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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
The vocal inspiration of expressing the complaints in the Qur'anic script
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Thanks and gratefulness be to Allah , the most merciful , and prayers be on his messenger and our prophet mohammed and his descendants.The voices have great influence on the diversity of methods of complaints and implication in the Qur'anic expression through
their inspiration , forms and notes. They also have influence on performing semantic and psychological condition of the emitter . that is because of the connection between the complaints and human behavior and emotions , since it is considered as the outlet by which the human expresses his repressed desired and instincts . he resorted to it " when he is helpless physically and mentally i.e. he cannot reach his goals or satisfy his needs." Complaints come from deprivation , social

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of The College Of Education For Women
The Sound of the letter (ق) in the Contemporary Arabic Dialects
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The Sound of the letter (ق) in the Contemporary Arabic Dialects

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Publication Date
Sun Nov 23 2025
Journal Name
Journal Of The Iraqi University
The experience of providing selective broadcasting of information in the library of the Institute of Management / Rusafa
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The selective information broadcasting service is one of the important services in libraries and information centers, as it is the link between the source and the beneficiary and between related sources, as it links similar sources through keywords and then sends them to beneficiaries, which contributes to reducing the time and effort spent by beneficiaries in obtaining sources or information. Therefore, the application of this service is an important matter and gives a positive indicator in the progress of the library towards the integration of its services. From this standpoint, this research came to answer some questions, including: 1. What are the outlets for beneficiaries (the research community) in obtaining information sources? 2. Wh

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Publication Date
Tue Oct 31 2023
Journal Name
College Of Islamic Sciences
The fatwa based on the statement of Zafar In the Hanafi school of thought
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Each school of Islamic jurisprudence has principles and rules upon which the diligent work in these schools is based. This is due to the view of sanctification of these rulings, as they are divine rulings. Therefore, the goal is to reach a ruling that represents the intent of the legislator as much as possible.
Hence, these schools of thought established rules for issuing fatwas with the intention of restricting the performance of a fatwa to the hands of those who are qualified for it and have met its conditions, so they gave priority to the most knowledgeable person over others to perform the fatwa. In the Hanafi school of thought, for example, the saying of Imam Abu Hanifa (may God have mercy on him) is given precedence over others,

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The effect of mineral levels in the mother’s circulation on the outcome of pregnancy
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Background: Dietary intakes are critical during pregnancy, because inadequate amounts of key nutrients may compromise fetal development or maternal health. In addition to that maternal diet could be one of the methods to select the gender of the baby. The aim of the study is to correlate the level of the minerals in the mother’s blood with the gender and wellbeing of the baby after delivery.Patients and Methods: Fifty women were involved in this study with a mean age (23.92 ± 4.75), collected from the labor room during labor in the period between December 2013 and May 2014, in Baghdad teaching hospital. After taking a full history from the women, 10 ml of blood was withdrawn from them, 2ml in EDTA tubes for lead estimation and 8 ml in pl

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Publication Date
Sun Aug 18 2019
Journal Name
Political Sciences Journal
The impact of energy's policy in the strategy of restoring the Russian global role
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Abstract : This research has tackled about the role of Russia in the international policies which concerning with energy , So the most important states in the world that possesses huge energy resources to be more able in the control over the reality and future production programs and the distribution of global energy alike , the latter had effectively influence on the economic and developmental aspects within many countries in the world and its impacts on political decisions and perhaps effected too much in the dimensions of strategic policies . In this context of research , Russia has been developed a high energy policy of strategic planning in order to restoring Russia position and its global role by using its potential powerful streng

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Publication Date
Sun Sep 15 2019
Journal Name
Al-academy
The Reality of the Artistic Direction of Illustrations in the Textbooks: امل ابراهيم محسن
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The images and drawings reduce the intellectual, symbolic and cognitive dimensions inside them that make them an intermediary that imposes itself on the educational method, as they have become responsive to all the needs of the student in the modern era unlike the previous periods. The artistic direction of the illustrations in the scientific books meets the educational and pedagogical needs of the learner and their frame in an illustrative educational method that contributes in developing the student's abilities to benefit from the scientific curricula in the age of scientific and cognitive development.

Here, the researcher finds that the artistic direction of the illustrations lacks the achievement of scientific and technical p

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Publication Date
Tue Jan 28 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of accounting system in the recovery from the impact of financial crisis
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          This study aims to identify the concepts of financial crisis and its reasons of creation , also explain the effects of the accounting disclosure and the International Accounting Standards in current financial crisis, In addition to,  indicate the role of accounting in the reform of the financial system from the impact of financial crisis.      

       The  methodology of this study orientied to two main aspects, the first is an identifying approach through exploring the opinion of financial experts, the second aspect is based on an analytical approach to satisfy the requirements  of experts to get there opi

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Publication Date
Fri May 01 2020
Journal Name
Journal Of Physics: Conference Series
Frequency Dispersion of the Signal in the Recursive Digital Section of the Second Order
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Abstract<p>The problems of modeling the signal and dispersion properties of a second order recursive section in the integer parameter space are considered. The formulation and solution of the section synthesis problem by selective and dispersive criteria using the methods of integer nonlinear mathematical programming are given. The availability of obtaining both positive and negative frequency dispersion of a signal in a recursive section, as well as the possibility of minimizing dispersion distortions in the system, is shown.</p>
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Publication Date
Sat Apr 30 2022
Journal Name
Sport Tk-revista Euroamericana De Ciencias Del Deporte
The effect of biomechanical feedback on the accuracy of the long serve in badminton
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The primary aim of the study was to find out the values of some biomechanical variables for the long serve skill in badminton and to identify the effect of biomechanical feedback on the performance of long serve. The present study had a single group, pre-post experimental study design. The research community was determined by the intentional method of one group with a pre-and post-test. The players of the Assyrian badminton club constituted the research community. A total of 12 players were present in the research community. The badminton players falling within the age group of 15-17 years for the season 2020-2021 were recruited as the participants for the study. A total of five players were selected as the participant

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