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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
Sat Dec 15 2018
Journal Name
Journal Of The College Of Education For Women
Bayiyatan Abi Firas Al-Hamadaniy's on the horns of ad dilemma of prison and longing a stylistic analytical study
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Abstract

The current study aims to study one Firas Al- Himdani's  Romeyat poems (320 – 357 AH), he was one of sham poets in the era of the Abbasid as to know the glories of the knight and Arabic poet, whose message led to preserve the honor of the nation and Islam prestige , along with exposing the better one . His message includes Arabic merits and high values in respect of chivalry , encouragement , sacrifice , forgiveness and tolerance in addition to morality and patience .

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Analysis of the clause relations in the presidential presuasion in a war against Iraq
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Publication Date
Wed Oct 05 2022
Journal Name
Journal Of Basic Science
Loss in the Translation of Colour Euphemstic Expressions in the Qur’an: A Pragmatic Analysis
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Publication Date
Sun May 10 2015
Journal Name
Al-academy
The system and Disorder of shape and content in Interior Design Educational halls in the Ministry of Labor and Social Affairs (Analytical study): رجاء سعدي لفتة
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Dealing with this study to find a link principle in the construction of the system and disorder to the promise of the principles and concepts of intellectual and philosophical form and content in the act of interior design of the halls education in the Ministry of Labor and Social Affairs , which leads to a reaction design objective and functionally and to increase the strength of the effect on users of the coaches and trainers . As it informs the side cognitive and developmental study of the design of the interior spaces . So it was the goal of research in the detection of the nature of the system and disorder with Focus indicators and the type of regulations and privacy and what constitutes the framework of knowledge in order to explai

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Publication Date
Wed Oct 01 2014
Journal Name
Al–bahith Al–a'alami
Student Survey in Public Relations Services, Registration and Counseling, A Case Study of Petra University for the academic year 2013/2014.
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The research discusses the public relations services, registration, and academic advising at Petra University for the years 2013-2014. Using a field study and surveying Petra University students to be informed about the services and to cover the tiny details that have to do with public relations role in the university as a specialized department interested in serving public and gaining their trust in terms of what is legal and possible to build and enhance the university reputation. And gain mutual trust between the university and its publics.
The public relations is consi

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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Using Public and Private Cloud Computing in developing the Evaluation System of annual employees' performance at Iraqi Universities: A comparative study
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Abstract

Business organizations are using the technological innovations like cloud computing (CC) as a developmental platform in order to improve the performance of their information systems. In that context, our paper discusses know-how in employing the public and private CC to serve as platforms to develop the evaluation system of annual employees' performance (ESAEP) at Iraqi universities. Therefore, we ask the paper question which is Is it possible to adopt the innovative solutions of ICTs (Like: public and private CC) for finding the developmental vision about management information systems at business organizations?”. In addition, the paper aim

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
The effectiveness of change and transformation of formal displacement in the internal space (historical passenger stations as a model)
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Intellectual and material displacement is one of the design strategies through many mechanisms and means, and depends on the idea of changing the shape within the internal spaces at times and has concepts related to the transformation at other times. And represented by the boxes for travelers, the research problem emerged through the following question: (What is the effectiveness of displacement in the formal structures in the interior design of historical sites), and the aim of the study is to reveal the reality of the use of historical internal spaces and to determine the formal displacement that occurs as a result of change and transformation, and it included two topics, the first topic Transformation and the effectiveness of formal d

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Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The phenomenon of Corruption and its impact on the growing problem of Unemployment in Iraq after a year ( 2003 ).
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        Corruption is a phenomenon that exists in all times and places, they appear in the developing countries and in developed countries, and in all political systems. And its repercussions and economic repercussions on the society in which it is rampant, and lead to the undermining of economic development and obstruction, is also working on increasing poverty and unemployment, as well as its role in the worsening of social problems, and political instability. And corruption is deviant behavior is illegal and contrary to the teachings of the religious and moral values. The emergence of this phenomenon is due to several reasons, including political, economic, social and cultura

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Publication Date
Mon Sep 30 2019
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
A Comparative Study of the Influence of Different Types of Polymers on Viscosity Index and Pour Point of Iraqi Base Oils
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In this study, the effects of blending the un-branched acrylate polymer known as Poly (n-decyl acrylate), and the branched acrylate polymer known as Poly (iso-octyl acrylate), on the viscosity index (VI), and the pour point of the Iraqi base stocks 40, and 60 respectively, were investigated. Toluene was used as a carrier solvent for both polymer types. The improvement level of oils (VI, & pour point) gained by blending the oil with the acrylate derived polymers was compared with the values of (VI, and pour point) gained by blending the oil with a commercial viscosity index, and pour point improver. The commercial lubricant additive was purchased and used by Al-Daura Refineries. It consisted of an un-known olefin copolymer dissolved i

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Publication Date
Sun Dec 27 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Analysis of factors affecting the desire of the customer and their impact on the market share in a competitive market National Insurance Company
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The research aims to identify the factors affecting the customer and their impact desire for market share in a competitive market National Insurance Company, where he was after the tremendous developments that have taken place in the insurance sector, crowded markets, private companies and the intensified competition among those companies on one side and public sector companies, including national insurance company on the other hand, increased attention and study in a big way the customer and the factors influencing the desire. As the national insurance company ascertains its targets once the sale of insurance documents only, but by knowing the tendencies and aspirations of current and prospective customers a way that helps to strengthen

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