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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 Mar 21 2023
Journal Name
Biomedical And Pharmacology Journal
Development and Validation of HPLC Method For the Detection of Fusidic Acid Loaded in Non-ionic and Cationic Nanoemulsion-Based Gels
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Fusidic acid (FA) is a well-known pharmaceutical antibiotic used to treat dermal infections. This experiment aimed for developing a standardized HPLC protocol to determine the accurate concentration of fusidic acid in both non-ionic and cationic nano-emulsion based gels. For this purpose, a simple, precise, accurate approach was developed. A column with reversed-phase C18 (250 mm x 4.6 mm ID x 5 m) was utilized for the separation process. The main constituents of the HPLC mobile phase were composed of water: acetonitrile (1: 4); adjusted at pH 3.3. The flow rate was 1.0 mL/minute. The optimized wavelength was selected at 235 nm. This approach achieved strong linearity for alcoholic solutions of FA when loaded at a serial concentrati

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Unipolarity and Its Influences in American Foreign Policy and the Future International Relations: Unipolarity and Its Influences in American Foreign Policy and the Future International Relations
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Abstract
The concept of unipolar has allowed the united states of America to
control the rest of the internations community units through the rxclusively of
control in international affairs without enabling other countries who have the
ability to compete with it to appear this comes as a result of it's position to all
kinds of powers like military, economic and technical powers that enable it to
continue dominating other countries, this superior control enabled it to be the
(hyper power) on the international political scene so that it allowed it to
exercise and implement the policy of domination against all this appeared
after its empire superiority became clear, in a unique way that have never
been known in

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Publication Date
Sun Dec 01 2002
Journal Name
Iraqi Journal Of Physics
THE THERMOELECTRLC POWER OF THE MAGNETLC Fe-Mn-Al COMPOUNDS
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The thermoelectric power as a function of temperature for the Iron-Manganese-Aluminum, Fe-Mn-Al, alloys for manganese concentrations 0.04, 0.06, 0.08, 0.10 and 0.20 have been investigated in the temperature range 300 K. to 500 K. these results showed that the thermoelectric power coefficient in hot probe measurements showed that the electrons are the majority charge carriers in these alloys.

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Publication Date
Mon Jan 02 2017
Journal Name
Al-academy
The contribution of the arts to interdisciplinary sciences: Art Therapy
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The history of the arts is closely connected with the history of humankind, since it is impossible to separate our scientific and artistic advances’. Therefore, the current research focuses on the close bond between art and other disciplines. The connection of the arts to the sciences is unequivocal and undisputed; the contributions of artists to the various scientific domains are clear. If one scrutinises the ability of artists to participate in building societies, one will find that the arts have penetrated deeply into a range of products and inventions, starting with the pencil and ending with the missile. The artist’s contributions play a part in the minutest of details across all fields of industry: production, craftsmanship, me

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Publication Date
Thu Oct 01 2020
Journal Name
Palarch's Journal Of Archaeology Of Egypt / Egyptology
THE JUDICAL BASIS FOR THE BRANCHING OUT OF CONSTITUTIONAL RIGHT
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The bifurcation of the constitutional rights of one of the techniques used by the constitutional court to expand the scope of the constitutional right to explicit, and access to the fact that guarantees constitutional rights, and establishes the constitutional elimination of this technique on a particular bond is the constitutional terms of reference, and in the light of his discretion in the exercise of the constitutional powers of , and tends at times To the adoption of a broad branching approach, which confers on the constitutional text containing constitutional rights a wider scope than the scope of an explicit right.

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Publication Date
Wed Jul 17 2024
Journal Name
Central Asian Journal Of Medical And Natural Sciences
Understanding of the Immunological Tolerance Mechanisms Underlying the Maternal-Fetal
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Publication Date
Thu Dec 31 2020
Journal Name
Political Sciences Journal
Foreign policy of the Trump Administration Toward the United Nations
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The Trump administration asserts that the actions of the United States are neither constrained by international organizations nor international controls, as they strive to seek a leadership position in a competitive manner, advance the reform of the United Nations in order to gain strength and support for US interests, and promote conservative social values. This negative policy is the result of the influence and mutual influence of long-term isolationism, the "American exception" and popular trends in the United States, as well as the result of the Trump administration's attempt to employ powerful means to revitalize the United States' strong position in the United Nations. However, the Trump administration’s policy toward the United

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Publication Date
Fri Nov 02 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
The Impact of Household Hazardous Waste upon the Environment Pollution
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Objectives: To determine the impact of the household hazardous waste’s aspects upon the environment
pollution .and to identify the relationship between the households’ demographic characteristics and the aspects
of household hazardous waste.
Methodology: A descriptive study is conducted between December 14th 2004 to October 20th 2005that uses of
an assessment tool. A probability (simple random sampling) of (336) principal’s households which is selected
from the zones around the (14) primary health care centers as focal points, (8) in the urban and (6) in the rural
areas of Baghdad Governorate. After reliability and validity were determined Data are collected through the use
of an assessment tool that is consist

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Publication Date
Sun Jun 30 2013
Journal Name
College Of Islamic Sciences
Abu Ubaidah's interpretative approach to the metaphor of the Qur’an
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In the name of of Allah the Merciful
        Praise be to God, and blessings and peace be upon the Messenger of God, Muhammad, and upon his family and his family and peace, and after:
 The honor of every knowledge of honor is related to it, and since the science of interpretation is related to the Book of God Almighty; it is considered one of the most noble and longest of sciences, and this science began long ago as the early ages of Islam have expanded the Islamic state, and people entered the religion of God in cohorts, and the mixture mixed In tongues, and people did not know much about the meanings of the Qur’an, so the need for authorship in this great knowledge was severe, and pe

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Publication Date
Wed Jan 01 2020
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees20
Studying the effect of the annealing on Ag2Se thin film
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