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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 Oct 01 2009
Journal Name
Iraqi Journal Of Physics
The Structural and Optical Properties of Hydrogenated and Nitrogenated a-Si0.1Ge0.9 and a-Si0.1Ge0.9:3% B Thin Films
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It is shown that pure and 3% boron doped a-Si0.1Ge0.9:H and a-Si0.1Ge0.9:N thin films
could be prepared by flash evaporation processes. The hydrogenation and nitrogenation
are very successful in situ after depositing the films. The FT-IR analysis gave all the
known absorbing bonds of hydrogen and nitrogen with Si and Ge.
Our data showed a considerable effect of annealing temperature on the structural and
optical properties of the prepared films. The optical energy gap (Eopt.) of a-Si0.1Ge0.9
samples showed to have significant increase with annealing temperature (Ta) also the
refractive index and the real part of dielectric constant increases with Ta, however the
extinction coefficient and imaginary part of dielect

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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
Perceptual for enrolled and not enrolled the puplis in kindergartens (comparative study)
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Enrollment in kindergarten child accomplishes many positive aspects, that’s what Im sure a lot of modern educational trends in child education preschool in the importance of exposing children to a variety of sensory stimuli that contribute to impart a range of sound concepts.

Current research aims to know:

1.the level of sensory perception in the first primary grade students a sample search.

2.differences in perception of elementary first-graders with variable gender male, female))   3.differences in perception of the first primary grade students attending and not attending kindergarten in accordance with variable attendance (attending, not attending).

school students (first grade) from attendi

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Legend between reality and its future Treatment in threatre analytics study
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The Legend between reality and its future Treatment in threatre analytics study

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Publication Date
Wed Sep 21 2022
Journal Name
Journal Of Planner And Development
The Role of Information Technologies in the Management and Sustainability of Land Use in Future Cities
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The most important contemporary issues which related to the survey of the influence of communication development technology to land use sustainability. The research aims to explain the changes that happened in the quality & land use activities performance by understanding the transformations due to modern technology and its impact on current uses and its impact on changing functional relationships between those uses to create new combinations or hybrid uses.Research will follow the analytical descriptive approach in presenting the problem of research. Research has several conclusions & recommendations, one of conclusions is the change of the place concept and its relation to changing the concept of land use and its sustai

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Publication Date
Tue Sep 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
The problem of elevating the status of values in scienceStudy in economic thought and macro analysis
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ان من اهم القضايا التي تثيرها المعرفة البشرية في تجلياتها، وتعبيراتها المفاهيمية، تكمن في مدى تأصلها وانتمائها الى البنى والتشكيلات الموضوعية (في مستوياتها التاريخية) التي تسعى لتفسيرها وادراكها ومضاهاتها. فالينبوع الذي يغرف منه الفكر مادته هو الكيان الاجتماعي المتموضع خارج الوعي والايدولوجيا.

ان قدرة الوعي على ادراك الواقع الموضوعي بخصائصه العامة يشكل الشرط  الضروري لاكتساب الوعي ل

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Publication Date
Fri Mar 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Management skills and their reflection in the settlement of insurance compensation: Applied Study in National Insurance Company and Iraqi Insurance Company
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The environment contemporary works for the insurance companies have seen a number of technological developments and changes rapidly in light of the intense competition in the insurance market, and this affects human behavior in the workplace, and to director in his work needs to be a set of managerial skills. so we find compensation activity in companies insurance needs a high managerial skills, so that compensation, director of the settlement procedure successfully. So research aims to test two hypotheses two major belongings variables search using some statistical methods to extract the results and interpretation and analysis (such as arithmetic mean, standard deviation, percentages, Alpha Cronbach's coefficient, Pearson correlation co

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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the external audit in improving the performance of the services provided: Applied research in the municipal directorate in ALMuthanna
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The subject of improving the performance of services provided by government institutions of the important topics at the present time because of their direct contact at the service of citizens and the increased importance of these units as a result of the diversity of activities performed by the so governments of the countries and their people made sure to pay attention to the good use of those allocated to those sectors of resources and spending in the service prescribed and manage the highest level of efficiency and effectiveness and monitor the proper management of the money used in those sectors and evaluate their performance through the Supreme Audit Institutions so that they can play their role oversight and contribute to th

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Publication Date
Wed Apr 30 2025
Journal Name
Journal Of Al-farabi For Humanity Sciences (jfhs)
Colonialism and Anticolonialism in English Fiction: A Study of Defoe’s Robinson Crusoe and H. G. Wells’ The Country of the Blind الاستعمار ومناهضته في الادب القصصي الإنجليزي: دراسة في رواية دانيل ديفو (روبنسون كروسو) وقصة هربرت جورج ويلز (بلد العميان)
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Colonialism as a movement was very popular in Europe more than two centuries before. It aimed at controlling and exploiting several countries in Africa and Asia in addition to imposing their power and control on uninhabited islands. It received adherence and criticism as well. There also appeared activists and nations who stood against it and its practices. English novels discussed this notion greatly by pointing out the bad practices of the colonizers and how the colonized received them. This paper explores two narrative fictions that tackle the different aspects of the term. While Defoe, in Robinson Crusoe (1719), shows a colonial European figure who expresses his superiority, Wells, in “The Country of the Blind” (1904), deconstructs

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Cognitive-Behavioral Guidance Program in Reducing the Level of Addiction on Social Media in a Sample of High School Students in Karak Schools
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Abstract

The current research aims to develop a guidance program suitable for high school students and apply it to them in order to ensure the reduction of addiction to the use of different means of communication. The researchers used the scale of addiction to the means of communication (SAS) to measure the level of addiction as well as to identify the impact of the proposed guidance program in reducing the degree of addiction to communication. It was applied to a sample of (20) female students divided equally into two groups: an experimental group of (10) female students and a control group of (10) female students from the secondary level in a school under the department of education in the education of the alma

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Publication Date
Sun Mar 01 2009
Journal Name
Baghdad Science Journal
Determination of Similarity and Variance in Energy and Depositional Environment, the Difference in Diagenesis and the Variance in the Petrophysical Properties of Reservoir Rocks in Zubair Formation , South Iraq
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Records of two regionalized variables were processed for each of porosity and permeability of reservoir rocks in Zubair Formation (Zb-109) south Iraq as an indication of the most important reservoir property which is the homogeneity , considering their important results in criterion most needed for primary and enhanced oil reservoir .Z and F tests that were calculated for the two above mentioned properties of pair units of Zubair Formation have shown the difference in depositional energy and different diagenesis between units IL and AB , DJ and AB , and the similarity in grains size , sorting degree , depositional environment and pressure gradients between IL and AB units , LS and IL units ; also the difference in the properties above betw

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