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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
Thu Jan 10 2019
Journal Name
Journal Of The College Of Education For Women
The provisions of the autistic in criminal penalties
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  Thankfully Thank meets the grace and pushes us Blaneh and a curse, peace and blessings be upon the Prophet after him, and his family and companions, and after:

    This research deals with the subject of the provisions of the autistic in criminal penalties, one of the important issues, especially after the spread in abundance in our contemporary society, as the patient is characterized by autism in most of spaces of isolation and depression and aggressive behavior, and in some cases try autistic to commit suicide as a result of going through the psychological pressure , was this research to clarify what follows autistic criminal penalties as a result of the capital crime of self or without them, and the stat

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Publication Date
Sat Jun 30 2018
Journal Name
College Of Islamic Sciences
The semantics of words in the Holy Quran
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The lexical connotation is one of the types of connotation that linguists have dealt with, and stipulated in their studies, meaning access to the real meanings of the words, that the lexicon can address after tracing the real meaning of the metaphorical meanings, if any, and this is known to the semantics additional significance, and the rhetorical meaning Figuratively.
The miraculous Qur'an in its systems often refers to the metaphorical uses of the words as well as the real use. The significance of the words in the Holy Qur'an came in a variety of contexts, making each word a special significance that belongs to it exclusively. This is the miracle of the Holy Qur'an. The coming of the slow walk, with its eight words (came, came, cam

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Publication Date
Wed Dec 15 2021
Journal Name
Al-academy
Fantasy Parody in the Design of the Advertisement
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This research deals with the topic (Fantasy Parody in the Design of the Advertisement) in view of the important role that fantasia plays in designing the most creative and attractive advertisements to the recipients. The research problem lies in accordance with the following question:
What is the Fantasy Parody in the Design of the Advertisement?
It means the imagination, the unfamiliar; and features that emerge for it that distinguish it from other concepts. Fantasy advertisement is creativity in innovative ways, either through collage, merging, or the use of various artistic expressions in terms of intellectual and cultural awareness. When uses in the parody of advertisement, it has helped to come up with an aesthetic experie

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Publication Date
Tue Jun 30 2015
Journal Name
College Of Islamic Sciences
Legislative miracle in the light of the light
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After the use of trust in God, and after the completion of my research called (the legislative miracle in the light of Surat), which studies the miracle in general and then unique legislative miracle, which was the largest share of the research where I built my research on several topics dealt with in the first topic: definition of miracles language and terminology and address Also discussed the Quran and the challenge and miracles and the status of the Arabs in the eloquence and eloquence, and then the literature in the miracle and dealt with legislation based on the foundations of individual education, family building, community building, and the most important advantages of Islamic legislation and presented some examples of legislativ

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Publication Date
Sat Jan 01 2022
Journal Name
Materials Today: Proceedings
The effectiveness of the manufacturing industry in Iraq
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The manufacturing industry in Iraq has faced, during the time stages, several obstacles that have had devastating effects on the Iraqi economy. These obstacles are represented by political events and wars that have led to the depletion of most human and material resources and the suspension of most vital industrial facilities from working, And the occurrence of this major deviation in the process of economic development, For the same reasons, the contributions of the manufacturing sector to the gross domestic product varied fluctuatingly, indicating instability in the growth rates of this sector, On the other hand, the supremacy of the belief that the dominance of oil resources as a main source for creating economic growth and achieving a h

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
The provisions of the uncle in Islamic jurisprudence
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There is talk of the Prophet ﷺ proud of his relative, which is the uncle, and the importance of this subject, this search for doctrinal matters related to the two things between us: the interest of the Prophet ﷺ responsible, and also responsible forbidden marriage and marriage as it is forbidden to marry the uncle, and in the uncle language: mother's brother, aunt Her uncle may spend his uncle's nephew, the uncle may embrace his nephew, the uncle shall be the guardian of the little or the small, not to cut off the uncle if he steals from his nephew's money. "

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Publication Date
Mon Feb 19 2018
Journal Name
Al-academy
The Effectiveness of the Movement in Graphic Design
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The movement is considered one of the important factors which attracts the receiver attention in designing artificial works in general, and especially in the advertisements, moreover the subject of the movement in the designing advertisements needs more care and study by the scholars. From this importance and from reaching to the basic streams of the research topic (the effect of the movement in the graphic design) the problem of the research has been set according to the following wonder:

  • What is the designing process that establishes the movement in the commercial advertisements designs?

           

      The researche

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Analysis and Control of PWM Buck-Boost AC Chopper Fed Single-Phase Capacitor Run Induction Motor
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Single phase capacitor-run induction motors (IMs) are used in various applications such as home appliances and machine tools; they are affected by the sags or swells and any fault that can lead to disturb the supply and make it produce rms voltage below or above the rated motor voltage, which is 220V. A control system is designed to regulate the output voltage of the converter irrespective to the variation of the load and within a specific range of supply voltage variation. The steady-state equivalent circuit of the Buck-Boost chopper type AC voltage regulator, as well as the analysis of this circuit are presented in this paper. Switching device for the regulator is an IGBT Module. The proposed chopper uses pulse width modulation (PWM) c

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Publication Date
Wed May 10 2017
Journal Name
Journal Of The College Of Languages (jcl)
РОЛЬ СРЕДСТВ НАГЛЯДНОСТИ В ПРОЦЕССЕ ОБУЧЕНИЯ РУССКОМУ ЯЗЫКУ КАК ИНОСТРАННОМУ В ИРАСКОЙ АУДИТОРИИ The Role of the Use of Visual Aids in the Process Of Learning Russian Language in Lraq as a Foreign Language
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В статье рассматриваются понятие наглядности и ее классификация, эффективное применение принципа наглядности, возможность и преимущество использования наглядности и современные инструменты ее реализации в ираке.

 

Вследствие глобальных изменений во всем мире изменилась и роль иностранного языка в системе образования. Современный человек, шагающий в ногу со временем, не мыслит себя без зна

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
A Comparative Biochemical Study of Proteins Profile in Iraqi Children and Adolescent with ?-Thalassemia
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The aim of the present research is to study different protein fractions in sera of children and adolescent with  β –thalassemia major and minor and to compare the results with that of healthy control.One hundred fifty children and adolescents were enrolled in this study,including 50 patients with β- thalassemia major , 50 patients with  β- thalassemia minor as pathological control group and another apparently 50 healthy individuals as a control group. The age of all studied  groups ranged from (4-18)years.Total protein, albumin and immunoglobulins were estimated in sera of all subjects.  A Significant  decrease  was  found  in  the  total  protein and  albumin&nb

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