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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 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
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
Mon Sep 04 2017
Journal Name
Journal Of The College Of Education For Women
Adolf Hitler, existence and his political victim until junuary, 1933 Dr.Suaad Rood Sheer Mohammed (PhD) Dr. Qassim Abdul Amir Waseem
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This study aims to track and analysis Hitler's personality by explaining the impact of the social environment in shaping his behavior and addressing the defeat of Germany in the World War 1 and its impact on building his political personality and included his political activism and his policy to get rid of the terms of the Versailles Military Treaty in the light of his plans in his book ( Kifahi) The nature of the study had to be divided into an introduction and two topics followed by the conclusion of the most important results, in addition to a list of references and a summary in English and from God the Good luck.

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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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Publication Date
Sat Dec 24 2022
Journal Name
Wasit Journal For Pure Science
β*-Regular supra topological spaces
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Form the series of generalization of the topic of supra topology is the generalization of separation axioms . In this paper we have been introduced (S * - SS *) regular spaces . Most of the properties of both spaces have been investigated and reinforced with examples . In the last part we presented the notations of supra *- -space ( =0,1) and we studied their relationship with (S * - SS *) regular spaces.

Publication Date
Tue Dec 05 2023
Journal Name
Baghdad Science Journal
Red Ginger's Anti-Anxiety Effect on BALB/c Strain Mice (Mus musculus) Pro-Inflammatory and Anti-Inflammatory Measurements as Anxiety Model
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There is a correlation between the occurrence of anxiety and the production of inflammatory mediators, and red ginger rhizome is a well-known herbal product with a high content of phenolic and flavonoid compounds that can be used as anti-inflammatories and antioxidants. The aim of study to evaluate the effect of red ginger as antianxiety in mice (Mus musculus) BALB/c strain by measuring levels of TNF-α, IL-6 and IL-10.  Anxiety model mice were carried out by giving treatment with the Forced Swimming Test (FST) for 7 days then assessed by carrying out the Elevated Plus Maze for Mice (EPM) test for one day. After the treatment, the anxiety mice model was made, followed by administration of red ginger ethanol extract therapy for 14 days.

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Publication Date
Sun Dec 01 2024
Journal Name
Russian Journal Of General Chemistry
Synthesis, Characterization, and Biological Evaluation for New Derivatives Based on 2Сhloro-N-[4-(5-phenyl-1,3,4-oxadiazol-2-yl)phenyl]acetamide
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Publication Date
Sun Dec 01 2024
Journal Name
Russian Journal Of General Chemistry
Synthesis, Characterization, and Biological Evaluation for New Derivatives Based on 2Сhloro-N-[4-(5-phenyl-1,3,4-oxadiazol-2-yl)phenyl]acetamide
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