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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 Sep 28 2021
Journal Name
Journal Of The College Of Education For Women
Classism Hate Speech in Katherine Mansfield's Short Story ‘The Doll’s House’: A Pragmatic Study: ايمان نوري جاسم , مصلح شويش احمد
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Hate speech (henceforth HS) has recently spread and become an important issue. This type of speech in children's writings has a particular formulation and specific objectives that the authors intend to convey. Thus, the study aims at examining qualitatively and quantitatively the classism HS and its pragmatic functions via identifying the speech acts used to express  classism HS, the implicature instigated as well as impoliteness. Since pragmatics is the study of language in context, which is greatly related to the situations and speaker’s intention, this study depends on pragmatic theoriespeech acts, impoliteness and conversational implicature) to analyze the data which are taken from Katherine Mansfield's short story (The D

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Adopting the Crowdsourcing in Activation Strategic Foresight for Leaderships Towards Managerial Reforming Strategies Selection A Suggested Study for Managerial Leadership
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Abstract                                                                                                            

Environmental data (whether pre-emptive or responsive perspect

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Publication Date
Thu Apr 13 2023
Journal Name
Sustainability
Experimental Study of the Effect of Tack Coats on Interlayer Bond Strength of Pavement
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The performance and lifetime of the flexible asphalt pavement are mainly dependent on the interfacial bond strength between layer courses. To enhance the bond between layers, adhesive materials, such as tack coats, are used. The tack coat itself is a bituminous material, which is applied on an existing relatively non-absorbent surface to ensure a strong bond between the old and newly paved layer. The primary objective of this study was to evaluate the effects of various types of tack coat materials on interlayer bond strength and to determine the optimal application rate for each type. The tack coat types used in this paper were RC-70, RC-250, and CSS-1h. Both laboratory-prepared and field-constructed hot mix asphalt concrete pavements usin

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Publication Date
Mon Nov 24 2025
Journal Name
Al–bahith Al–a'alami
Propaganda speech in the Gulf press articles about the Qatari crisis An analytical study in the political articles published in the newspapers (Riyadh) Saudi Arabia and (Al-Ittihad) UAE from 5/6/2017 to 5/9/2017
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Propaganda speech in the Gulf press articles about the Qatari crisis, an analytical study in the political articles published in the newspapers (Riyadh) Saudi Arabia and (Al-Ittihad) UAE from 5/6/2017 to 5/9/2017, University of Baghdad, College of Media, Press Department, 2019. The problem of the research was to monitor the contents of propaganda messages to Saudi Arabia and the UAE regarding the Qatari crisis, especially with the escalation of propaganda media campaigns between the four boycotting countries on the one hand and Qatar on the other hand, in light of crises and conflicts in the Gulf region and the Arab region in general. The researcher used the survey method to answer the research questions and achieve its results. This res

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Suggested Plan for Developing the Sources of Energy in Enviroment In Light Of Sustinable Development and the Affective Of Geographic Arabic Teacher
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It is known that energy subiect has ocuppied a lot of scientests minds about
how to treat the traditional energy and the renewing energy . we know that
most traditional energy coal , oil , Natural gas, neuclear fuel , are limited
guantiy and alsow subjected to be ended .Statics studies refer to reserve
of oil in world will exhausted btween ( 2075- 2100) and alsow cosl too .
While neuclear fuerl which the world seek today through explod the uranium
atom ( 233) the therum atom (239) and neuclear mxied through ruemlear
mixing , These energy have effect on environment and humanity speciaty if
they are used in militery purposes .
For all theses scientests srarch for resources of renewing enery through
researches

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Publication Date
Thu Jun 22 2017
Journal Name
Research Journal Of Pharmaceutical, Biological And Chemical Sciences
Testing the Efficiency of Probiotic in Reducing the Growth of Aspergillus flavas in Corn Stored and its Effect on Performance of Broiler
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This study has been done for testing the effectiveness and efficiency of probiotic in its ability to inhibit Aspergillus flavus , which secretes the aflatoxin B1 and compare it with materials that were approved to be effective in the inhibition of the growth of fungi and break down and reduction of mycotoxin. these are the filax substance and ozone gas. A laboratory experiment has been conducted to determine the isolates out of the fungus producing the aflatoxin B1.the isolate producing aflatoxin B1 has grown on the yellow corn seed. the probiotic was added along with the filax and they have been exposed to ozone gas and then they were stored from 30 days. A bio test was con conducted to knw the effects of biological toxin on the broiler me

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Morphological Participation in the Forms of (Faul) and (Fael)
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This research examines the phenomenon of the Arabic language repeated in the Qur'an and poetry, as some morphological formulas are valid in their uses and indications in more than one way. search).

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
Women and Symbol In the stories of Mowaffaq Khadr
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The world of Muwaffaq Khidr Al-Qasasi has a clear and realistic orientation. This trend is in full harmony with his philosophy and vision of life and things. Through self-awareness is nothing but an expression of an imbalance in the interaction between self and reality, and it remains lacking in credibility.

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Publication Date
Sun Jan 27 2019
Journal Name
Journal Of The College Of Education For Women
Jews and their role in the heritage of Baghdadi
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The research sheds light on an important religious sect that played a fundamental role in the structure of the Iraqi society in general and the Baghdadi society in particular, in which the Jews in general and the Jewish women in particular played an active role in the culture and heritage of Baghdadi society. The educational, cultural and artistic activity of Jewish literacy is a model for study.

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Publication Date
Fri Dec 15 2023
Journal Name
Al-academy
The dialectic of form and meaning in postmodern art
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Some have considered the dialectic in form and meaning from different points of view, and dismantled them from each other, and this view is correct if we adopt according to the logic of Aristotle when it comes to dialectic, the dialectic of form and meaning has different aspects and does not share a single line in terms of conceptual meaning, the form is the appearance What the recipient sees with the help of cognitive tools, the content or content is the mental meaning, which in turn depends on his own tools, and to this extent this view is correct, and the intellectual content or meaning of the artwork or the human message that the artist wants to convey to the viewer.
The research included four chapters. The first chapter included

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