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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
Wed Sep 30 2020
Journal Name
College Of Islamic Sciences
Arabization and its contemporary applications A jurisprudential study of the provisions and certifications of Arabization and migration
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The place in which the person lives and his geographical and social environment have a great impact on building his personality, belief and culture, Islam has alerted the importance of the Muslim to make sure to choose the appropriate place in which he resides and dwells in that it is compatible with his religion and belief in order to ensure communication with Islamic knowledge in a way that enhances his belief Arabization occurs when a person makes himself an Arab by living the life of the Bedouins, and creates the morals of the Bedouins from the inhabitants of the Badia with its harshness, cruelty, ignorance and lack of understanding in religion and far from the sources of knowledge of Islamic knowledge. Blasphemy and polytheism, and

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Publication Date
Thu Jun 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Estimation of Time of Survival Rate by Using Clayton Function for the Exponential Distribution with Practical Application
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Each phenomenon contains several variables. Studying these variables, we find mathematical formula to get the joint distribution and the copula that are a useful and good tool to find the amount of correlation, where the survival function was used to measure the relationship of age with the level of cretonne in the remaining blood of the person. The Spss program was also used to extract the influencing variables from a group of variables using factor analysis and then using the Clayton copula function that is used to find the shared binary distributions using multivariate distributions, where the bivariate distribution was calculated, and then the survival function value was calculated for a sample size (50) drawn from Yarmouk Ho

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Publication Date
Wed May 01 2019
Journal Name
Journal Of Engineering
Optimization of Friction Stir Welding Process Parameters to joint 7075-T6 Aluminium Alloy by Utilizing Taguchi Technique
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In this study, a 3 mm thickness 7075-T6 aluminium alloy sheet was used in the friction stir welding process. Using the design of experiment to reduce the number of experiments and to obtain the optimum friction stir welding parameters by utilizing Taguchi technique based on the ultimate tensile test results. Orthogonal array of L9 (33) was used based on three numbers of the parameters and three levels for each parameter, where shoulder-workpiece interference depth (0.20, 0.25, and 0.3) mm, pin geometry (cylindrical thread flat end, cylindrical thread with 3 flat round end, cylindrical thread round end), and thread pitch (0.8, 1, and 1.2) mm) this technique executed by Minitab 17 software. The results showed th

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Publication Date
Sun Sep 06 2020
Journal Name
European Journal Of Dental Education
Evaluation of technology‐based learning by dental students during the pandemic outbreak of coronavirus disease 2019
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Publication Date
Wed May 18 2016
Journal Name
Al-academy
The Role of T.V. Shaws in Transmitting Violence in Children: An Analytic Study for T.V. Chanels for Children During 1/3/2014 – 1/9/2014: يوسف محمد حسين
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Our study comes up to clarify the role of television in spreading the culture of violence with a child. This study represents one of the important studies that have tried to highlight the impact of these programmes, particularly cartoons, on the child's behaviors, actions and acquired habits.Violence considers a common phenomenon among the people, as the role of the media, particularly TV has a vital role due to its properties, characteristics and its significant impact on different segments and groups in society and in children particularly through exposure to programmes of films.The results of the study have been affected by the rising proportion of females to males, and that the contribution of real life has a big role in the child ac

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Publication Date
Wed Mar 05 2025
Journal Name
Jordan Journal For History And Archaeology
The Construction of Al-Sultaniyyah City and Its Most Important Urban Manifestations During the Ilkhanid Mongol Period (651-756 AH/ 1253-1355 AD)
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The Ilkhanid Mongols (651-756 AH / 1253-1355 AD) were interested in urbanization and construction in keeping with civilized countries and to have an architectural imprint that competed with the neighboring nations. The Ilkhan Öljeitü Muḥammad Khudābandeh (703-716 AH / 1303-1316 AD), known for his love of building and construction, wanted to have a capital that would immortalize his name and history, so he ordered its construction to compete with contemporary cities, and he summoned workers and engineers from all over the world to contribute to its construction. The city has several educational and service institutions such as schools, ribats, khanqas, mosques, hospitals, markets, and baths, as well as a mausoleum for him, which

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Publication Date
Fri Jul 15 2022
Journal Name
Bmc Health Services Research
Design and evaluation of a new mobile application to improve the management of minor ailments: a pilot study
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Abstract<sec> <title>Background

Seeking pharmacist advice about minor ailments is a common practice among Iraqi patients because such advice is free and quick. Unfortunately, the assessment and management of minor ailments by Iraqi pharmacists were inappropriate. Therefore, this study aimed to develop a model for a mobile application that can assist community pharmacists in the diagnosis and management of minor ailments.

Methods

The scientific content of the application was based on the information in the symptoms in the pharmacy and British Nati

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Publication Date
Tue Mar 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The impact of cognitive processes in the areas of organizational changeApplied Study in the Directorate General of Training and Development / Ministry of Electricity
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Centric study on the interest of the Directorate General of Training and Development / Ministry of Electricity to consolidate the concept of process and enhancement of knowledge in the areas of organizational change، it reached a sample of the study (44) people who are highly heads of departments، technicians and administrators in different sections of the Directorate and by using the correlation coefficient (Spearman) & coefficient of simple regression been tested correlations between variables and the impact of the study، as has been reached to integrate the role of cognitive processes with the areas of organizational change and relationships that were significant at the level of overall dimensions and subsidiary organs.

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
THE USE OF SIMULATION AND LINEAR PROGRAMMING IN THE PLANNING OF AUDIT WORK (An Empirical Study in the Office of Financial Supervision)
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Research includes three axes, the first is the average estimate time of achievement (day) to work oversight, to five supervisory departments in the Office of Financial Supervision Federal and then choose the three control outputs and at the level of each of the five departments above, and after analyzing the data statistically back to us that the distribution of the times of achievement It is the exponential distribution (Exponential Distribution) a parameter (q), and the distribution of normal (Normal Distribution) with two parameters (μ, σ2), and introduced four methods of parameter estimation (q) as well as four modalities parameter to estimate (

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Publication Date
Wed Sep 01 2010
Journal Name
Al-khwarizmi Engineering Journal
A Study of the Effect of Kaolin as a Fuel Oil Additive on the Corrosion Inhibition of Fireside Superheater Boiler Tubes
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The objective of the present study is to determine the effect of Kaolin as a fuel oil additive to minimize the fireside corrosion of superheater boiler tubes of ASTM designation (A213-T22) by increasing the melting point of the formed slag on the outside tubes surface, through the formation of new compounds with protective properties to the metal surface. The study included measuring corrosion rates at different temperatures with and without additive use with various periods of time, through crucible test method and weight loss technique.

      A mathematical model represents the relation between corrosion rate and the studied variables, is obtained using statistical regression analysis. Using this model,

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