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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
Fri Nov 01 2019
Journal Name
Global Journal Of Public Health Medicine
PURIFICATION OF INULINASE FROM KLEBSIELLA PNEUMONIAE AND STUDY THE ANTIBACTERIAL EFFECT OF COMBINATION OF INULINASE AND CEFTAZIDIME
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Klebsiella pneumoniae are Gram-negative which cause many diseases such as urinary tract infections, respiratory tract infections and septicemia. Inulinase is an enzyme used in food manufacture and pharmaceuticals. Inulinase is used in decreasing lipid ratio and, cholesterol in blood and considered as a prebiotic factor inside intestine. Many microorganisms can produce inulinase, such as yeast, fungi and bacteria; among such bacteria: Bacillus spp., Arthrobacter spp., and Pseudomonas spp. but there are no studies about inulinase production by K. pneumoniae have been reported. So the current study aims at investing the ability of producing and purification inulinase by K. pneumoniae. Method: K. pneumoniae were isolated from many hospitals and

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Economics And Finance Studies
THE ROLE OF EXTERNAL INDEBTEDNESS OF THE ECONOMIC AND FINANCIAL DEVELOPMENT IN IRAQ
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The imperative of achieving financial stability has transcended national boundaries, necessitating heightened attention from both researchers and policymakers. Consequently, this article delves into an examination of the impact of government debt and public debt on financial development within the context of Iraq. The study employs monetary policy, interest rate, inflation, and population growth as control variables to prognosticate financial development. Utilizing data extracted from the World Development Indicators (WDI) spanning the period from 1995 to 2022, the study employs the dynamic autoregressive distributed lag (DARDL) approach to scrutinize the associations under investigation. The findings underscore a negative association betwe

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Publication Date
Wed Jun 15 2022
Journal Name
Al-adab Journal
Semantic and stylistic characteristics of the category of the species in modern Russian
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هذه الدراسة مكرسة للخصائص الوظيفية والدلالية المعقدة للفئات اللفظية من التوتر والنوع في اللغة الروسية سيتم الكشف في هذه الدراسة عن السمات الدلالية والأسلوبية للفرق بين الأفعال المكتملة وغير المكتملة، قد تكون الاختلافات مرتبطة بخصائص المعاني المعجمية للكلمات، وكذلك معاني اللواحق المكونة للكلمات) السوابق واللواحق). يعكس استخدام هذه الفئة النحوية في أنماط مختلفة بوضوح تفاصيل كل منها، لأن درجة واقعية ال

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Publication Date
Sun Jan 05 2014
Journal Name
Journal Of Educational And Psychological Researches
The role of educational curricula and teaching methods in the development of environmental
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Described the Arabic language being of genius sets by top models of eloquence , rhetoric and clarity of sounds and developments Moreover , it is an important element of our existence and our identity and our survival . That my methods and best in teaching Arabic language what has pursued the easiest ways to learning and teaching and helped learners to be aware of the function linguistic information , and they need it and its impact on their lives , and contributed to unleashing the potential of activism and led them to make the effort to apply them in the form of examples and uses of new life , as well as fits are the capabilities and tendencies of different learners , so the goal of current research into the importance of the curriculum

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Publication Date
Wed Mar 15 2023
Journal Name
Al-academy
The Relationship of Aesthetics in the Art of Interior Architecture and Architectural Criticism
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The concept of aesthetics is one of the postmodern propositions, and it is one of the branches of philosophy that examines beauty, its standards and theories, and it is a holistic concept that includes several concepts, including the beautiful, the ugly, and the sublime.
The concept of aesthetics dealt with several studies in general (and in the field of architecture in particular), and the problem of aesthetics is in the blurring of the relationship between aesthetics and architectural criticism, based on the research hypothesis which states that there is a relationship between aesthetics and architectural criticism. The importance of the research in accommodating aesthetic standards and bases of evaluation that increases the possi

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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of The College Of Languages (jcl)
The tragedies of love and death in the tragedy of Federico Garcia Lorca
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Abstract:

    Federico Garcia Lorca is considered in european and american literary circles as revolutionary symbol of contemporary literature writer through close association with the concerns of his country and the world, and also through the violent propensity to freedom, emancipation and innovation. This personal multi-talent has a significant impact in the spanish literary movement, in particularly, and in world, in general. If Lorca has andalusia blood, is no stranger to contemporary arab man to read to him, and contemplates his experience analyst and literary critic. This research is serious study of this character. There is no doubt the reader will put in front of many facts about personali

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Publication Date
Sun Mar 12 2017
Journal Name
Al-academy
Polarization and the mechanism of communication in the form of industrial products (green)
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Our research which is under the name "Polarization and Communication mechanism in the formation of green industrial products " The problem of the research focuses in identifying what is polarization and its function mechanisms , by displaying the inventive and creative cases of the designer in how to exploit the industrial products and its recycling process to attract the user and recipient by asserting on the values of beauty of the appearance of the industrial product with the attraction Of the user and the recipient with the new function of that product and how its different from the function achieved by the old product , with consideration of nature and its preservation . The results of the research were as following : The designer e

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Publication Date
Thu Feb 01 2024
Journal Name
Kurdish Studies
The Jurisprudence of Clans in the Balance of Social Jurisprudence (Criticism and Analysis)
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It is known that the science of jurisprudence is one of the most important Islamic sciences. Because it is a science that regulates the life of man and society and provides them with happiness in this world and the hereafter, if they follow its provisions with precision and care. The importance of this topic lies in the fact that it represents an urgent social need to show the compatibility of tribal customs with social jurisprudence. The job of the jurists was and still is to clarify the legal rulings according to what the Holy Qur’an has shown, and what has been reported on the authority of the Great Prophet (6) and the pure imams (:).It is no secret to everyone that the Islamic civilization is (the civilization of jurisprudence), just

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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of the Self-Questioning Strategy on the Achievement of the Fourth Grade and Their Reflective Thinking in Physics
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Abstract

The aim of the research is to identify the effect of using the self-questioning strategy on the achievement of fourth-grade students in science and the development of their reflective thinking in physics in the city of Baghdad. The research sample was divided into two groups: an experimental group of (20) students and a control group of (20) students. The researchers developed two tools: a test of (40) multiple-choice questions. The second tool is a test to measure the reflective thinking skills of fourth-grade students. It consists of (25) multiple-choice questions distributed on skills as follow: reflection and observation, detection of inaccuracies, reaching conclusions, giving clear explanations, an

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Publication Date
Mon Jun 16 2025
Journal Name
مجلة كلية التربية الاساسية
A MINI-REVIEW ON THE FABRICATION OF EXPANDED GRAPHITE AND ITS METAL OXIDE COMPOSITES FOR THE PHOTODEGRADATION OF DYES
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This mini review provides an overview of methods for manufacturing expanded graphite (EGT) and the use of its composites with metal oxides in the field of photodegradation of dyes. Dyes from textile manufacturing represent a significant environmental pollution problem in waterways worldwide, highlighting the need for environmentally friendly and efficient technologies to remove dyes from industrial and local wastewater. Photodegradation technologies offer a low-cost, sustainable solution with minimal secondary pollution. Carbon-based materials, such as expanded graphite, are advantageous in enhancing catalytic activity. Accordingly, this review will explore the different fabrication techniques of expanded graphite and summarize the recent d

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