and Velsfatta and conduct,

It also included the symbol for GTA and idiomatically and Velsfatta and hold, while the second chapter includes three sections are straight, semantics and icon, a brief on Iraqi contemporary sculpture, About the lives of contemporary Iraqi sculptor Then choose the terms of the research sample,

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Publication Date
Fri Dec 15 2023
Journal Name
Al-academy
Artistic processing of Emotional Scenes in the Narrative Film
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This research entitled: "Artistic processing of Emotional Scenes in the Narrative Film" deals with how to process and embody those emotional scenes. As there are certain filmic elements that play an effective role in deepening the viewer's sense of the importance of those scenes, and that their presence in the film is necessary and inevitable, and cannot be dispensed because it forms an interconnected connection with the rest of the film's scenes, in addition to its dramatic and aesthetic value in the film in crystallizing the viewer's feelings and integrating him/her into the scene.
The research was divided into four chapters, the first chapter includes: the methodological framework, which represented the research problem, and brin

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Publication Date
Thu Dec 31 2020
Journal Name
Political Sciences Journal
The problem of applying Sharia in contemporary Islamic thought
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The Islamic Issue did not rise the “widespread arguments” in contemporary times, just as the issue of applying Islamic Law.  Just as the Islamic forces used this purpose, or employed it during their march to reach to power by adopting the sacred as motivation towered the power, or control the governance. However, the reality show that this goal remained within the boundaries of slogans in the sense of a teleological slogan, and did not go beyond the limits of advocacy or arrangement as the primary source of legislation with differences of teleological reasoning, in a manner that reflected an intellectual problem about the validity of the use of this concept or the ability to apply and enforce the law in today's world, to impose

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Publication Date
Wed Jun 29 2022
Journal Name
Journal Of The College Of Education For Women
EFL Student- Teachers' Perception in the Culture of Thinking
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Many studies have recommended implying the skills and strategies of creative thinking, critical thinking, and reflective thinking in EFLT curriculum to overcome EFL teaching-learning process difficulties. It is really necessary to make EFL teachers aware of the importance of cultural thinking and have a high perception of its forces. Culture of thinking consists of eight cultural forces in every learning situation; it helps to shape the group's cultural dynamic. These forces are expectations, language, time, modeling, opportunities, routines, interactions, and environment. This study aims to investigate EFL student-teachers’ perceptions of cultural thinking. The participants are selected randomly from the fourth-stage students at

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