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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 Dec 30 2015
Journal Name
College Of Islamic Sciences
The communicative dimension of Andalusian-Moroccan poetry In the classification and refining book (The pleasure of the soul of the five senses)
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The heritage of the human peoples remains a beacon of data, after renewed awareness of them, open to their propositions, which are born from the womb of intertwined elements of customs, knowledge, arts, and literature ... Misleading the reception process, it may be something intriguing to identify with caution with the text sample selected by the current search procedures prepared according to the adoption of a descriptive therapist in a three-dimensional approach, as well as a comprehensive textual reference for that specific communication dimension within Anthology Andalusian - Moroccan poetry in the book of pleasure in the perception of the five senses Tahdib ibn Manzoor (d. 711 e) from the origin of Tivashi (d. 651 e) Tagged: Separat

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Publication Date
Mon Jul 01 2019
Journal Name
International Journal Of Swarm Intelligence Research
A New Strategy Based on GSABAT to Solve Single Objective Optimization Problem
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This article proposes a new strategy based on a hybrid method that combines the gravitational search algorithm (GSA) with the bat algorithm (BAT) to solve a single-objective optimization problem. It first runs GSA, followed by BAT as the second step. The proposed approach relies on a parameter between 0 and 1 to address the problem of falling into local research because the lack of a local search mechanism increases intensity search, whereas diversity remains high and easily falls into the local optimum. The improvement is equivalent to the speed of the original BAT. Access speed is increased for the best solution. All solutions in the population are updated before the end of the operation of the proposed algorithm. The diversification f

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Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Lightwave Technology
A Random Number Generator Based on Single-Photon Avalanche Photodiode Dark Counts
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Publication Date
Mon Sep 03 2018
Journal Name
Al-academy
The Use of Light Text in Arab TV Shows (The Voice TV Program) -A Model
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The research tackles an important subject, namely, the light text and how it works well in the Arab television programs. The methodological framework of the research     presents the research problem stated in the following question: How can the text be used and what is its impact in the Arab TV programs? The importance of this research is that it deals with the subject of light text and its impact on Arab television programs.

This study is useful to the workers and scholars in the field of lighting as well as the goal of the research in (studying of the employment of light text in Arab television programs).

The limits of research were manifested in the study of the light text and how to make use of it

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Publication Date
Thu Dec 15 2022
Journal Name
Al-academy
Evaluating the education quality in the College of Fine Arts "Design Department as a model"
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Education quality evaluation is one of the objectives of education quality. The evaluation includes assessing the education standards and academic program outcomes to develop intellectual, scientific and practical concepts for the educational structure. It considers the determination of the rates of the number of accepted students and graduates. The research focuses on "what are the levels of education quality according to the evaluation mechanisms in the design department" to enhance the quality system and the objectives of theoretical and applied education.
It is identifying the levels of education quality and evaluating it according to the numbers and rates of graduate students of the design department branches for morning and ev

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Publication Date
Sun Jun 11 2017
Journal Name
Al-academy
The approach of deliberation in the ontemporary Iraqi theater text - theatricality Afwah-as a odel
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The deliberative system of communicative studies is exposed to cultural openness, according to modern cultural studies, to establish a verbal language system that achieves reciprocal and cross-cultural relations. This research has examined the concept of deliberative approach in the contemporary Iraqi theater text by studying the deliberative system of text and its interrelationship with The stage of the verbal embodiment of the dramatic event, because the dramatic text achieves in its construction of racism, a deliberative approach between the verbal event and the language, and what later leads to the completion of the dramatic action. The research included four chapters. The first chapter was the systematic framework of the research, T

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Publication Date
Wed Dec 01 2021
Journal Name
Baghdad Science Journal
A complete (48, 4)-arc in the Projective Plane Over the Field of Order Seventeen
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Publication Date
Thu Apr 25 2019
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
ROLE OF CORPORATE GOVERNANCE IN PROTECTING INVESTORS' RIGHTS / ANALYTICAL STUDY IN THE IRAQI STOCK EXCHANGE: ROLE OF CORPORATE GOVERNANCE IN PROTECTING INVESTORS' RIGHTS / ANALYTICAL STUDY IN THE IRAQI STOCK EXCHANGE
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The current research focuses on a major problem: the weak role of disclosing corporate information in the application of laws, regulations and instructions related to the application of corporate governance principles weakens the ability to protect the rights of shareholders and investors in companies listed on the Iraqi Stock Exchange and the study aims to study and analyze the role of disclosure and transparency in achieving the necessary protection to ensure the rights of shareholders. The study was applied to a sample of (42) analysis samples representing (84%) of the total questionnaires distributed to investors and shareholders in all listed companies in the Iraqi Stock Exchange. The results confirm the shareholder's right to obtai

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Publication Date
Tue May 09 2017
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
TIME MANAGEMENT AND WORK PRESSURE AND THEIR RELATIONSHIP TO ADMINISTRATIVE LEADERSHIP/ A CASE STUDY AT THE HIGHER INSTITUTE FOR ADMINISTRATIVE DEVELOPMENT OF SECURITY AND ADMINISRATIVE: TIME MANAGEMENT AND WORK PRESSURE AND THEIR RELATIONSHIP TO ADMINISTRATIVE LEADERSHIP/ A CASE STUDY AT THE HIGHER INSTITUTE FOR ADMINISTRATIVE DEVELOPMENT OF SECURITY AND ADMINISRATIVE
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The research aims to determine the strength of the relationship between time management and work pressure and administrative leadership, where he was taken a sample of (47) of the administrative leadership at the Higher Institute of security and administrative development in the Ministry of Interior was used questionnaire as a key tool in collecting data and information and analyzed the answers to the sample surveyed by using Statistical program (spss) in the arithmetic mean of the calculation and test (t) and the correlation coefficient, the research found the most important results: the existence of significant moral positive relationship between both time management and work pressure and administrative leadership, the leadership of th

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Publication Date
Fri Dec 31 2021
Journal Name
Political Sciences Journal
Populism in the Palestinian political discourse The Fatah and Hamas movements are a model
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Receipt Date:10/11/2021 Acceptance Date:29/12/2021 Publication Date:31/12/2021

Creative Commons LicenseThis work is licensed under a Creative Commons Attribution 4.0 International License.

The study aimed to clarify the conceptual explanations and the theoretical rooting of the concept of the populist phenomenon. And explore the political and cultural implications and connotations contained in populist political discourse. And to stand on the foundations and meanings on w

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