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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 Jan 29 2019
Journal Name
Journal Of The College Of Education For Women
Islamic Clothing and the Modern Woman (Intellectual Study)
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In the name of Allah, the Beneficent, the Merciful.
Praise be to Allah, Lord of the Worlds and peace and blessings on the honest and trustworthy (Muhammad) and his family and his divine good companions.
The Islamic clothing is one of the requirements of the common and original innateness to humans; the innateness that is created by God to all people, Allah says, (So set thou thy face steadily and truly to the Faith: [establish] Allah's handiwork according to the pattern on which He has made mankind: no change [let there be] in the work [wrought] by Allah: that is the standard Religion: but most among mankind understand not) (1). Islam as a natural religion has ordered the Muslims to wear decently, Allah says, ( O Children of Adam!

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Publication Date
Sun Nov 23 2025
Journal Name
Misan Journal For Physical Education Sciences
An analytical study of the percentage of performance contribution of some defensive skills by playing positions (1,5,6) for the free player (libero) in volleyball
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The game of volleyball, like all other sports, has been made by new amendments, the most important of which is the system of what is not the system of the free player in 1998, which gave added importance to the skills of receiving the transmission and defending the stadium being one of the important skills where the law allowed the free player to move and position in the back positions of the stadium Limited support mainly defensive skills. This is to make the state of stability and balance between defensive and offensive skills, which helps in the development of the game and make it exciting and enjoyable for players and fans. Therefore, the researchers decided to shed light by identifying the percentage of the contribution of the free pla

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Publication Date
Thu Dec 31 2015
Journal Name
Al-khwarizmi Engineering Journal
Experimental Study on the Effect of Insertion of Copper Lessing Rings in Phase Change Material (PCM) on the Performance of Thermal Energy Storage Unit
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Abstract

One of the most suitable materials to be used in latent heat thermal energy storage system (LHTES) are Phase change materials, but a problem of slow melting and solidification processes made many researchers focusing on how to improve their thermal properties. This experimental work concerned with the enhancing of thermal conductivity of phase change material. The enhancing method was by the addition of copper Lessing rings in phase change material (paraffin wax). The effect of diameter for the used rings was studied by using two different diameters (0.5 cm and 1cm). Also, three volumetric percentages of rings addition (3%, 6% and 10%) were tested for each diameter. The discharging process was done with

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Publication Date
Wed Sep 30 2015
Journal Name
College Of Islamic Sciences
The difference The doctrines of the four jurists were built in Achieving the purposes of Tesper in Islam
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The difference The doctrines of the four jurists were built in Achieving the purposes of Tesper in Islam

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Publication Date
Sat Dec 28 2024
Journal Name
Journal Of Physical Education
The Effect of the (Team - Pair - Solo) Strategy in Learning the Accuracy of the Spiking Skill in Volleyball
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This study aims to prepare educational sessions for the strategy (team-pair-solo) in practical volleyball lessons for female students and identifying its effect on learning the accuracy of the spiking skill in volleyball. An experimental design with experimental and control groups was employed on a purposive sample of (30) female students who were to constitute (42.254%) from their community represented by the sophomores at the College of Physical Education and Sports Sciences for Girls / University of Baghdad who are in good standing in the morning study for the academic year (2022-2023), whose total number is (71) students. According to the determinants of the experimental design, participants were divided into two equal groups, a

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Publication Date
Sun Dec 30 2018
Journal Name
Baghdad Science Journal
Comparative morphological and histological study of the pecten oculi in two species of Iraqi birds (Falco tinnunculus L. and Streptopelia decaocto F.)
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Study showed structure of pecten oculi in the Kestrel Falco tinnunculus L.was
Pleated type and consisted of 17 folds which were thick. While in the Collared Dove
Streptopelia decaocto F. was Vaned type and consisted of 13 folds and it described
thin. The illustrated histological study of pecten oculi folds in the Kestrel and the
Collared Dove was composed of large number of capillaries, large blood vessels and
pigment cells which were few in Kestrel compare with the Collared Dove. The bridge
in the Kestrel and the Collared Dove pecten oculi was consisted of connective tissue,
many pigment cells, and contains on little capillaries and it linked the membrane to
the internal limiting membrane of the retina in the Kes

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Publication Date
Tue Sep 28 2021
Journal Name
Journal Of The College Of Education For Women
Reasons for Lying in Kindergarten Children from the Kindergarten Teachers’ Point of View: A Comparative Study between Males and Females: سجلاء فائق هاشم , كلثوم عبد عون ردام
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Lying is considered a dangerous tendency among children if it has become a habit. It results in many social problems, such as child’s loss of confidence, lack of others’ respect to him, and his lack of respect to the desired values ​​of the society, such as honesty and trust. Consequently, he will be led to a deviation when he becomes old; especially if the child’s socially unaccepted behavior has not been directed. The research, thus, aims to examine the causes of lying in the most important stage of children’s life; that is, between (4-6) years. Such an aim helps to know about the individual reasons of lying among males and females from teachers’ perspectives. To meet the objective of the study, a number of (128) children

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Publication Date
Sun Dec 06 2015
Journal Name
Baghdad Science Journal
The effect of aqueous crude extract of ginger on the histology of corpus luteum and the concentration of hormones estrogen and progesterone in pregnant mice
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This study was designed to investigate the effect of aqueous extract of ginger Zingiber officinale Roscoe on the histology of corpus luteum and the concentration of the hormones progesterone and estrogen during the first trimester of pregnancy (0 - 7) days from fertilization. 30 pregnant mice were divided into five experimental groups: control group (administrated with distilled water), and four groups treated at doses (284, 568, 1136,1420 mg / kg), orally administrated , daily with (0.1 ml). Microscopic examination results have shown histopathological changes in corpus luteum included: Pyknosis in some nuclei of granulosa cells, Karyorrhexis, Karyolysis in some granulosa cells, and necrosis in corpus luteum, with additional significant dec

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Publication Date
Fri May 01 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
Building and codifying a scale of the level of tactical performance of advanced volleyball players
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The research objectives, to build a measure of the level of tactical performance of volleyball players applying for the Iraqi Premier League for the 2018-2019 season. The nature of the research problem, then the researchers determined the research sample in the deliberate manner of the players of the Iraqi clubs for the Premier League (B, A). The researchers adopted the entire community as a sample for the research, and the number (156) players distributed over (13) clubs and divided the sample into (12)players an exploratory experiment player representing (the police club) and (100) player representing the construction sample and after a maximum period of two months has passed since applying the scale to the construction sample the researc

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Publication Date
Thu Jul 18 2024
Journal Name
Herança
Heresy and Hypocrisy of the Church: A Marxist Analysis of Okezie Nwoka's God of Mercy
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Hypocrisy is found in various aspects of life, whether in religion, politics, or social parts. Hence, some of the church's hypocrisy is an outcome of different ups and downs in life. Starting with the problem in the novel, some of the hypocritical pastors engaged in an immense role in affecting the folk's lives because they persuaded people that God ordered them to do so. To accomplish their personal interests, the abusive monks disguise their verbal speech, smiles, and fine clothes like mild sheep to delusional followers, leaving them with guilt, shame, and spiritual scars. The present study aims to examine the hypocrisy and heresy of the church as portrayed in Okezie Nwoka's novel entitled God of Mercy. It reflects the source of

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