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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 Sep 30 2023
Journal Name
Journal Of The College Of Education For Women
Topic Management in Selected Dementia Patients' Speeches: A Clinical Discourse Analysis Study
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Topic management is the awareness of how speakers deal with initiating, developing, changing, and ending a topic and how they fix the relationship when a misunderstanding occurs. It is such an important unit of conversation as it includes the transition from one strategy to the other to be accomplished in a systematic and orderly manner. These strategies are impaired in dementia patients thus lead to communication breakdown. This study aims at detecting the dementia patients' topic management strategies in selected speeches and answering the questions of which of these strategies are fully or partially detected in these speeches. The researchers use a qualitative method to examine the speeches of those patients and they adopt an eclectic

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of The College Of Education For Women
Identity in Sonia Sanchez's Poem "right on: white america" :A Stylistic Study
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Language is an important means through which one can construct one's social world. Accordingly, the way we view ourselves and the world is basically formed by language use whereby identities, relations, and values are constructed and maintained. Most discourse analysts consider narrative not only the locus of construction and enactment of identity, but also a distinguished genre for its analysis.The present study is concerned with how identity can poetically be informed, hence exploring the way black poets use language when reflecting their identity and culture. The poem, right on: white america by the black American poetess Sonia Sanchez, is chosen to be analyzed based on Simpson's stylistic model (2004). In this model, the ana

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Publication Date
Tue Dec 19 2023
Journal Name
Journal Of Ethnic And Cultural Studies
Request Constructions in Classical Arabic versus Modern Arabic: A Corpus-based Study
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The present study aims to investigate the various request constructions used in Classical Arabic and Modern Arabic language by identifying the differences in their usage in these two different genres. Also, the study attempts to trace the cases of felicitous and infelicitous requests in the Arabic language. Methodologically, the current study employs a web-based corpus tool (Sketch Engine) to analyze different corpora: the first one is Classical Arabic, represented by King Saud University Corpus of Classical Arabic, while the second is The Arabic Web Corpus “arTenTen” representing Modern Arabic. To do so, the study relies on felicity conditions to qualitatively interpret the quantitative data, i.e., following a mixed mode method

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Publication Date
Tue Mar 01 2016
Journal Name
Journal Of Engineering
Critical Success Factors in Construction Projects (Governmental Projects as a Case Study)
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The importance of the construction sector and its Great role in the provision of services and infrastructure, reduce poverty, improve living conditions and improve the economic situation in the country, impose attention to the way in which the projects implemented for its improvement and to get successful projects. The objective of this research was to determine the criteria for success as well as critical success and failure factors that have a significant impact on project success. A selected 75 engineer (department managers, project managers and engineers) are asked to fill  the questionnaire form, Sixty-seven valid questionnaire forms were analyzed statistically to get search results, which were as follows : Twe

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Publication Date
Sun Jan 08 2023
Journal Name
Journal Of Planner And Development
Design bases for waste recycling rules in cities/ Baghdad, a case study"
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Waste is one of the most important problems affecting the city’s environment and its urban landscape, which results from the activities and activities of man and the natural environment. Its sources have varied between residential, commercial, industrial, medical and hazardous, and its spread in cities, on roads and on abandoned open lands, has led to significant negative effects and risks to human health and the environment.

  Therefore, there were serious attempts to deal with waste and follow sequential steps that formed a waste management system such as (collection, sorting, transport, then treatment and disposal). Preventing and reducing waste, then recycling and recovering by composting or burning, and ending with bu

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Publication Date
Fri Mar 04 2022
Journal Name
Journal Of Water Resources And Geosciences
A Review Study on Gypseous Soils Stabilized with Different Additives in Iraq
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Publication Date
Sun Sep 27 2020
Journal Name
Journal Of The College Of Education For Women
Degree of Availability of the Integrated Preparation Criteria inArabic Language Teachers’ Preparation Program in Syrian Universities from the Educational Qualification Diploma Students’ Viewpoint
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The study aimed to know the degree of availability of integrated preparation criteria in the Arabic Teacher training Program in Syrian universities from the viewpoint of university students of the Educational qualification diploma, and the degree of availability of these standards in the outputs of the preparation program. To achieve the Goals of the study, a list of integrated preparation criteria was prepare comprising (110) indicators, distributed to (11) criteria. The list was applied to a randomly chosen sample of (45) educational qualification diploma students. The results of the study showed that the Standards for integrated preparation are provided in a medium degree overall in the program for preparing teachers of Arabic languag

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Publication Date
Mon Jan 01 2024
Journal Name
Studies In Systems, Decision And Control
The Effect of Using an Accounting Information System Based on Artificial Intelligence in Detecting Earnings Management to Enhance the Sustainability of Economic Units
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This research aims to clarify the importance of an accounting information system that uses artificial intelligence to detect earnings manipulation. The research problem stems from the widespread manipulation of earning in economic entities, especially at the local level, exacerbated by the high financial and administrative corruption rates in Iraq due to fraudulent accounting practices. Since earning manipulation involves intentional fraudulent acts, it is necessary to implement preventive measures to detect and deter such practices. The main hypothesis of the research assumes that an accounting information system based on artificial intelligence cannot effectively detect the manipulation of profits in Iraqi economic entities. The researche

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Publication Date
Wed Dec 29 2021
Journal Name
Journal Of The College Of Education For Women
The Degree of Secondary School Managers' Practice of Servant Leadership in Gaza from the Teachers’ Perspective : رندة عيد شرير, و سحر محمد حرب
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Abstract

The study aims to know the degree of secondary school managers' practice of servant leadership in Gaza from their teachers’ perspective. It further aims to examine whether there are any statistically significant differences at (α 0.05≥) between the means of the study sample’s members attributed to variables such as (gender, educational qualification, and years of experience). To achieve the objectives of the study, the study adopted the descriptive survey method, using a questionnaire consisting of (30) items distributed to four domains: (workers service, ethical dealing, motivation & influence, and building an organized, integrated society). Then, the questionnaire was distributed to  t

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Publication Date
Tue Jan 29 2019
Journal Name
Journal Of The College Of Education For Women
Student services provided to university students at the Faculty of Education for Girls at Baghdad University In light of the overall quality indicators
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The goal of current research is marked "student services for the university student at the Faculty of Education for Girls at Baghdad University in light of the overall quality indicators)" to identify the relative importance of the availability of student services offered by the College of Education at the University of Baghdad, from the viewpoint of the students. The research was Aaguetdy followers researcher Find descriptive approach to suitability research topic and in order to achieve the purposes of research, the researcher designed questionnaire examined consisted of (18) items and has been questionnaire on arbitrators and experts to verify the validity and reliability that's been applied to the questionnaire on a group of students

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