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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
Thu Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The relationship between organizational justice and empowerment and their impact on achieving organizational commitment (field study in the Department of Labor and Vocational Training)
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The research has deal with the relationship between organizational justice and empowerment and their impact on the achievement of organizational commitment in the office of Labour and Vocational Training. To study the research problem which is represented a sense that employees with low levels of organizational justice and empowerment and the reflection on the organizational commitment of the employees, so that Has been collecting data and information relating to research by designing a questionnaire, were distributed to a sample of (50) people in the office mentioned, and the results of the study to confirm the research hypotheses. and the key results of the research was the presence of correlation relationships and the effect o

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Employing the results of evaluating employees'performance in achieving organizational integrity Field study at the Technical Institute in Mosul
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The objective of the study is to study how to employ performance evaluation in achieving organizational integrity and the impact of performance evaluation on achieving organizational integrity. In light of this, the following questions were raised:

Are the dimensions of organizational integrity available in the field in question?

In order to answer the research questions, a questionnaire questionnaire was distributed to the sample of 30 members of the teaching staff at the Technical Institute in Mosul. The three-dimensional Lycert scale was used. The statistical methods were used, ie, the frequency distribution, the computational circles, the standard deviations, Pearson), simple

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Publication Date
Sat Feb 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The impact of customer contact on operation performance Case study in the specialist Dental Centre in Al-alwia
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the researchers Sought to determine the impact of the customer contact (Within a client contact there are two times, first is the total time required to create a service and within it there is contact time while the second time is the time of client contact ؛ where means a time that records the physical presence of the customer during the process of service) on operations performance by concentrate attention on the cost (labor productivity) and quality (patient ratio to the doctor) and speed (cycle time) and flexibility (the flexibility range) , as well as ruling out variable of innovation because of impossibility to measure this variable in the Specialty Center for Dental in al-alwia due to the center is lacking of mechanisms t

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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
The impact of a practical treatment program in enabling victims of bullying in a sample of 6th graders
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This study was aimed to explore the impact of a practical program on supporting and reducing
symptoms of school bulling victims in a sample of student in the sixth grade. The study sample consisted of (18)
students that have been chosen from two schools (Al-Abass and Alataa’) it was an intended sample, because
there were enough student with high scores in bulling victims diagnostics test, the sample was divided into two
groups: the control group of (9) student from (Alataa’) school, and the experimental group consisted of (9)
student from Alabass) school keeping in mind to keep the two groups equivalent in maintaining equal controls.
The researcher applied the practical program which is based on cognitive behavioral

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Publication Date
Wed May 18 2016
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
THE APPLICITIONS OF JUST IN TIME PRODUCTION AND ITS ROLE ON THE COMPONENTS OF MARKETING INFORMATION SYSTEM: AN APPLIED STUDY IN ALMANSOUR OUR STATE COMPANY FOR CONSTRUCTIONAL CONTRACTS.: THE APPLICITIONS OF JUST IN TIME PRODUCTION AND ITS ROLE ON THE COMPONENTS OF MARKETING INFORMATION SYSTEM: AN APPLIED STUDY IN ALMANSOUR OUR STATE COMPANY FOR CONSTRUCTIONAL CONTRACTS.
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Live the present companies in a competitive business environment going on and try to achieve excellence in their industry through the marketing of their products and achieve greater market share as possible to ensure its continued existence, and perhaps the concept of time production, which confirms, in essence, on the need to reduce inventory to a minimum in the production process as well as the concept of the marketing information system which asserts, in essence, to document all the events that are related to the marketing of the product provided by the production process, together constitute the subject deserves research and investigation as they have raised well-known in the fields of production management and marketing management.

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Publication Date
Sun Jun 30 2024
Journal Name
Lark
The Image of the Arab in Hebrew Literature for Young Adults – A Reading of the Novel “Nadia” by Kalila Ron Feder
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يهدف هذا البحث الى التطرق الى صورة العربي كما يعرضها ادب اليافعين العبري في رواية " نادية " للكاتبة العبرية " كاليلا رون فيدر " . والتي تعد من الاديبات العبريات اللواتي تطرقن بصورة مباشرة الى موضوع ما خلف الجدار ، والصراع العربي – الإسرائيلي وانعكاساته على المجتمع الإسرائيلي بصورة عامة والمجتمع العربي بصورة خاصة . ينقسم هذا البحث إلى ثلاثة فصول، تطرق الفصل الأول  إلى "ادب اليافعين"، و تاريخه ، مميزاته والفئ

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Publication Date
Fri Jun 20 1930
Journal Name
College Of Islamic Sciences
Education in the Koran: (Objective study)
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The name of God the Merciful
Praise be to Allah, Lord of the Worlds, and prayers and peace be upon the prophets and messengers Prophet Muhammad and his family
And his companions who followed his approach to the Day of Judgment. After that, Islam has paid great attention to the aspects of education
The promise of a way to degrade and correct behavior, and to reach the individual to the highest levels through his intellectual upbringing
Mentally, mentally, mentally and intellectually, education at all times and places is the best way to communicate to a human being
The degree of happiness in religion and the other, as it develops all aspects of his personality, and supports the love of goodness for himself
For people, edu

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Publication Date
Sun Dec 16 2018
Journal Name
Al-academy
The Overlap of Visions between the Scenographer and the Director in the Theatrical Show
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After the spread of the function of the scenographer in the modern theater, his vision has become present in most of the theatrical works and because the director is the master of the work and the owner of the vision that appears in front of the audience, the overlap between the visions of each of them was required. This research is an attempt to detect the overlap and disengagement in the work of each of them.
The research is divided into a methodological framework that included the research problem, importance, limits, and purpose, and then the definition of terms. In the theoretical framework, the research dealt with two theoretical sections that pave the way for raising ideas related to this subject: the first section (scenography

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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
(Love and Love) in the light of the significance of Quranic
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Thanks allah and peace be upon our prophet muhammed and upon his family and his
followers……
Love means in holy quran what comes to people s mind nowadays and what it inspired its
signi ficence is related with sensual desire and it means adore and passion .by the waythe
word (ishiq) adore wasn’t mentioned in holy quran which means that both of their bases are
farfrom each oiter in m eaning.
The significance of love means virtue while adore means the excess and desire so adore is
dis praised . as al askari said (died 395h )between love and adore.adore is the strain of desire
to get the purpose from lovers if it was ahuman who intended to make love affairs.
Today both of love and adore changed in their meani

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Publication Date
Wed Aug 02 2023
Journal Name
Migration Letters
The Effectiveness of the Public Relations of the Sunni Endowment Diwan through Social Networking Sites: An Analytical Study of the official Facebook page of the Diwan
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The Internet has added another dimension to public relations in institutions and organisations, as it provided tools and communication channels, especially social networking sites, which provided information and data on public relations for the institution through these websites. In addition to its communication with its audience, and the audience's interaction with it, so our research tagged (the effectiveness of public relations of the Sunni Endowment Diwan through social networking sites): An analytical study of the official Facebook page of the Diwan that addresses the knowledge and monitoring of the contents of the official Facebook page that public relations adopt in providing information, data, and activities of the Sunni End

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