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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 29 2020
Journal Name
Journal Of Mechanics Of Continua And Mathematical Sciences
NUMERICAL INVESTIGATION OF DEVELOPING LAMINAR FLUID FLOW THROUGH RECTANGULAR ANNULUS DUCT
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The laminar fluid flow of water through the annulus duct was investigated numerically by ANSYS fluent version 15.0 with height (2.5, 5, 7.5) cm and constant length (L=60cm). With constant heat flux applied to the outer duct. The heat flux at the range (500,1000,1500,2000) w/m2 and Reynolds number values were ≤ 2300. The problem was 2-D investigated. Results revealed that Nusselt number decrease and the wall temperature increase with the increase of heat flux. Also, the average Nusselt number increase as Re increases. And as the height of the annulus increase, the values of the temperature and the local and average Nusselt number increase.

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
The phenomenon of building the act of the actor and the effect in the Quranic readings                          (Structural and semantic study)
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After this systematic presentation of the phenomenon of rotation of formulas, ie the construction of the verb and the verb, and the narrated narratives therein differed among the readers, it became clear to us how the difference was clear between reading and the other, and how readers have varied in their readings of the verb, As we have noted through our modest research that the phenomenon of building the verb for the actor and the effect have included the act of both past and present tense, and not limited to a specific time, and this difference in reading was not limited to a particular environment, but beyond To more than one environment This is evidenced by the readings of various readers from the environment of Kufa, Basra, Mecca,

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Publication Date
Wed Sep 15 2021
Journal Name
Al-academy
Designing Clothes that Meet the Functional and Aesthetic Needs of Children with Hip Dislocation: تهاني عبد الله القديري
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Children who have a health problem need special requirements for their clothes. The purpose of the study is to design functional and aesthetic clothes to meet their needs. The research used the applied descriptive approach. The research sample comprised 120 women whose children suffered from hip dislocation. Designs for injured children presented and submitted to the arbitrators for evaluation regarding the functional and aesthetic aspects. The finding was achieving the design solutions. The most important recommendations are to increase attention to designing clothes to suit all the needs of society.

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Publication Date
Sat Jul 27 2024
Journal Name
International Journal Of Economic Perspectives
The impact of strategic leadership on the building of intelligent organizations: A field study of a group of economic institutions in Algeria
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This study aims to highlight the role of strategic leadership in adopting the intelligent organization model. The study was conducted on 7 economic organizations in Algeria. The study population consisted of 354 leaders, of whom a random sample of 176 leaders (managers, department heads, division heads, engineers) was selected. The researcher used a questionnaire as the main tool of the study. Statistical analysis and hypothesis testing were conducted using SEM (Structural Equation Modeling) with the aid of SPSS.v26 and AMOS.v24 software. The study concluded with a set of results, most notably: there is a statistically significant direct positive effect between strategic leadership and building intelligent organizations at a significance le

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the forensic accounting philosophy in the transparency and quality of financial statements: : An applied study on a sample of workers at the Trade bank of Iraq and the Gulf Commercial Bank in Babylon
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This research aims to identify the role that forensic accounting plays on the transparency and quality of the financial statements in trade bank of Iraq and the Gulf Commercial Bank in Babylon. This research came to address the problem that most financial institutions suffer from, which is represented by the lack of transparency and the quality of the financial statements issued in a manner. Annual also the manipulation and fraud in the financial data, which causes a big gap between that institutions and organizational stakeholders. According to the implementation of the research hypothesis and the objectives of the research, a questionnaire was prepared consisting of three axes, the first axis dealing with the demographic distri

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Publication Date
Thu Nov 20 2025
Journal Name
Al–bahith Al–a'alami
Consumer attitudes towards the integrated marketing communications of the UAE Etisalat company: A study of a sample of its subscribers in the emirate of Abu Dhabi
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The continuous technical development in the means of communication and information technologies has led to an increase in competition in the provision of service and product on the part of the organizations, as this competition does not know silence and stability on specific methods, but rather it is a world that is constantly moving and renewed in approaches, methods and approaches, and the focus of attention of integrated marketing communications practitioners are Customers, for them, organizations sell their goods, products, services, and ideas, and with them, they become stronger in competition.
This scientific study aimed to identify the trends of the initiators towards the integrated marketing communications of (the Emirates Tel

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Human Sport And Exercise - 2019 - Spring Conferences Of Sports Science
The effect of special force training on the development of biomechanical variables for running raising awareness during the performance on the jumping table
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Publication Date
Mon Feb 13 2023
Journal Name
International Journal Of Professional Business Review
The Reality of Local Investment in Iraq and Prospects for its Development: a Case Study in the Baghdad Investment Commission
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Purpose: This research is to identify the most important challenges for the local investment commissions and to develop solutions and proposals to encourage local and foreign investment in local governments in Iraq (the Iraqi provinces are irregular in the region).   Theoretical Framework: This research suggests a conceptual framework for the local investment commissions in order to solve their problems, the most important of which was to identify the most critical challenges which are facing the Baghdad Investment Commission BIC and how to overcome them.   Design/The methodology approach: Research involved a mixed-methods approach through two stages. During the first stage, the researcher gathered quantitative data from all inves

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Publication Date
Tue Oct 18 2022
Journal Name
Arab World English Journal For Translation & Literary Studiesissn: 2550-1542 |www.awej-tls.org17awej For Translation & Literary Studies,
The impact of landscape on the emotional shift in Tayo’s Character: A Study of memory and displacement in Leslie Marmon Silko’s Ceremony
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This paper examines the decolonizing methods used by Leslie Marmon Silko in her novel Ceremony (1977) to heal the indigenous people from the patriarchal traditions of the white hegemony. This study aims to emphasize the vulnerable responses of the Pueblo people to the memories of the clan and to highlight Silko’s methods to sustain the history and lifestyle of the indigenous people. Therefore, Silko’s novel can be situated historically and culturally within memory-studies. To analyze the contrasting behaviors of characters, this paper projects the relationship between the collective patriarchal doctrines and that of the individual within the framework of memory studies. Theories of Jan and Aleida Assmann are used here to explore the

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Publication Date
Sun Sep 28 2025
Journal Name
Journal Of Physical Education
A survey Study to Measure the level of Motivation a Squash lesson for junior students in the College of Physical Education and Sports Sciences
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            Human behavior is one of the topics that has captured the attention of researchers throughout the ages, and motivation is one of the manifestations of this behavior, which indicates the extent of interest in a particular topic and their unwillingness to rush towards a particular topic. The topic of motivation is one of the important topics of interest to the teacher and coach in the field of sports. The aim of this research was identifying the level of motivation for junior students, and the differences in the dimensions of motivation for junior students in squash lessons. We used the descriptive survey method, and the research sample was chosen randomly. Only male of the junior students in the College of Phys

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