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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
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
consideration In the purposes of faith and destiny
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consideration
In the purposes of faith and destiny

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Publication Date
Sun Nov 20 2016
Journal Name
مجلة كلية التربية الاساسية
The secret of Repentance and Confession in Christianity
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The reason for studying (The secret of Repentance and Confession in Christianity) goes back to the deep roots of repentance in all religions, specially the three revealed religions, and those who adhere to them. The human psych by nature is incessantly demanding sins and the wrong deeds. It is in need of repentance which God has opened for them. Almighty God is happy when his creatures repent and refrain from sinning. This is the reason for success in life and the hereafter and the principle of the happiness. It is also a condition for the good course. Therefore, man should refrain from sinning and feel regret for committing sins forever.

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Publication Date
Tue Jun 30 2015
Journal Name
College Of Islamic Sciences
Markets in the Islamic Mashreq   (Iraq / Persia / the country beyond the river) From the era of the Prophet Muhammad (may Allah bless him and his family) To the end of the Buddhist era
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The follower to study the markets in the Islamic Mashreq (Iraq, Persia and the country of Ma
Behind the river for the period from the reign of the Prophet Muhammad until the end of the Islamic era) to find that there
A remarkable development in the pattern, shape, planning and privatization of markets
Islamic cities and places are the main conditions for their existence, which is the mosque of the mosque
And markets, and these markets have evolved from being a space in which there are no building and no ceilings to shade them in
The places of sale and purchase to specialized markets classified according to the materials and goods produced in them
This would facilitate the task of supervising it by the market factor and

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Publication Date
Wed Dec 04 2024
Journal Name
المورد
((The effect of mentioning, deleting, or changing the form of some Arabic letters on the meaning of the context of the sentence in Arabic))
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The letters are exposed in some texts of the classical Arabic language (poetry or prose), or in some of the Qur’anic texts, which are the main sources that were adopted on the day when provisions, rules and linguistic controls were established. I say that some of these letters are exposed in some contexts to deletion, mention, or change in the structure and shape of the letter. As for the omission, it is one of the aspects that distinguished Arabic, as well as other languages, for many purposes that differ among their user.

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The Influence of The Kind of Feeding on The Average of Body Growth for The Infant of The Age (3-6) Months in Baghdad.City
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This paper was conducted to identifying the body growth averages for the infants of the age (3-6) months and their relation with brest (natural ) or artificial feeding The results showed that the higher percentage was for the infants with the natural feeding in comparison with those of the artificial or mixed feeding. Also there was a clear increase in the average of the body growth for those with the natural feeding and such results were closer to the standard criterion. While the averages of body growth for those with the artificial or mixed feeding were low. In addition, it was clear that the averages of body growth of the i

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Publication Date
Thu May 14 2020
Journal Name
Journal Of Planner And Development
The Impact of the Method of Dealing with the Product of Wars in the Continuity of the Crisis Wars. Beirut city as an Example
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This research investigates the subject of the impact of wars (as a manifestation of crisis) on architecture, and the extent of continuing wars physical and moral results of wars, even after the end of the cause of the crisis. The impact of different rebuilding which exposed to the effects of the war seems different in crisis regions.

The problem of research is about the uncertainty of the impact of the way chooses for reconstructing the buildings after wars in the continuity of the crisis of war. The goals of this research are to clarify the influence of methods of reconstruction of buildings in a city chosen which is Beirut, on the continuation of the war crisis with the argument of demolishing and rebuilding newly or keeping tr

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Publication Date
Tue Feb 01 2022
Journal Name
Academy Of Accounting And Financial Studies Journal
THE ROLE OF THE TARGET COST SYSTEM IN ACTIVATING ENVIRONMENTAL COST MANAGEMENT AN APPLIED STUDY AT ASHOUR GENERAL CONSTRUCTIVE CONTRACT CO
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The problem of the study was to identify the possibility of benefiting from the application of the target cost system as a modern cost system to activate the environmental cost management instead of the traditional systems used in the company due to the great transformations witnessed by the business environment in all fields, which have resulted in the search for modern systems to provide more accurate and more appropriate information to reduce Costs, because accurate information makes the company have a complete vision to achieve the company’s goals. To solve this problem, the research was based on the following hypothesis (that the role of the target cost system leads to the activation of environmental cost management). Target c

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Publication Date
Sun Jan 01 2023
Journal Name
Revista Brasileira De Enfermagem
Healthy lifestyle behaviors and risk of cardiovascular diseases among nursing faculty during COVID-19 Pandemic
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ABSTRACT Objective: Cardiovascular diseases are the first ranked cause of death worldwide. Adhering to health promoting lifestyle behaviors will maintain an individual’s cardiovascular health and decrease the risk of cardiovascular diseases. Methods: In this descriptive study, 150 nursing faculty were surveyed via a non-probability (purposive) sampling method to assess their adherence to health promoting lifestyle in order to know the risk of cardiovascular diseases. The Arabic version of Health-Promoting Lifestyle Profile II (HPLP-II) was used to achieve this goal. Results: Seventy-two nursing faculty completed the survey. The results indicated that the study sample had moderate level of health promotion based on Health-Promot

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Publication Date
Mon Jan 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Toward a theoretical model of the terrorist personality and differentiation from psychopathic personality
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The current theoretical research targeted to construct a model of terrorist personality and its differentiation from psychopathic personality . Several assumptions or theories of perspectives of psychopathic personality have been compared with the terrorist personality studies that concerned . The suggested theoretical  model is interrupting the terrorist personality . The conclusions , discussions are mentioned. Finally, recommendation is suggested .

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Publication Date
Wed Mar 25 2015
Journal Name
Comptes Rendus Chimie
A novel method for the synthesis of biodiesel from soybean oil and urea
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The increasing demand for energy has encouraged the development of renewable resources and environmentally benign fuel such as biodiesel. In this study, ethyl fatty esters (EFEs), a major component of biodiesel fuel, were synthesized from soybean oil using sodium ethoxide as a catalyst. By-products were glycerol and difatty acyl urea (DFAU), which has biological characteristics, as antibiotics and antifungal medications. Both EFEs and DFAU have been characterized using Fourier transform infrared (FTIR) spectroscopy, and 1H nuclear magnetic resonance (NMR) technique. The optimum conditions were studied as a function of reaction time, reactant molar ratios, catalyst percentage and the effect of organic solvents. The conversion ratio of soybea

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