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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
Sat Nov 01 2025
Journal Name
Journal Of Language Teaching And Research
Identity Crisis in Diana Abu-Jaber’s Origin: A Pragma-Stylistic Study
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Identity crisis is a dominant literary theme, especially in most Arab women writers’ works. However, it has not been given enough attention from a linguistic point of view. By so doing, the current study intends to fill this gap by analyzing the identity crisis from a pragma-stylistic perspective by examining the writer's style in three purposely selected extracts from Diana Abu-Jaber’s novel Origin (2007). The study aims to examine the identity crisis by using pragmatic and stylistic tools and to explore the effects of Abu-Jaber’s stylistic choices on the readers of her work. To conduct this study, an eclectic model comprising Searle’s speech acts (1979), Brown and Levinson's politeness theory (1987), Leech's model of figur

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Publication Date
Thu Dec 01 2011
Journal Name
International Review Of Physics (e-journal) (irephy)
Red shift band enhancement of the nanostructure ZnO100-xAlx thin films as a function of Al concentration for optoelectronic applications
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Publication Date
Tue Dec 13 2022
Journal Name
Frontiers In Chemistry
Numerical analysis of the energy-storage performance of a PCM-based triplex-tube containment system equipped with arc-shaped fins
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This study numerically intends to evaluate the effects of arc-shaped fins on the melting capability of a triplex-tube confinement system filled with phase-change materials (PCMs). In contrast to situations with no fins, where PCM exhibits relatively poor heat response, in this study, the thermal performance is modified using novel arc-shaped fins with various circular angles and orientations compared with traditional rectangular fins. Several inline and staggered layouts are also assessed to maximize the fin’s efficacy. The effect of the nearby natural convection is further investigated by adding a fin to the bottom of the heat-storage domain. Additionally, the Reynolds number and temperature of the heat-transfer fluid (HTF) are e

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Publication Date
Mon May 27 2019
Journal Name
Al-academy
The Linguistic Vocabulary and its Role in Constructing the Design Thought: هدى محمود عمر --- سداد هشام حميد
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The importance of the Arabic language and its deep vocabulary in the live translation of the work of science and interior design can't be hidden from the whole world. The previous studies have dealt with the role of the linguistic vocabulary and Arabic calligraphy in interior spaces in terms of decoration and design. However, this research sheds light on the importance of linguistic vocabulary in the construction of design thought and how it has become the a basic motivation in the process of scientific and practical construction and not just aesthetic formations that took their place in the interior spaces, as linguistic vocabulary emerged recently and echoed within the specialization of interior design and formed a key motive to explor

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Publication Date
Thu Sep 15 2022
Journal Name
Al-adab Journal
Ideological and artistic features screenplay by L. Ulitskaya "The Plague, or CDC in the City" (1978-2020)
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    The article analyzes the ideological and genre features of L. Ulitskaya's work "The Plague, or OOI in the City", examines the features of building an artistic whole, ways of creating images of characters and their characteristics, stylistic features of the work.

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Publication Date
Tue Feb 04 2020
Journal Name
College Of Islamic Sciences
The Seljuk Rum State in  Asia Minor and the Mongol Invasion 634 - 708 AH / 1236 - 1308 AD
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Praise be to God, Lord of the worlds, and prayers and peace be upon our master Muhammad and upon his family and companions.
And after:
      The research dealt with an important and critical era in the history of the Seljuk State of the Romans in Asia Minor, as that country, after the assumption of Sultan Ghiath al-Din Kehsaru II in the year 634 AH / 1236 CE, was subjected to the constant Mongol threat, so the research came marked with (the Seljuk State of Rome in Asia Minor and the Mongol invasion 634 - 708 AH / 1236 - 1308 AD) The research showed the succession of the Seljuk Sultans to the rulers whose rule after the death of Sultan Alaeddin Kikbad was weak and subject to the authority of the Mongols

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Publication Date
Sat Apr 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Proposal framework to activate the international accounting procedures for disasters and wars effects in the local environment
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natural and non-natural disasters, is an environmental challenges the society and the economy as well as a direct and indirect economic affect, and the units are part of the system overlapping among themselves and thus affected by external indicators, directly or indirectly, these direct effects appear in the destruction or damage inflicted by disasters in property , infrastructure , superstructure , accounting information systems and indirectly in the outcome of future business, comes research problem through access to accounting treatments issued by the Federal Office of financial supervision to address the damage caused by the disasters and prepare the missing financial accounts it turns out us that there is negligence of a nu

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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
comparison between the methods estimate nonparametric and semiparametric transfer function model in time series the Using simulation
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 The transfer function model the basic concepts in the time series. This model is used in the case of multivariate time series. As for the design of this model, it depends on the available data in the time series and other information in the series so when the representation of the transfer function model depends on the representation of the data In this research, the transfer function has been estimated using the style nonparametric represented in two method  local linear regression and cubic smoothing spline method The method of semi-parametric represented use semiparametric single index model, With four proposals, , That the goal of this research is comparing the capabilities of the above mentioned m

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Publication Date
Mon Aug 01 2022
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
A survey of deepfakes in terms of deep learning and multimedia forensics
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Artificial intelligence techniques are reaching us in several forms, some of which are useful but can be exploited in a way that harms us. One of these forms is called deepfakes. Deepfakes is used to completely modify video (or image) content to display something that was not in it originally. The danger of deepfake technology impact on society through the loss of confidence in everything is published. Therefore, in this paper, we focus on deepfakedetection technology from the view of two concepts which are deep learning and forensic tools. The purpose of this survey is to give the reader a deeper overview of i) the environment of deepfake creation and detection, ii) how deep learning and forensic tools contributed to the detection

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Publication Date
Thu Jan 01 2015
Journal Name
Al–bahith Al–a'alami
Identify trends of media students about satellite channels specialized and its role in the satisfaction of their wishes and develop their abilities
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This search is field research, which aims to explore the trends of students in media department toward specialized Satellite Channels and identify the knowledge capacity and its role in the development of their knowledge’s, represented by watching those channels as well as media students' habits exposed by those channels. As to the public is a key element in the process and substantive communication, the Sociological studies information on that article information is not complete its work, but that he was receiving from before receiving, and send every piece of information content in order to achieve a certain goal, therefore, is the future of receiving such information in order to achieve a particular goal, which is

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