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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
Mon Jan 01 2024
Journal Name
2nd International Conference For Engineering Sciences And Information Technology (esit 2022): Esit2022 Conference Proceedings
Synthesis of Sn1-xMnxO2Nanoparticles and study of the structural and optical properties
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Publication Date
Tue Dec 28 2021
Journal Name
College Of Islamic Sciences
The concept of the phenomenon of nuns: an analytical ideological study
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ملخص البحث باللغة الإنجليزية

The concept of the phenomenon of nuns: an analytical ideological study

Dr. Samia bint Yassin Al-Badri

Department of Islamic Doctrine & Contemporary Ideologies

College of Shariʿah & Islamic Studies

Qassim University

 

The study of concepts is one of the main pillars of doctrinal studies, in order to understand the formation of the concept, and to understand its contexts in religious sources, in order to be systematically criticized; So, this research came with the title:

The concept of the phenomenon of nuns, an analytical doctrinal study

The study concluded with resu

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Publication Date
Sat Mar 30 2002
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study of the Factors Affecting the Efficiency of Reverse Osmosis Process
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Publication Date
Sat Nov 22 2025
Journal Name
Baghdad Science Journal
Study the effect of position on the time of astronomical twilight
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Twilight is that light appear on the horizon before sunrise and after sunset, Astronomically it is known that sunrise and sunset are effected by high above sea level, but the effect of high above sea level on the time of astronomical twilight still not decided and controversy among astronomers, in This research we studies the effect of high above sea level on the time of astronomical twilight, through adding the equation correct high above sea level to equation computation of twilight and then calculate of changing in the time of twilight for different highest (0-10000) meters above sea level , and the ratio of increase for time with high between (15.45-20.5) minutes. It was found that there was an increase in the time of the twilight along

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Publication Date
Wed Aug 17 2022
Journal Name
Al–bahith Al–a'alami
Lawyers’ Use of the Website of the Supreme Judicial Council and the Gratifications Obtained from It Drawn Research Submitted for the Study of the Higher Professional Diploma
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The field study of this paper focused on the motives for lawyers to use the website
of the Supreme Judicial Council, and the gratifications achieved as a result of its use.
This study sought to achieve a number of goals, including:
1. Monitoring the patterns of lawyers’ use of the website of the Supreme Judicial Council.
2. Determining the forms that lawyers use to interact on the website of the Supreme
Judicial Council.
This study is a descriptive in kind as the researcher relied on the ‘survey method’ in
its study of the external audience (lawyers) using the questionnaire and scale toolThe questionnaire was distributed among a deliberately chosen sample, consisting of
(160) lawyers who used the website of

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Publication Date
Fri Sep 15 2023
Journal Name
Journal Of Water Resources And Geosciences
Evaluation of Water and Wheat Productivity under Center Pivot Sprinkler Irrigation in Desert Soils/Holly Karbala Governorate
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Two field experimسents were conducted in one of the fields of the Agriculture Division of Ain Al-Tamr /Holy Karbala Governorate at two sites of different textures during the agricultural season 2020/2021. The first site has sandy loam texture (gypsum soils). The second site has loamy sand texture (calcareous soils). The factors of the study included: The first factor included two types of soil, gypsum and calcareous soil. The second factor is the tillage systems (no-tillage, spring spike harrows, disc harrows, and mold board plow). The experiment was designed in the two study sites according to the RCBD with three replications. The Valley type center pivot irrigation system was evaluated before planting, three speeds, 30, 50 and 100% of th

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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
The Interchange of Sign Transformation between Locality and Universality in the Iraqi Theatre, "Romeo and Juliet in Baghdad Show" - A Model
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The research deals with the interchange of the sign transformed from the universal to the local in the theatrical show through the direction processing in the production of a communicative artistic discourse and message, thus making the process of reading the speech and recognizing it by taking into account the cultural differences, customs and local rituals of each country, region, or area. The problem of the research was focused on answering the following question: What are the requirements for the sign in terms of its transformation between the universality and locality in the read-out?

               The importance of research is to determine the requiremen

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Organizational commitment and its role in enhancing the performance of employees : exploratory search of the views of a sample of managers and employees of the General Company for Dairy Products
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Expected to The organizational commitment by employees increases their loyalty towards their organization and thus contribute to enhancing their performance , therefore this study aimed to discover the relationship and the impact between the organizational commitment (emotional commitment, standard commitment, continuous commitment) and the performance of employees in the company researched, additional to know the available organizational commitment levels of employees in the company researched and its impact on the performance of employees, Research was conducted at the General Company for products in the dairy to achieve the goals of research has been developed questionnaire conation (22 ) items to collect data from the study s

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Phonological and Suggestive Rhythm in the Context of the Quranic Text: The Phonological and Suggestive Rhythm in the Context of the Quranic Text
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Abstract
The perpetuity of the Quranic discourse required being suitable for all ages.
Accordingly, the method of the Glorious Quran a pre request for the conscious
investigation and realization in order to detect the core of the texts, as the Quranic
discourse is considered a general address for the humanity as a whole. For this
reason, the progress of the concerned studies neceiated that it should cope with the
current development in the age requirements and its cultural changes within ages.
The texts of the Glorious Quran lightened the human reason as being the
Creator’s miracle for it is characterized by certain merits that makes it different from

poetry and prose. It is a unique texture in its rheto

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Publication Date
Thu Oct 06 2022
Journal Name
Advances In Systems Science And Applications
Stability and Bifurcation of a Delay Cancer Model in the Polluted Environment
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It is well known that the spread of cancer or tumor growth increases in polluted environments. In this paper, the dynamic behavior of the cancer model in the polluted environment is studied taking into consideration the delay in clearance of the environment from their contamination. The set of differential equations that simulates this epidemic model is formulated. The existence, uniqueness, and the bound of the solution are discussed. The local and global stability conditions of disease-free and endemic equilibrium points are investigated. The occurrence of the Hopf bifurcation around the endemic equilibrium point is proved. The stability and direction of the periodic dynamics are studied. Finally, the paper is ended with a numerical simul

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