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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 May 12 2010
Journal Name
Tikrit Journal Of Pure Science
Synthesis and Characterizationof Mn(II),Co(II),Ni(II) , Cu(II) Complexes with 2- ( 4- Antipyrene azo )-tyrosine Ligand.
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Coupling reaction of ( 4-amino antipyrene) with the (L- tyrosine ) gave the new azo ligand 2- ( 4- Antipyrene azo ) - tyrosine .Treatment of this ligand with metal ions (Mn(II) ,Co(II), Ni(II), and Cu(II) )in ethanolic medium in (1:2) (M:L) ratio yield a series of a neutral complexes of the general formula [M(L)2] . The prepared complexes were characterized using flame atomic absorption , FT.IR , UV-Vis spectroscopic and elemental microanalysis (C.H.N) as well as magnetic susceptibility and conductivity measurement

Publication Date
Thu Aug 24 2023
Journal Name
Environmental Monitoring And Assessment
Rice husk coated with copper oxide nanoparticles for 17α-ethinylestradiol removal from an aqueous solution: adsorption mechanisms and kinetics
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The 17 α-ethinylestradiol (EE2) adsorption from aqueous solution was examined using a novel adsorbent made from rice husk powder coated with CuO nanoparticles (CRH). Advanced analyses of FTIR, XRD, SEM, and EDSwere used to identify the classification parameters of a CRH-like surface morphology, configuration, and functional groups. The rice husk was coated with CuO nanoparticles, allowing it to create large surface area materials with significantly improved textural qualities with regard to functional use and adsorption performance, according to a detailed characterization of the synthesized materials. The adsorption process was applied successfully with elimination effectiveness of 100% which can be kept up to 61.3%. The parameters of ads

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Publication Date
Wed Jul 05 2017
Journal Name
Chemical Engineering Communications
Microwave-assisted preparation of mesoporous-activated carbon from coconut (<i>Cocos nucifera</i>) leaf by H<sub>3</sub>PO<sub>4</sub>activation for methylene blue adsorption
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Publication Date
Tue Nov 01 2011
Journal Name
Australian Journal Of Basic And Applied Sciences
Closure Operators on Graphs
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The aim of this paper is to generate topological structure on the power set of vertices of digraphs using new definition which is Gm-closure operator on out-linked of digraphs. Properties of this topological structure are studied and several examples are given. Also we give some new generalizations of some definitions in digraphs to the some known definitions in topology which are Ropen subgraph, α-open subgraph, pre-open subgraph, and β-open subgraph. Furthermore, we define and study the accuracy of these new generalizations on subgraps and paths.

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Publication Date
Mon Sep 04 2017
Journal Name
Journal Of The College Of Education For Women
Adolf Hitler, existence and his political victim until junuary, 1933 Dr.Suaad Rood Sheer Mohammed (PhD) Dr. Qassim Abdul Amir Waseem
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This study aims to track and analysis Hitler's personality by explaining the impact of the social environment in shaping his behavior and addressing the defeat of Germany in the World War 1 and its impact on building his political personality and included his political activism and his policy to get rid of the terms of the Versailles Military Treaty in the light of his plans in his book ( Kifahi) The nature of the study had to be divided into an introduction and two topics followed by the conclusion of the most important results, in addition to a list of references and a summary in English and from God the Good luck.

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Publication Date
Sun Sep 01 2024
Journal Name
Baghdad Science Journal
Graphene Oxide Decorated with Nickel Cobaltite Nanoparticles as an Adsorbent for Cationic Methyl Green Dye: Kinetic, Isotherm, and Thermodynamic Studies
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‎تم في هذه الدراسة ، تزيين ‏رقائق أكسيد الجرافين (‏GO‏) بجسيمات ‏كوبلتيت النيكل النانوية ‏NiCo2O4‎‏(‏NC‏) عن طريق الترسيب في ‏الموقع ، وتم استخدام المتراكب ‏المحضر (‏NC: GO‏) كسطح ماز لإزالة ‏صبغة الميثيل الخضراء ( ‏MG‏) من ‏المحاليل المائية. تم التحقق من ‏التغطية الناجحة لأوكسيد الجرافين ‏بجزيئات كوبلتيت النيكل النانوية ‏‏(‏NC‏) باستخدام دراسات ‏FT-IR‏ وحيود ‏الأشعة السينية (‏XRD‏). كانت أحجام  ‏الجسيم

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of The College Of Languages (jcl)
Investigating English Composition Writing Problems Encountered by Preparatory School Students and Finding Solutions to These Problems through Schema- Based Approach
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Writing in English is one of the essential factors for successful                      EFL learning .Iraqi students at the preparatory schools encounter problems when using their background knowledge in handling subskills                                  of writing(Burhan,2013:164).Therefore, this study aims to investigate the 4thyear preparatory school students’ problems in English composition writing, and find solutions to these pro

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Publication Date
Fri Jun 30 2023
Journal Name
Mathematical Modelling Of Engineering Problems
Enhanced Prosthesis Control Through Improved Shoulder Girdle Motion Recognition Using Time-Dependent Power Spectrum Descriptors and Long Short-Term Memory
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Surface electromyography (sEMG) and accelerometer (Acc) signals play crucial roles in controlling prosthetic and upper limb orthotic devices, as well as in assessing electrical muscle activity for various biomedical engineering and rehabilitation applications. In this study, an advanced discrimination system is proposed for the identification of seven distinct shoulder girdle motions, aimed at improving prosthesis control. Feature extraction from Time-Dependent Power Spectrum Descriptors (TDPSD) is employed to enhance motion recognition. Subsequently, the Spectral Regression (SR) method is utilized to reduce the dimensionality of the extracted features. A comparative analysis is conducted between the Linear Discriminant Analysis (LDA) class

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Publication Date
Wed Dec 30 2009
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Differences Between Sodium Metasilicate and Silicic Acid as Silica Source for Zeolite Y Nano particles Synthesis by Sol- Gel Method
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Zeolite Y nanoparticles were synthesized by sol - gel method. Dffirent samples using two silica sources were prepared.
Sodium metasilicate (Na2SiO3) (48% silica) and silicic acid silica (H2SiO3) (75% silica) were employed as silica
source and aluminum nitrate (Al(NO3)3.9H2O) was the aluminum source with tetrapropylammonium hydroxide
(TPAOH) as templating agent.
The synihesized-samples were characterized by X-ray diffraction, showed the requirement of diffirent aging time for
complete crystallization to be achieved. Transmission Electronic Microscope (TEM) images, showed the particles were
in the same range of 30 - 75 nm. FT-IR spectroscory, showed the synthesized samples having the zeolite Y crystal
properties. The i

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Publication Date
Mon Jan 01 2024
Journal Name
Dyes And Pigments
3′,3′,4′,4′,5′,5′,6′,6′,6′-nonafluoro-hexyloxy groups substituted phthalocyanines: Synthesis, characterization and their biological properties
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