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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
Tue Aug 18 2020
Journal Name
Journal Of Mechanics Of Continua And Mathematical Sciences
THE COMPARISON OF THE METHODS ESTIMATING THE FRACTIONAL DIFFERENCES OF PARAMETER AND ITS DEPENDENCE ON ESTIMATION THE BEST LINEAR MODEL OF TIME SERIES IN THE ENVIRONMENTAL FIELD
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Publication Date
Wed Oct 17 2018
Journal Name
Journal Of Economics And Administrative Sciences
The use of the Principal components and Partial least squares methods to estimate the parameters of the logistic regression model in the case of linear multiplication problem
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Abstract

  The logistic regression model is one of the nonlinear models that aims at obtaining highly efficient capabilities, It also the researcher an idea of the effect of the explanatory variable on the binary response variable.                                                                                  &nb

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Publication Date
Mon Feb 13 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of the Cooperative Inquiry Strategy in the Achievement and Development of Mathematical Communication Skills of Elementary School Students
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Abstract

This study aims at investigating the effectiveness of the cooperative inquiry strategy in developing the achievement and development of mathematical communication skills of elementary school students. To achieve this aim, the experimental method was utilized. The study sample consisted of an experimental group (n = 34) and a control group (n = 31), which were randomly selected from primary schools. A Teacher's Guide for teaching a unit entitled "Statistics and Graphic Representations" for the sixth elementary graders in the first semester were devised. A (30) multiple-choice item achievement test distributed at the levels of (recall, comprehension, and application), as well as an (18) item mathematical c

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Publication Date
Mon Feb 13 2023
Journal Name
Journal Of Educational And Psychological Researches
The Future of Educational Management Reform in Ibn Ashour Vision of Purposes and the Objectives Of The Kingdom's Vision 2030
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The study aims at explaining the extent to which the principles of educational management reform contribute to Ibn Ashour in achieving educational management reform and the extent to which the pillars of the Kingdom's Vision 2030 in the field of Education in achieving the educational management reform. The study also aims to provide a future vision of what the educational administrative reform and its results should be in the Kingdom during the next ten years. To achieve the goals of the study, the researcher followed two approaches: on the theoretical side, he relied on applying the content analysis method. As for the applied side, the researcher adopted the Delphi method by two questionnaires to ask (36) participants from the experts a

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Publication Date
Mon May 27 2019
Journal Name
Al-academy
The Deliberative Action in the Labor Market of Iraqi Art The Concepts and the Application: شيماء وهيب خضير
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The analysis of the orientations of Iraqi art commodification contributed to the discovery of deliberation, which was founded in the deliberative discourse in the trends towards commodification in the Iraqi art, since the important transformations in social structures and relations produced a dictionary with new vocabulary and tools that replaced the traditions and norms that have been in circulation for a century. Deliberation and commodification have become more prevalent in the mechanics and trends of the art where the pace of change is becoming increasingly frantic towards the market. The general market for art constitutes one of the most effective phenomena within contemporary art, that there has been a proliferation of sales auctio

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Publication Date
Wed Jan 01 2020
Journal Name
International Journal Of Innovation, Creativity And Change
The techno-strategy of the management information system and its role in enhancing risk management in the general directorate of school and sport activity
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The importance of this research lies in shedding light on the concept of techno-strategy for information management from vital and important topics that showed response for change in all areas of life. As this necessitates the updating and changing of it in order to achieve its strategic goals and enhance its technological advantage. The research problem looked at the role of the information technology system (ITS) in enhancing risk management in general directorates for sports and school activity from the viewpoint of its department heads. The research aimed at the relationship of information techno-strategy in risk management and the ratios of the contribution of information techno-strategy in risk management from the viewpoint of heads o

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Scopus
Publication Date
Mon Jan 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The impact of the proposed strategy in accordance with the objectives of science in achievement and some science operations at the second-grade middle students in chemistry
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It aim current researchs֬ to identify the impact of a proposed strategy in accordance with the objectives of science in the achievement and some science processes, where the experimental method was adopted, and define the research community was students second grade averag in Education Bagdad / Rusafa third, research sample intentionally chosen as school Radwan, and (30) students experimental group and (29) of control group, research tools were achievement test and the test of science operations and use the appropriate statistical tools to process information and data, showing results, the experimental group surpassed the control group in the collection and operations science, and light it, the researcher recommended several recommendat

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Publication Date
Sat Jan 01 2022
Journal Name
Mustansiriya Medical Journal
Molecular Detection of Agglutinin-Like Sequence 1 Gene in Candida albicans that is Isolated from Diabetic Foot Patients
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Objectives:

Candida albicans is a microbe living within the natural human flora and is found in the upper respiratory tract, mouth, intestines, and vagina. C. albicans is able to cause infections that range from superficial infections of the skin to life-threatening systemic infections.

Aim of Study:

Detection of virulence gene agglutinin-like sequence (ALS) 1 by using molecular technology from clinical samples (C. albicans

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Publication Date
Mon Feb 25 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Planning and implementation of the audit process by using the styles of time management and its impact on the quality of the audit process: Applied Research in the Federal Board of Supreme Audit
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Witnessing the global arena many changes in the political, economic, social, scientific and technological have left their mark on the world as a whole, these changes require necessarily Advancement of the profession of auditing, and improve their performance, especially after the mixer skepticism the health of approach and the method followed by a check in the major audit firms global view as for the external audit of an active role in providing services to members of the community in various sectors, were to be provide these services to the highest level of quality.To ensure the quality of the audit process to be a proper planning is based on a scientific basis to be the substrate a strong underlying different audit works, and if planni

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Publication Date
Sun Jan 03 2016
Journal Name
Journal Of Educational And Psychological Researches
The effect of the probing questions in the collection of literature for students of the Kurdish language department in the College of Education / Ibn Rushd for the Humanities
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    The goal of this research to identify the effect of the probing questions in the collection of material literature with students of the Kurdish language department, to achieve the aim of the research, the researcher has chosen a sample from the students of third stage of the Kurdish language Department, Faculty of Education / Ibn Rushd as a field for the application of experiment.The number of sample  reached (71) students divided into two groups represented two divisions of the experimental groups under study to the style of questions sounding by (35) students, and represented the other division of the control group, which studied in the way normal and by (36) students, as rewarded r

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