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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
Sun Mar 12 2017
Journal Name
Al-academy
The reality of Figure and content in the design of logos, civil society organizations
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Civil society organizations in Iraq have become a community hard case dispensable as the link between the state institutions and their leaders, and between citizens of different orientations and age groups, as it represents the diversity of the terms of reference and understanding of the laws and standards of Universal Declaration of Human Rights, which requires governments to provide supplies president of its citizens to live in dignity, direct and Msasha in the life of society and the dictates we scientific our role in achieving scientific benefit and transfer of expertise to the community has become imperative for the researcher to campaign in the midst of the scientific research of the slogans of those or

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
System of governance and administration in the state of the Ottoman Algeria (1518-1830)
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Algeria is one of the states that are important to the Ottoman state, because of its geographic location is important to the Mediterranean Sea, as well as the economic resources of the nature of its soil geography and climate,diverse, making it the focus of attention of the Ottomans, along with the van, which has increased the interest of the Ottomans in Algeriais the fall Andalusat the hands of the Spaniardsin1492, and force the Muslims to get out of them, and did not Only Europeans do it, butrushed to the prosecution of Muslims tothe coast of North Africa and seizing control of manyofits ports and cities, prompting the Ottoman state to go forth and back to the barn Muslims,Especially after hehad appealed to the Arabs of the Ottoman sta

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The impact of learning strategies in the collection of biology and their systemic thinking
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Research Summary The aim of the search for knowledge of the effect generative learning strategy in: 1 - Achievement of the second grade. 2 - Systemic thinking for the second grade students when studying the biology. The study sample increased (60) students distributed into two equal experimental and control groups. Prepare the test of 40 pieces of multiple choice type and prepare a test for systematic thinking according to three skills 1. Understand the relationships between the parts of the systemic form and complement the sentences given 2 - complement the relationships between parts of the systemic form 3. Building the systemic form. It was a search result 1- There is a difference of statistical significance (at level 0.05) between th

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Publication Date
Tue Mar 31 2020
Journal Name
College Of Islamic Sciences
The position of women In Literary Literature Models of the Arabic and Kurdish literature
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This research deals with the topic of "the status of women" in the literature of Sufism. The researcher cites a bundle of mystical yarns, and examples of verses and poems from this high literature that look at women with reverence and appreciation. The researcher tried to find an appropriate explanation and away from the arbitrariness of the symbols used by the poets of Islamic Sufism In their poems.

    The research is considered a comparative study of the Arabic and Kurdish dialects, by selecting six famous poets from the literature of literature, three of them from Arabic literature, and the other three from Kurdish literature, so the research is di

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Publication Date
Tue Jun 30 2020
Journal Name
College Of Islamic Sciences
The position of women In Literary Literature Models of the Arabic and Kurdish literature
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This research deals with the topic (the position of women) in the literature literature, and the researcher cites a bouquet of woolen yarn, examples of verses and poems from this fine literature that looks at the woman with respect and appreciation. In their poems.
The research is a comparative search for Arab and Kurdish literature, by selecting six famous poets in the literature, three of them are from Arabic literature, and the other three are from Kurdish literature, and thus the research is divided into two subjects and six demands.
Finally, the researcher tried to set a brick that would be an entry point to find an indicative explanation and a suitable explanation that would break those symbols and signs that caused the exp

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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Extent of Fulfilling Total Quality Standards by Applied Sciences Colleges in the University of Technology and Applied Sciences in Light of the National Strategy of Education 2040 in the Sultanate Of Oman.
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Abstract

The study aims to identify the extent to which the applied colleges at the University of Technology and Applied Sciences meet the comprehensive quality standards in light of the national education strategy for the 2040 Vision in the Sultanate of Oman. To do this, the researchers used the descriptive approach. They used a questionnaire as a tool for data collection that was applied to (237) administrators, academics, and support functions. The study found that the extent to which the applied colleges at the University of Technology and Applied Sciences meet the comprehensive quality standards in the light of the National Education Strategy 2040 in the Sultanate of Oman recorded a high range. The study als

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Publication Date
Thu Dec 29 2022
Journal Name
Journal Of The College Of Languages (jcl)
The morphological structure of nouns and verbs in the novel "Astonishment" by the novelist Aharon Applefield, Morphological study.: מבנה שמות עצם והפעלים ברומן תימהון לסופר אהרון אפלפלד עיון מורפולוגי
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This research sheds light on the morphological structure of nouns and verbs in the novel "ASTONISHMENT" by the novelist Aharon Applefield by analysing selected models from the novel in a morphological analysis in order to identify the most important morphological features of this structure according to a statistical analytical approach.

 The morphological structure is the main pillar of the linguistic structure of the literary text. Morphology is the science that studies the word, by which its structure and original letters are known, and the change that has occurred to it.  The aesthetics of the fictional text is reflected in this structure, through which the writer conveys his ideas and narrations to the reader.  The research

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Publication Date
Sat Jan 01 2022
Journal Name
Revista Iberoamericana De Psicologia Del Ejercicio Y El Deporte
THE EFFECT OF A PROPOSED TRAINING PROGRAM USING INTERMITTENT TRAINING TO DEVELOP SOME PHYSICAL AND BIO-KINEMATIC VARIABLES AND ACCURACY OF THE JUMP SPIKE SERVE SKILL IN VOLLEYBALL
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The purpose of this paper is to identifying the values of some physical and Bio- Kinematic variables during the performance of the jump spike serve skill, and identifying the effect of the proposed training program using intermittent training to develop some physical and Bio- Kinematic variables and accuracy of the jump spike serve skill among the research sample. The experimental method was used and the research was conducted on a deliberately chosen sample of the players of the Army Club, who were primarily advanced in volleyball, and the number of the sample was (10) players. The conclusions were reached that the proposed training program using intermittent training has a positive effect on some of the physical and Bio- Kinematic variabl

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Scopus (1)
Scopus
Publication Date
Tue Sep 01 2020
Journal Name
Baghdad Science Journal
Preparation of Polymeric Composites from Polypropylene and Palm Fronds and the Study of Some of Their Physical Properties
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Abstract:
              In this study a type of polymeric composites from melting poly propylene as a basic substance with Palm fronds powder were prepared. Evaluation of polymeric composites was done by studying some of it is mechanical properties, which included:Yong modulus (E), Impact Strength (I.S), Brinell hardness (B.H) and Compression Strength (C.S). The polymeric composites were studied before and after reinforcment by comparing between them. There was an increase in resistance of Yong modulus (E), Impact Strength (I.S), Brinell hardness (B.H) and compression Strength (C.S). Also, the effect of some acids were studied such as (HCl, H2

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Cognitive Conflict Strategy in Comprehending Reading Among the Fifth Literary Students in the Subject of Literature and Texts
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The aim of the current study is to identify the effectiveness of cognitive conflict strategy in comprehending reading among literary fifth students in literature and literature texts. The researcher uses experimental method with partial control. The sample consisted of (80) students distributed into control and experimental groups. The scientific material, the behavioral goals, the teaching plans, and the instrument of the research have been prepared (reading comprehension test) by the researcher.

The instrument's validity and reliability have been calculated and then applied to the sample. After treating the data statistically by using SPSS, the results have revealed that there is a statistically significant difference at the si

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