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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 Nov 22 2025
Journal Name
Al–bahith Al–a'alami
Media separation: The Relationship of Arab Immigrants with the Media of the Countries of Diaspora (Sweden as a model) (A Research Derived from PhD Dissertation)
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The research seeks to study the subject (Media separation: the Relationship of Arab Immigrants with the Media of the Countries of Diaspora/ Sweden as a model). Where this phenomenon, "problem" has not been subjected to an in-depth study to find out the causes of this media separation and its repercussions on the immigrant, whether in the problem of integration, or his opportunity to work, or adapt to live in the new society.

Separation is a kind of word that is rarely used in Arabic media studies, relevant, sometimes, to the meaning of “refraining from watching TV or listening to the radio or reading newspapers”. Sometimes, it means “not tuning to or using any form of media like radios or newspapers to be updated about what

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Publication Date
Tue Jan 01 2019
Journal Name
African Journal Of Hospitality, Tourism And Leisure
Integrating the value chain and balanced scorecard to evaluate the overall performance of a tourism organization
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This study presented an endeavour to integrate the value chain activities with the Balanced Scorecard for a comprehensive evaluation of an organization’s strategic performance. It also demonstrated the connection and the integration of the activities of the value chain with the Balanced Scorecard. The financial measurement was linked with non-financial measurement by integrating these techniques to achieve an appropriate performance that supports all aspects of the organizational performance. Consequently, the research problem in this study emerged, which is due to the concentration of many organizations on the measurement of financial performance. Notably, the latter caused the decline of some organizations from the competitive market. T

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Publication Date
Tue Jun 30 2015
Journal Name
Al-khwarizmi Engineering Journal
Deflection Analysis of an Elastic Single Link Robotic Manipulator
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Abstract

Robotics manipulators with structural flexibility provide an attractive alternative to rigid robotics manipulators for many of the new and evolving applications in robotics. In certain applications their use is unavoidable. The increased complexity in modeling and control of such manipulators is offset by desirable performance enhancements in some respects. In this paperthe single- link flexible robotics manipulator was designed and implemented from Perspex and designed with 0.5 m length , 0.02 m width and with 0.004 m thickness with mass located at the tip. There are four subsystems; motion, control, accelerometer and gyro and a host computer subsystem. The work principle of single-link robotics manipul

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Publication Date
Wed Sep 18 2019
Journal Name
مجلة الدراسات الدولية
The media message of ISIS: The content of the discourse and the mechanisms of media confrontation. The media message of ISIS: The content of the discourse and the mechanisms of media confrontation.
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يهدف البحث الى صياغة استراتيجية اعلامية لمواجهة اعلام التنظيمات الارهابية

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Publication Date
Fri Jan 01 2021
Journal Name
Prepodavatel Xxi Vek
Enrichment of Vocabulary and the Formation of Grammatically Correct Speech of Foreign Students When Studying the Text of a Literary Work
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Publication Date
Sun Jun 12 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Study the Effects of Anadrol Overdose on Liver Function in Male Rats
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Anadrol (oxymetholone) is an active androgenic anabolic steroid that has been clinically studied in numerous diseases since the 1960s. It is used in the treatment of anemia and the replacement of male sex steroids. Unfortunately, in attempts to improve physical performance, Anadrol could be misused by athletes, that can lead to poisoning contributes to hepatotoxicity.

The aim of this study was to investigate the impact of anadrol on the liver function in rat model, via assessment of liver enzymes and histopathological study.

A forty male rats, weights about (200-300 gm), aged 8-12 weeks, after acclimatization, the rats were ‎randomly divided into four groups (10 rats in each group) as follow: control group (in w

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Study the Application of Ultrasonic Technology for Phenol Removal in Petroleum Industry
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In this study, the sonochemical degradation of phenol in water was investigated using two types of ultrasonic wave generators; 20 kHz ultrasonic processor and 40 kHz ultrasonic cleaner bath. Mineralization rates were determined as a function of phenol concentration, contact time, pH, power density, and type of ultrasonic generator. Results revealed that sonochemical degradation of the phenol conversion was enhanced at increased applied power densities and acidic conditions. At 10 mg/L initial concentration of phenol, pH 7, and applied power density of 3000 W/L, the maximum removal efficiency of phenol was 93% using ultrasonic processor at 2h contact time. Whereby, it was 87% using and ultrasonic cleaner bath at 16h contact time and 150 W

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Publication Date
Fri Feb 23 2018
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Study the Influence of Captopril on Bone Metabolism in Elderly Hypertensive Women
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Widespread use of antihypertensive agents in clinical practice necessitates the knowledge of their pleiotropic effects. At the present time there are no sufficient evidences of positive effect of these medications on bone coming from randomized controlled trials; knowledge of additional effects of those drugs on the bone metabolism will allow doctors to choose optimal treatment of hypertension, taking into account the state of bone tissue. At the same time it will also allow to prevent osteoporosis in patients having osteoporosis risk factors or initial signs of bone loss.

Ten elderly hypertensive women age > 60 years old (64.2±3.6) treated with captopril for a 5-6 years ago while they attending Al Yarmouk Teaching Hospital i

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Standards Evaluate The Performance of Emergency Departments In Iraqi Hospitals / Case Study
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     This study aims to evaluate the performance of emergency departments according to international standards through studying the performance in some of Iraqi public hospitals, where the evaluation performance is considered one of the important topics that take a great deal of officials' attention, especially decision makers in health organizations.

      The researcher has derived the research idea from the importance of work in emergency department in hospitals and to what it provides of medical services and quick and immediate nursing care that help in patients' lifesaving, and it is the mirror that reflects the real image for the hospital

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Publication Date
Mon Jan 02 2017
Journal Name
Al-academy
Aesthetic art of stained glass in the middle Ages Study (historical analysis)
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This paper deals with the role of the clergy in the Church and artists in the emergence of this art, which is represented by an atmosphere of spiritual, aesthetic, artistic, technical and engineering very magnificence and is located in two Find.Chapter One: the stages of stained glass in the Middle AgesThe Architects Goths to get rid of the walls gradually, based Baloctav plane, columns and beams strengthened with the vehicle, as previously mentioned, making the building looks like a glass of excessive use of colored windows building, this art has been known to the art of stained glass And the second chapter: the stages of stained glass in the Middle Ages Department of Winston (Winston) works of stained glass since its inception in the t

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