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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 Sep 20 2023
Journal Name
Baghdad Science Journal
Synthesis, Characterization and Bioactivity Evaluation for Some Metal Ions Complexes with New Ligand Derived from 2-hydroxy-1- napthaldehyed
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The newly synthesized Schiff base ligand (E)-2-((2-phenylhydrazono)methyl)naphthalen-1-ol (phenyl hydrazine derivative), is allowed to react with each of the next mineral ion: Ni2+, Cu2+, Zn2+andCd2+successfully resulting to obtain new metal complexes with different geometric shape. The formation of Schiff base complexes and also the origin Schiff base is indicated using LC-Mass that manifest the obtained molar mass, FT-IR proved the occurrence of coordination through N of azobenzene and O of OH by observing the shifting in azomethines band and appearing of M-N and N-O bands. Moreover, we can also detect by such apparatus, the presence of aquatic water molecule inside the coordination sphere. UV-Vis spectra of all resultants reveale

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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
Wed Dec 17 2025
Journal Name
Al.qadisiya Journal For The Sciences Of Physical Education
Making standards limits for some skill tests in basketball for juniors players age (15-16) year to choosing national team players
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The basic skills (defensive & offensive) in basketball it is a base for completion and decide the level of the team and the rank, in same time considers the axel of the researchers when putting tests and forming new groups so close from real situation games to create real vision and estimate for skill state and a method to recorrect & presenting positive resolutions, the problem of research were indicate to variables may happen in training operation it demand tests matches with these variables and forming new standards, and another way the researchers find a few patterns for measuring basic skills (defensive & offensive) also application these tests on samples it differs from the originals one that the tests designed for it. The sample repr

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Publication Date
Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
Linguistic Errors in second language learning through Error Analysis theory: هه‌ڵه‌ زمانییه‌كان له‌ فێربوونی زمانی دووه‌مدا (له‌ ڕوانگه‌ی تیۆری شیكاری هه‌ڵه‌ییه‌وه‌)
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Second language learner may commit many mistakes in the process of second language learning. Throughout the Error Analysis Theory, the present study discusses the problems faced by second language learners whose Kurdish is their native language. At the very stages of language learning, second language learners will recognize the errors committed, yet they would not identify the type, the stage and error type shift in the process of language learning. Depending on their educational background of English as basic module, English department students at the university stage would make phonological, morphological, syntactic, semantic and lexical as well as speech errors. The main cause behind such errors goes back to the cultural differences

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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
Thu May 29 2025
Journal Name
Indonesian Journal Of Chemistry
Synthesis, Spectral Identification, Thermal Studies, Antioxidant Properties, and Biological Effects for Some Metal Ion Complexes with New Schiff Base Ligand
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The tetradentate N2O2 Schiff base ligand, which is produced via the condensation reaction of 2-hydroxynaphthaldehyde with phthalohydrazide, is prepared in this work with a fair yield. The prepared ligand was characterized using a microanalysis technique (C.H.N), UV-vis, FTIR, 1H-,13C-NMR, mass spectrometry, and thermal gravimetric analysis (TGA). New complexes were synthesized by a reaction between ligand (N'1E,N'2Z)-N'1,N'2-bis((1-hydroxynaphthalen-2yl)methylene)phthalohydrazide and metal chloride of Co+2, Ni+2, and Zn+2 ions in absolute ethanol. The present complexes are also characterized by techniques such as C.H.N, UV-vis, FTIR, TGA, molar conductivity, atomic absorption, and magnetic moment measurements. The in vitro antimicro

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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
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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