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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
Tue Dec 01 2020
Journal Name
Environmental Nanotechnology, Monitoring & Management
Sulfonated polyindole coated magnetic zincoxysulfide ([email protected]@SPID) core/shell nanocatalyst for simultaneous photocatalytic H2 production and BPA degradation
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Photocatalyst composed of core/shell magnetic zincoxysulfide nanocomposite coated with sulfonated polyindole ([email protected]/SPID) has been prepared and used for simultaneous photocatalytic H2 production and Bisphenol A (BPA) degradation. XRD, FE-SEM, EDX, BET surface area, UV-vis DRS and VSM were used to characterize the synthesized nanocomposites. The photocatalytic performance was evaluated using batch reactor under visible light irradiation. The photocatalytic activity of [email protected]/SPID nanocomposite was revealed to exceed that of [email protected] nanocomposite due to the heterojunctions between SPID and [email protected] species. The results exhibited that the effect of BPA initial concentration was found to be effectual on the improvement

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Publication Date
Wed Oct 30 2024
Journal Name
Internet Technology Letters
Using <scp>5G</scp> Standards for Smart Healthcare Applications and Designing an Artificial Intelligence‐Based Industry 4.0 Communication System
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ABSTRACT<p>The introduction of Industry 4.0, to improve Internet of Things (IoT) standards, has sparked the creation of 5G, or highly sophisticated wireless networks. There are several barriers standing in the way of 5G green communication systems satisfying the expectations for faster networks, more user capacity, lower resource consumption, and cost‐effectiveness. 5G standards implementation would speed up data transmission and increase the reliability of connected devices for Industry 4.0 applications. The demand for intelligent healthcare systems has increased globally as a result of the introduction of the novel COVID‐19. Designing 5G communication systems presents research problems such as optimizing </p> ... Show More
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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
Sat Oct 31 2026
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
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
Wed Jun 03 2026
Journal Name
Applied Physics A
Hydrogen sulfide (H2S) gas sensor based on cobalt-manganese spinel oxide (MnCo2O4) prepared by chemical precipitation and green synthesis methods
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Hydrogen sulfide (H₂S) gas sensor based on cobalt–manganese spinel oxide MnCo₂O₄ thin films that were prepared by chemical precipitation and green synthesis methods. Structural, morphological, and compositional characterizations of MnCo₂O₄ thin films were performed using XRD, FE-SEM, EDS, and AFM. It was found through XRD patterns that MnCo₂O₄ was formed in a cubic spinel structure for both methods; however, the chemically precipitated thin films possessed better crystallinity and larger crystallite sizes, whereas the green-synthesized films exhibited slightly lower crystallinities and smaller sizes, as evidenced by the broader peaks observed. In addition, FE-SEM and AFM images revealed that the MnCo₂O₄ films prepared by

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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
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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