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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 Nov 03 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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Publication Date
Sun Jan 04 2026
Journal Name
International Journal Of Environmental Science And Technology
Novel EDTA-modified Santa Barbara Amorphous-15 and Fe3O4@SiO2 adsorbents for highly efficient Ni (II) removal from aqueous solutions
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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
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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Publication Date
Sat Aug 01 2026
Journal Name
Journal Of Molecular Structure
Synthesis, multidimensional characterization, biological evaluation, and computational insights into novel N2O2-tetradentate Schiff base metal complexes as potent antimicrobial agents
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