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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 Oct 01 2014
Journal Name
Al–bahith Al–a'alami
Study of the patterns of media frames used in the production of Arabic spring breaks in Al Arabiya channel
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production of the spot in the news channels - a study of patterns of spot media used in the production of spring breaks Arab Al-Arabiya

 The spacers news in Arabic, one of the messages that seek channel output are fit and policy on the one hand and meet the needs of viewers for information intensive and image influential to find out the latest developments on the Arab arena, especially the Syrian revolution on the other and thus The viewer for the type of coverage the stomach through a newsletter about the event on the one hand to keep following up on her and eager to watch the other hand

 

 

And sou

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Forced displacement in Iraq its causes and its effects on displaced families (A field study of displaced families to the city of Baghdad)
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After a temporary halt to forced thghebr in different cities of Iraq this methodlogy
opeations returned directiy in the areas of political conflict on the ground which are translated
operations and forced displacement violence es they operations aimed at completing the
forced displacement that occurred after the occupation in(2003)which took an upward curve
publicly after these events and some of which are aimed at the liquidation of some provinces
than any demographic diversity of religious or sectarian or alhens and others aimed at
redemographic distribution within the province itself to produce a net sectarian zones as is the
case in Diyala Nineveh and Babylon Baghdad has the epicenter of sectarian violence and th

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Publication Date
Tue Jan 19 2021
Journal Name
Isprs International Journal Of Geo-information
The Potential of LiDAR and UAV-Photogrammetric Data Analysis to Interpret Archaeological Sites: A Case Study of Chun Castle in South-West England
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With the increasing demands to use remote sensing approaches, such as aerial photography, satellite imagery, and LiDAR in archaeological applications, there is still a limited number of studies assessing the differences between remote sensing methods in extracting new archaeological finds. Therefore, this work aims to critically compare two types of fine-scale remotely sensed data: LiDAR and an Unmanned Aerial Vehicle (UAV) derived Structure from Motion (SfM) photogrammetry. To achieve this, aerial imagery and airborne LiDAR datasets of Chun Castle were acquired, processed, analyzed, and interpreted. Chun Castle is one of the most remarkable ancient sites in Cornwall County (Southwest England) that had not been surveyed and explored

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Illegal migration and the European Union " a perusal of securing the phenomenon"
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Abstract This study seeks to deal academically with how the EU treats clandestine immigration, through adopting a purley security approach, based on the European understanding of security threats posed to the security of communities and States in EU at all levels. So they agreed upon criminalizing this threat within the bloc while using repressive tools and steps to limit illegal immigrants flow to European territories. Accordingly, the EU gave the phenomen a security character. So it takes it from low politics level , that of employment and economic field to that of high politics, as a new security problem lying within a new security language embraced by ruling European elites, in other words EU touched on this issue as a speech act emp

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Bacteriological study of water tributary Zab down and its impact on the environment the waters of the Tigris River
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During the study the current selection seven stations in the Zab River bottom and the Tigris River took samples a month to study the signs of bacterial contamination study coliform and colon fecal Almsobhaat and Almsobhaat Bazah and the total number of bacteria and bacterial gangrene gas causing Knkeran as well as a study to isolate and diagnose some races and types of bacterial pathogens in water or intensityusing the traditional system and the system of intestinal bacteria

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Publication Date
Thu Dec 15 2022
Journal Name
Al-adab Journal
Metaphors and comparisons as a means of rethinking the phenomena of the surrounding world
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The article characterizes metaphors and comparisons as a means of rethinking the phenomena of the surrounding world; two directions are named within which metaphors and comparisons are studied: 1) the linguo-classification direction combines several classifications of metaphors and comparisons, which are basically focused on comparing two denotations through the meanings of word forms that are part of the trope; 2) the theoretical and conceptual direction is associated with the concept of conceptual displacement and is the basis of the theoretical and methodological study of metaphor and comparison, i.e. the modern theory of metaphor is being formed; The main attention is focused on the comparative concept of Aristotle, which postul

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
A Unit Plan Based Upon The MI Theory: A theoretical study with an application Inside The Classroom
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This research basically gives an introduction about the multiple intelligence
theory and its implication into the classroom. It presents a unit plan based upon the
MI theory followed by a report which explains the application of the plan by the
researcher on the first class student of computer department in college of sciences/
University of Al-Mustansiryia and the teacher's and the students' reaction to it.
The research starts with a short introduction about the MI theory is a great
theory that could help students to learn better in a relaxed learning situation. It is
presented by Howard Gardener first when he published his book "Frames of
Minds" in 1983 in which he describes how the brain has multiple intelligen

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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 Jan 01 2017
Journal Name
Aro-the Scientific Journal Of Koya University
A Comparative Study for String Metrics and the Feasibility of Joining them as Combined Text Similarity Measures
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