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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
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The Causal Relationship Between Money Supply , Inflation and Exchange Rate in Iraq for the Period ( 1990-2011)
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   The paper aims to measure the impact of monetary policy on price stability , by testing the causal relationship between the money supply,  inflation rate and the exchange rate , In order to prove that the  inflation is a monetary phenomenon in the Iraqi economy , and that the exchange rate is controlled in the money supply , the money supply as an endogenous  variable continued we found by using the standard tests to the existence of a single co-integration  between the money supply and the rate of inflation and the money supply and the parallel exchange rate, This confirms the existence of a long-term relationship between the variables , It also confirmed the results of the vector error correctio

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Publication Date
Thu Jun 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Examining the Asymmetric Impacts of Interest and Exchange Rate on Investment in Egypt for the Period 1976-2020: Applying NARDL Model
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Most of the studies conducted in the past decades focused on the effect of interest rates and exchange rates on domestic investment under the assumption that the independent variables have the same effect on the dependent variable, but there were limited studies that investigated the unequal effects of changes in interest rates and exchange rates, both positive and negative, on domestic investment.  This study used a nonlinear autoregressive distributed lag (NARDL) model to assess the unequal effects of the real interest rate and real exchange rate variables on domestic investment in Egypt for the period 1976 - 2020.  The results revealed that positive and negative shocks for both exchange rates have unequal effects on

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Publication Date
Fri Oct 16 2020
Journal Name
Solid State Technology
Study and Investigation of Transition Rate at Metal–Organic Semiconductor Interfaces
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In this paper,we focus on the investigated and studied of transition rate in metal/organic semiconductor interface due to quantum postulate and continuum transition theory. A theoretical &nbsp;model has been used to estimate &nbsp;the transition rate cross the interface through estimation many parameters such that ;transition energy &nbsp;,driving electronic energy U(eV) ,Potential barrier ,electronic coupling &nbsp;,semiconductor volume ,density ,metal work function ,electronic affinity and temperature T. The transition energy &nbsp;is critical facter of charge transfer through the interfaces of metal organic films device and itscontrol of charge injection and transport cross interface. However,the potential at interfa

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
A Study of the Problems of Learning and Translating Idioms
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Idioms are a very important part of the English language: you are told that if you want to go far (succeed) you should pull your socks up (make a serious effort to improve your behaviour, the quality of your work, etc.) and use your grey matter (brain).1 Learning and translating idioms have always been very difficult for foreign language learners. The present paper explores some of the reasons why English idiomatic expressions are difficult to learn and translate. It is not the aim of this paper to attempt a comprehensive survey of the vast amount of material that has appeared on idioms in Adams and Kuder (1984), Alexander (1984), Dixon (1983), Kirkpatrick (2001), Langlotz (2006), McCarthy and O'Dell (2002), and Wray (2002), among others

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Publication Date
Thu Dec 31 2015
Journal Name
مجلة كلية العلوم الاسلامية
The Secret of Marriage in Christianity A Descriptive Study
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Marriage is a holly secret in Christian religion .So it id natural that its ceremonies acquired religious form .In general the marriage is contracted by minister of religion in presence of the two parties or by a proxy or presence of parents if it is necessary . And to make the condition of publicity for the marriage ,its procedures must be made before witnesses .Also the minister of religionhave to confirm the agreement of the two parties before beginning the procedures.The marriage ceremonies are made.These procedures are religious traditions that includes praying and make blessings and putting the rings in fingers by thepriest . The marriage is a holly secret performed by the crown pray according to the church religious traditions

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Publication Date
Fri Aug 30 2019
Journal Name
Journal Of The College Of Education For Women
A Cognitive Linguistic Study of the English Preposition 'in'
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The present study aims at analyzing the polysemy of the English preposition in from the cognitive linguistic (CL) point of view using Evans' and Tyler's approach (2003). The perplexity faced by Iraqi second language learners (L2) due to the multi-usages of this preposition has motivated the researcher to conduct this study. Seventy-six second year university students participated in this experimental study. The data of the pre-test and post-test were analyzed by SPSS statistical editor. The results have shown the following: First, a progress of more than (0.05≤) has been detected as far as students' understanding of the multiple usages of the preposition in is concerned. Second, the results of the questionnaire have s

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Publication Date
Thu Sep 10 2020
Journal Name
Journal Of Advances In Mathematics
A Study of The Density Property in Module Theory
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In this paper, there are two main objectives. The first objective is to study the relationship between the density property and some modules in detail, for instance; semisimple and divisible modules. The Addition complement has a good relationship with the density property of the modules as this importance is highlighted by any submodule N of M has an addition complement with Rad(M)=0. The second objective is to clarify the relationship between the density property and the essential submodules with some examples. As an example of this relationship, we studied the torsion-free module and its relationship with the essential submodules in module M.

Publication Date
Wed Nov 03 2021
Journal Name
Al-ghary Journal Of Economic And Administrative Sciences
The Role of Marketing Vigilance in Analyzing the Strategic Position of Tourism Organization: A Survey Study of the Opinions of a Sample of Travel and Tourism Companies
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The study aims at studying and analyzing the subject of marketing vigilance as it is one of the modern approaches in the marketing field that can be used to face changes in the competitive and strategic environment and that represents quick reactions on the part of the institution to ensure its survival and distinctiveness other aims are: Consolidating the strength of the marketing organization and its success continuously, represented by changes in the market share, awareness of the institution's position in the market and its relations with competing tourism companies, diversification of tourism services, as well as an analysis of the competitive strategic position of tourism institutions for the purpose of conducting a r

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Publication Date
Wed May 15 2024
Journal Name
International Journal Of Religion
The Theory of Quantity in Measures and Scales a Comparative Jurisprudential Study
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Every body has a size and mass that distinguishes it from others and makes it different from others. Some of these bodies are huge and large in size, and some are small and light in weight. Among these masses and bodies are some that are dealt with by their size and weight, each according to its quantity, weight, and cheapness. This is why they created quantities by which these weights and quantities could be estimated, so they used measures and weights for that. Objectives: The research aims to know some measures and weights, such as the wife’s maintenance, the amount of zakat, etc.I found it to be a widely spread topic, and widely used in the folds of jurisprudence. During my reading of jurisprudence books, I found jurists using many qu

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Publication Date
Wed Dec 01 2021
Journal Name
Civil And Environmental Engineering
Developing A Mathematical Model for Planning Repetitive Construction Projects By Using Support Vector Machine Technique
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Abstract<p>Each project management system aims to complete the project within its identified objectives: budget, time, and quality. It is achieving the project within the defined deadline that required careful scheduling, that be attained early. Due to the nature of unique repetitive construction projects, time contingency and project uncertainty are necessary for accurate scheduling. It should be integrated and flexible to accommodate the changes without adversely affecting the construction project’s total completion time. Repetitive planning and scheduling methods are more effective and essential. However, they need continuous development because of the evolution of execution methods, essent</p> ... Show More
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