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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 Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
A Contrastive Study on the Syntactic Structure of Standard English and Standard Arabic Determiner Phrase
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The determiner phrase is a syntactic category that appears inside the noun phrase and makes it definite or indefinite or quantifies it. The present study has found wide parametric differences between the English and Arabic determiner phrases in terms of the inflectional features, the syntactic distribution of determiners and the word order of the determiner phrase itself. In English, the determiner phrase generally precedes the head noun or its premodifying adjectival phrase, with very few exceptions where some determiners may appear after the head noun. In Arabic, parts of the determiner phrase precede the head noun and parts of it must appear after the head noun or after its postmodifying adjectival phrase creating a discontinu

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Publication Date
Thu Jul 30 2020
Journal Name
Journal Of Sustainability Science And Management
THE DIFFERENTIATION IN WORK ENRICHMENT STRATEGIES AND ORGANIZATIONAL CREATIVITY FUNCTION: A PERSPECTIVE FROM THE LEADERS OF THE MINISTRY OF OIL IN IRAQ
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Publication Date
Wed Jan 01 2020
Journal Name
International Conference Of Numerical Analysis And Applied Mathematics Icnaam 2019
Prevalence of gastrointestinal parasites in Iraq during 2015
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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
Federated states of monks in the holy Quran (Study and analysis)
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Thank God also taught us that thanks . thank meets the blessings and rewards mazidk glory we have no knowledge except what you have taught you Alim hakim , not counted praise you as yourself praised and pray and to recognize the envoy mercy to the worlds , prophet Mohammed and his family and companions and guided to the day of judgment .
But after :
Aware of the interpretation of the most important science needed by Muslims because God Almighty sent down the Quraan to be a way of the life for Muslims is subject to a healing for what is in the breasts and it slaham and flaham and has spared the nation from crisisThe stats of the monks , like other verses talking about Christians and Jews and what they have invented in the religion o

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Timings of people and their significance in the Koran: (Objective study)
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We try through this research to show the relationship between the crescent and the month in the Koran, and then their importance and their relationship to timing, and the timing of this relationship with people, and the significance of these timings, so we gathered verses that spoke about the family and the month, and we tried to study them in a detailed objective study, so this came The research of five subjects was the first topic introductory research and the time and month, while the remaining four detectives on the verses that talked about the timing of the month, and we have explained the relationship of this timing with people and the significance of these times.

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Study of Traffic on The Roads The Governorate Of Karbala
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The study of traffic on the roads the governorate of Karbala, Where is the study of traffic on the roads measure is necessary to determine the extent of the road and highlighting the importance of its role in the transfer of individuals from original to destination as well as the importance of the region that attracted its movement. This research aims to analyze the traffic in the governorate of Karbala through the study and analysis of surveys of traffic that were made in the governorate. Based on this analysis, it has been reached to identify volumes of the traffic and its density and how the roads are efficient and accommodating these volumes, the results of the traffic survey of the studied roads in the area of the study have shown t

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
Obscene speech in the Qur'anic perspective An objective study based on the verses and interpretation of the Noble Qur’an in diagnosis and treatment
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t:

The most famous thing a person does is talk. He loves and hates, and continues with it confirming relationships, and with it, too, comes out of disbelief into faith. Marry a word and separate with a word. He reaches the top of the heavens with a kind word, with which he will gain the pleasure of God, and the Lord of a word that the servant speaks to which God writes with our pleasure or throws him on his face in the fire. Emotions are inflamed, the United Nations is intensified with a word, and relations between states and war continue with a word.

What comes out of a person’s mouth is a translator that expresses the repository of his conscience and reveals the place of his bed, for it is evidence of

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Publication Date
Sun Feb 17 2019
Journal Name
Iraqi Journal Of Physics
A Study of the electronic structure of CdS Nanocrystals using density functional theory
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Density Functional Theory at the generalized-gradient approximation level coupled with large unit cell method is used to simulate the electronic structure of (II-VI) zinc-blende cadmium sulfide nanocrystals that have dimensions 2-2.5 nm. The calculated properties include lattice constant, conduction and valence bands width, energy of the highest occupied orbital, energy of the lowest unoccupied orbital, energy gap, density of states etc. Results show that lattice constant and energy gap converge to definite values. However, highest occupied orbital, lowest unoccupied orbital fluctuates indefinitely depending on the shape of the nanocrystal.

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Publication Date
Sun Dec 01 2019
Journal Name
Al-ustath Journal For Human And Social Sciences
Landscape as History: A Postcolonial Ecopoetic Study of the Poetry of Derek Walcott
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Abstract: As human history is implicated in landscape or the natural history, it can be stated that the origins of the Caribbean writers' conflict, in general, are the colonial history of West India. That history which tells the story behind not only their fragmented identity, but also the problems connected to their language as well. Building on the arguments of the prominent Postcolonial ecoccritics such as Elizabeth DeLoughrey, George Handley, Helen Tiffin, and Graham Huggan, this research analyzes selected poems by Derek Walcott's which are bounded in his volume, Collected Poems. It shows how the Caribbean history has been erased due to the brutality of colonization offering landscape as a reliable source which has recorded that history

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Publication Date
Wed Dec 28 2022
Journal Name
Al–bahith Al–a'alami
Public Relations Strategies in Building the State’s Reputation An analytical study of the publications of the website of the UAE Ministry of Foreign Affairs and International Cooperation
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The aim of this paper is to know the persuasive methods and public relations strategies in building the reputation of the United Arab Emirates, since the UAE is progressing among the international indicators in good reputation. The researcher used the survey method, using the content analysis tool, to analyze the publications of the UAE Ministry of Foreign Affairs and International Cooperation for the period from 10/1/2021 to 12/31/2021.The researcher reached a set of results, the most important of which are: The UAE Foreign Ministry relied on public relations strategies in order to build a good reputation for the country, as it focused on the media strategy and gave little importance to the consensus-building strategy, as well as focuse

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