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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
Thu Dec 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Computerized Knowledge Operations in Improving Business Performance
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This research aimed at studying the role of calculated knowledge an its efficiency in improving the performance especially most of the organizations are living within knowledge era which concentrate on new technology investment in different fields of modern live . Under the scientific trends towards the economy of calculated knowledge which depend basically on new computer program in order to utilize the knowledge to raise the level of work performance exploiting different resources in the best way that helps the organizations to achieve their objectives because the information technology and computer programs became a means of survival and indispensible instrument within the developed world which depend on prosperity . progress

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Publication Date
Sun Dec 31 2023
Journal Name
The College Of Law And Political Science Jornal
Compensation through Guarantee Funds in the Promotion of Extremist Ideas
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Compensation is one of the most discussed topics in the arena of civil law that requires research About solutions to the damages that arise from the promotion of extremist ideas, which were imposed by the developments taking place in society and the increasing escalation of accidents and their increasing risks, which now threaten individuals and their property on a daily basis in large numbers, as the injured party always seeks to require quick compensation from the person responsible for the damage that satisfies his desires and removes the effects of the damage caused, The importance of compensation increases if the violation affects a person’s physical integrity or his right to life, which is the highest right recognized for humans in

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Publication Date
Mon Aug 01 2022
Journal Name
International Journal Of Hydrogen Energy
Exploring the application of AlN graphyne in calcium ion batteries
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Destiny functional theory (DFT) calculations are undertaken in order to scrutinize the electrochemical and calcium (Ca) storage characteristics of a graphyne-like aluminum nitride monolayer (G-AlNyen) as an electrode material for Ca-ion batteries (CIBs). The results show that the change in internal energy as well as the cell voltage values for the CIB with the G-AlNyen anode are comparable to others with two-dimensional 2D nano-materials. It is shown that Ca is adsorbed primarily onto the center of a hexagonal and triangular ring of G-AlNyen with absorption energies of −2.06 and −0.42 eV. After increasing the concentration of Ca atoms on G-AlNyen, the adsorption energy as well as the cell voltage decreases. Lower values of 0.15–0.32 e

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Publication Date
Tue Oct 21 2025
Journal Name
American Journal Of Research In Humanities And Social Sciences
Jurisdiction In Outer Space From The Perspective Of International Law
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This research aims to clarify the principles governing the exploration and utilization of outer space, emphasizing the role of international law, particularly international criminal law, in addressing crimes committed beyond Earth whether aboard spacecraft, the International Space Station, or in outer space generally. It examines relevant international treaties governing outer space activities, evaluates their strengths and ambiguities, and highlights deficiencies in their provisions. Furthermore, the study analyzes traditional principles of state criminal jurisdiction territoriality, nationality, universality, and protection and assesses their applicability to offenses committed in outer space.

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Publication Date
Thu Oct 01 2020
Journal Name
The Asian Efl Journal
The Habits of Mind in Constructing Typical EFL Teacher's Stereotypes
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Publication Date
Sun Nov 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
The effect of using Nano iron oxide in radiological shielding
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Abstract<p>In this study, some attenuation parameters of gamma shields were studied. This shields consisting of composite materials of Unsaturated polyester as a base material and Nano iron oxide (Fe<sub>2</sub>O<sub>3</sub>) and, micro iron (Fe) as reinforcement materials at different percentages (1, 3,5,7and 9)wt%, and with different thickness (1, 1.5, 2, 2.5, 3, 3.5and 4) cm. The results showed that the use of nanoparticles is better than the microparticales in the field of radiation shielding. It has been shown that the values of attenuation parameters of gamma it bitter in the case of nanoparticles than case of the use of micro material.</p>
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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of The College Of Languages (jcl)
The Poetics of Transition in T. S. Eliot's "Ash-Wednesday"
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  1. S. Eliot is one of the important founders of the modernist movement in literature, a cutting-edge poet of the first order. After his 1927 conversion to Anglicanism, he began calling himself a conservative, royal, and a classicist.
  2. "Ash Wednesday" is the first long poem written by him after his conversion. It deals with the struggle that ensues when one who has lacked faith acquires it. It is richly but ambiguously allusive, and deals with the aspiration to move from spiritual barrenness to hope for human salvation.

    "Ash Wednesday" not only struggles with an approach to faith but with an approach to a language capable of expressing it. Eliot's style is different from that that predates his conve

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Publication Date
Sat Apr 02 2022
Journal Name
The International Conference On Science In Engineering And Technology (icosiet) 2020 (virtually)
The Possible Application of Intelligent Systems in Traditional Courtyard House.
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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The impact of public debt on financial stability in Iraq
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Countries have faced the challenges of high levels of public debt and seek to define the optimum limits to reduce risks to which the financial system can be exposed and its impact on the economy as a whole. Hence the importance of research in studying the impact of internal and external public debt components on indicators of stability of the financial system for the period 2005-2017 for the purpose of knowing the extent of the financial stability indicators response to the high level of the public debt from its optimum ratio, as the aim of the research is to estimate and analyze the dynamic relationship of short and long term between the components of public debt and indicators of financial stability using the (ARDL) model that

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Publication Date
Thu Sep 12 2019
Journal Name
Al-kindy College Medical Journal
The role of prophylactic antibiotics in nasal packing for epistaxis
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Background: This study is to evaluate the necessity of prescribing prophylactic antibiotics for nasal packing in spontaneous epistaxis. There are few published papers of infective complications in such patients.

Methods: This prospective study analysed 149 consecutive patients admitted to AL-Kindy teaching hospital with spontaneous, epistaxis, who underwent nasal packing  over 2 years period . in the first  year, 78 patients received prophylactic antibiotics , In the second  year 71 patients were not given prophylatic antibiotics.  Exclusion criteria included antibiotics prescribed for unrelated  pathology and post-operative epistaxis. Signs and symptoms of acute otitis m

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