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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
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
He saw a linguistic study, in the Noble Qur’an
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In the name of God, praise be to God, and prayers and peace be upon the best of God’s creation, Muhammad bin Abdullah, and upon his family and companions, and from his family:
And after:
     He saw from verbs that transcend one effect if it is visual and to two effects if it is heart and this action has several strokes and it is an awareness of the sense and illusion and imagination and reason and in addition to that it has many meanings dealt with in the glossary books and as for what the verb included in the audio studies it is the explanation and deletion and slurring The heart of my place. As for what the grammatical studies included, it focuses on one or two effects according to its l

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measuring the relationship between the skills required for the labor market and the employment of graduates of community colleges in KSA: An applied study on a sample of faculty members at KKU
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This study has aimed to measure the relationship between the skills required for the labor market and the employment of graduates of community colleges at King Khalid University. For gathering the required data, a questionnaire has been designed and distributed to the faculty members of community colleges at King Khalid University in a random sample method. The chosen sample size has covered (123) individuals. Questionnaire forms have been distributed and retrieved from (117) participants. Therefore, the estimated response has reached 95 % of the total sample size. The results of the study have shown that there is not any significant relationship between the skills which the graduates   acquire and the requirements of employmen

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Publication Date
Wed Feb 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The development of ethics management system to enhance the social responsibility of government institutions in Iraqi society An analytical study on a sample of top leadership and the presidency of
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Abstract

The objective of this research is to identify the analysis of the ethics of the administration in the development of the social responsibility of one government organizations, and to achieve the objectives of the research was the use of a questionnaire developed for the purpose of data collection and distribution to the research sample, was chosen as a total sample population (50) individuals were relying on statistical package to do a statistical analysis for this research, user, ANSI (SPSS) simple regression analysis, standard deviation, Pearson correlation coefficient.

Research findings show the role of social responsibility in achieving the university's strategy,

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Business incubators the entrance of organizations to shift towards pioneering performance a study by a number of employees of the technical education organizations in mosul
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     The importance of this research is due to its importance goals, Which are about the attempt of researchers to investigate the probability of depending on businesses, environments to transform organizations, performance in away that enhance the leading  role of organizations  in their environments , and through views of a number of the staff working in the foundation of technical institutes in Mosul.  .

     After deciding the methodology of the study that ,in one hand ,performs the goals of the study , and achieving a suitable theoretical framework to present the concepts of businesses, environments and the leadin

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
A New Vision in the Locality and the Factors of Forming Meander
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The research addressed an analytical field investigation of the locality of meander, the factors responsible of the locality of the meander at certain points of the stream other than others, and the role sequence of these factors in the formation process.
The research revealed that the location of forming the meander was associated closely with the scale structural composition of the bank materials from which the first stage of forming the curved stream, for the inhomogeneous or non-identical opposite banks in their scale structural composition saw an activity of differential corrosion, while the homogeneous and identical opposite banks in their scale structural composition saw an identical corrosion activity in its intensity at both

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Publication Date
Sun Mar 05 2017
Journal Name
Baghdad Science Journal
Study the Effects of Olive Leaves Extracts in the activity of the enzyme GOT and their Biological Activities
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The olive tree, has been used it is important plant for the time being some of their parts on a large scale in the treatment of gastrointestinal disorders and stimulate circulation . Moreover, it is used as antibacterial material and also to address some of the respiratory system, diabetes, food preservation osteoporosis. This study involved the collection of olive leaves from different areas in Baghdad / Iraq. These leaves have been harvested, wash it, then dried and crushed, where the study aimed to identify the active ingredients and chemical elements in the olive leaf as well as its effect on the action of GOT enzyme .The study showed that the aqueous extracts (cold and hot) of the olive leaves powder are acidic in nature pH values

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Effect of Swelling Soil on Load Carrying Capacity of a Single Pile
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Expansive soils are recognized by their swelling potential upon wetting due to the existence of some clay minerals such as  montmorillonite. An effective solution was found to avoid the danger of such soils by using piles. A single pile embedded in an elasto-plastic expansive soil has been analyzed by using one of the available software which is ABAQUS to investigate the effect of applied loads on pile’s top and investigate the effect of swelling soils on load carrying capacity of the pile. The result shows that as the pile is axially loaded at its top, the axial force along the pile gradually changes from (tension) to (compression) and the pile tends to move downward. The applied load needed to initiate pile’s settlement depend

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Publication Date
Sun Apr 15 2001
Journal Name
University Of Baghdad, College Of Veterinary Medicine
A Study of Antimicrobial Effect of Oil Extracts of Black Seed (Nigella sativa L.) on some Pathogenic Microorganism that is isolated from Clinical Pathogenic Cases.
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Publication Date
Wed Sep 30 2015
Journal Name
College Of Islamic Sciences
Preservation of the mind and its development Makassedi study in the light of prayers Almathur
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A great abbey in the Shari'a, and is therefore destined to be preserved in many texts and by methods
There are many prayers in the Qur'an and Sunnah to encourage them
They have a clear relationship with the preservation of the purposes of the Sharia in general, and with a purpose
Save the mind in particular, but the scholars - the mercy of God - when they declare that the costs of Sharia
Due to the preservation of my intentions in the creature, they limit their words to orders and intentions, and are not exposed
In particular,
If they were included in the texts of the Shariah and Tawjiyatiya,
To be related to the preservation of the purposes of the law, which confirms the words of the former leaders, and light the li

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Publication Date
Fri Dec 30 2022
Journal Name
College Of Islamic Sciences
Verses of cheerfulness and fluency of the face in the Holy Qur’an: An Objective Study
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Most of us are tired of the circumstances that surround us because of their deficiency, deprivation, and sullenness, even though troubles and pains are the soil in which the seeds of strong personality  sprout.             

   The content of the research is summed up in the fact that there is no need to frown, so let our face be free, and our word good and tolerant, so that we can be the most loving people of those who give them, and the Messenger of God (may God’s prayers and peace be upon him and his family) was known to be the heaviest  concerns  of people, but he was most smiling of people, by smiling, we buy lives, so we should get used to it, because that gives us hope and finds the world in our hands, an

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