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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
Wed Sep 15 2021
Journal Name
Al-academy
The Communicative Functions in The Speech of The UAE National Anthem in The Light of The Eloquence of The Audience: زينب دريانورد (الغيصي) - رسول بلاوي - أحمد موسى البطاينة
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  The national anthem is one of the most eloquent communicative discourses that the language establishes due to its deep impact on the audience and forms a broad mass base that interacts with the chanting of the national anthem. Moreover, communication is the cornerstone in building social and educational relations. From this point of view, the communicative approach studies language in the communicative context and its six important functions identified by linguist Roman Jacobson. The official UAE national anthem is considered as a model for expressing the enthusiasm of the Emirati Arab public, who is proud of their Arabism, loyalty and love of the homeland, because of the expressions that this anthem carries, urging the public to

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Publication Date
Sun Nov 23 2025
Journal Name
Journal Of Physical Education
The effect of special exercises using a designer device and added relative weights to develop some of the physical abilities of volleyball players
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Publication Date
Thu Sep 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Importance of Liquidity and Profitability in Enhancing the Banking Value in Private Banks for the Period 2016 - 2019
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The article aims to study the liquidity that is required to be provided optimally and the profitability that is required to be achieved by the bank, and the impact of both of them on the value of the bank, and their effect of both liquidity and profitability on the value of the bank. Hence, the research problem emerged, which indicates the extent of the effect of liquidity and profitability on the value of the bank. The importance of the research stems from the main role that commercial banks play in the economy of a country. This requires the need to identify liquidity in a broad way and its most important components, and how to

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Publication Date
Thu Feb 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluating the Observing Internal System in the General State of Taxes and its Role in Increasing the Taxes Revenue
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The internal observing system is considered a cornerstone for the high management in all the systems. It aims at defending the things for waste and increasing efficient and application the rules and regulations and constrictions. To easier for the high management activity in the internal observing system which in presented and practiced and to what extent can depend on it. Thus it goes to evaluate the internal observing system periodically to check the weak points in that system so as the find out the mistake, in the construction of the system or mistake, by indication of the workers. The importance of this study is represented in the need of increasing the coactivity in the internal observing system so as to be in touch with the new tre

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Publication Date
Tue Jun 21 2022
Journal Name
Journal Of Planner And Development
Use of GIS to study spatial analysis of the migration of nineveh governorate residents for the period 2014-2017
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The Migration is one of the important dynamic population movement phenomena in population studies because of its great impact in changing many demographic characteristics between the region of origin and arrival. And the multiplicity of forms and types according to the different reasons for it and the motives that prompted the population to move, as well as the currents and their size are also different according to the different causes, and here there are many types of migration, and many of them have been studied at the local and regional levels, and as long as the population is in a continuous dynamic movement, other types of migration are generated. (Al Douri, 2015, 230)          &nbs

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The role of Rabi’a tribe in the history of Iraq in the rightly guided caliph’s period Prof. Dr.: The role of Rabi’a tribe in the history of Iraq in the rightly guided caliph’s period Prof. Dr.
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Abstract:
Rabi’a tribe lived on the land of Euphrates since the first century of the
Christ. Then that land becomes her homeland. The Persians tried many times
to drive her away from that land, but with out result.
In the course of time Rabi’a become more knowledgeable of Persia.
This tribe proved her love and sanctification to the land of Euphrates, in the
battle of Dhyqar.
Rabi’a converted to Islam quickly and helped the Muslims to conquer
Iraq with a big number of fighters in many battles like al- Qadisyyah. That
influenced the anger of Mudriat Arab tribes who were their old enemies.
Mudriat tribes did their efforts to reduce the importance of Rabi’a because of
some its branches were among of t

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Publication Date
Mon Dec 30 2019
Journal Name
College Of Islamic Sciences
The mother of the believers, the mother of Salamah and her narrators of jurisprudence In attaining the goal of the rulings evidence Ibn Hajar al-Asqalani (d. 852 AH)      (prayer book)
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The Muslim woman actively participated in narrating, preserving, controlling and maintaining the hadith, along with her brother, the man who later became an inexhaustible representative of the effort to preserve, control, and narrate the Sunnah. Undoubtedly, the mothers of the believers, may God be pleased with them, had a great advantage in communicating Islam and spreading the Sunnah of the Prophet Especially among women, all of them heard from him, may God’s prayers and peace be upon him, and lived with him in the details of his life on the disparity between them in memorizing and narrating and publishing them. It narrated (378) recently, and it is considered the second narrator after the mother of the believers Aisha, may God be pl

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Publication Date
Tue Dec 24 2024
Journal Name
Malaysian Journal Of Mathematical Sciences
Exploring the Role of Hunting Cooperation, and Fear in a Prey-Predator Model with Two Age Stages
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The aim of this study is to utilize the behavior of a mathematical model consisting of three-species with Lotka Volterra functional response with incorporating of fear and hunting cooperation factors with both juvenile and adult predators. The existence of equilibrium points of the system was discussed the conditions with variables. The behavior of model referred by local stability in nearness of any an equilibrium point and the conditions for the method of approximating the solution has been studied locally. We define a suitable Lyapunov function that covers every element of the nonlinear system and illustrate that it works. The effect of the death factor was observed in some periods, leading to non-stability. To confirm the theore

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Publication Date
Fri Aug 15 2025
Journal Name
Journal Port Science Research
The Antimicrobial Characteristics of Some Natural Remedies in Root Canal Disinfection and Artificial Intelligence (AI): A Review
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The primary goal of root canal treatment (RCT) is to expel the presence of any necrotic or vital tissue, microbes and their byproducts from the canal space before press forward with the following steps of the RCT procedures. Although this is difficult to attain, various strives had been practiced by employing chemical and mechanical methods to eliminate as much microorganisms as possible and make the canal space valid for the obturation materials to be received. The aim of this review is to demonstrate some of what new remedies that could be used as root canal disinfectant by summarizing the recent studies regarding the efficacy of different natural products against the most persistence microbiota that could be responsible for most

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Publication Date
Fri Mar 01 2024
Journal Name
الذكوات البيض
The problem of employing political discourse and its role in promoting community peace: Iraq as a model
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After 2003, Iraq witnessed new challenges represented by the predominance of sectarian discourses, hatred and extremism at the expense of moderate political discourse and the predominance of sub-affiliations and external agendas at the expense of national affiliation, which led to the creation of an unsafe or stable environment dominated by the character of violence and terrorism. Moderate discourse would work to fuse sub-affiliations into one melting pot in which it would be the first loyalty to the homeland and not to the tribe, party or sect... Etc., and this in turn will contribute to promoting peaceful coexistence between the various other sub-affiliations within the framework of one community construction