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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
Mon Nov 21 2016
Journal Name
Journal Of Medicinal Chemistry
Largazole Analogues Embodying Radical Changes in the Depsipeptide Ring: Development of a More Selective and Highly Potent Analogue
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Sun Jan 01 2017
Journal Name
International Journal Of Advanced Computer Science And Applications
A Proposed Framework to Investigate the User Acceptance of Personal Health Records in Malaysia using UTAUT2 and PMT
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Publication Date
Sat Feb 24 2024
Journal Name
Journal Of Studies And Researches Of Sport Education
The effect of the use of the Colb model according to the two forms (adaptive, ascending) in learning some of the technical skills of women
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The objective of the study was to identify the effect of the use of the Colb model for the students of the third stage in the College of Physical Education and Sports Sciences, University of Baghdad,As well as to identify the differences between the research groups in the remote tests in learning skills using the model Colb.The researcher used the experimental method and included the sample of the research on the students of the third stage in the College of Physical Education and Sports Science / University of Baghdad by drawing lots, the third division (j) was chosen to represent the experimental group,And the third division (c) to represent the control groupafter the distribution of the sample splitting measure according to the Colb mode

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Settling Accounts of tax According to the unified Tax A Suggested Mechanism for: Application in the general Commission for Taxes
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Consistent "with the thought of tax talk is unified tax natural evolution for him, as the application leads to the inclusion of tax all branches of income and its sources and through truncated part of this entry through the application of price ascending it, it means the procedures of tax reform. Taxes on total income characterized by giving a clear picture of the total income of the taxpayer and its financial situation and its burden family which allows granting exemptions, downloads, and application of prices that fit this case. This requires reconsideration of the structure of the tax system in force and the transition from a system specific taxes to the tax system on the total income of the integration of income from the rental of re

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Publication Date
Sat Oct 01 2022
Journal Name
Al–bahith Al–a'alami
THE LANGUAGE OF MEDIA BETWEEN THE CLASSICAL LANGUAGE AND THE DIALECT
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The media: ((Providing people with the right news, audio information, and constant facts that help them form a correct opinion in an incident or a problem, this opinion gives an objective expression of the mentality of the audience, their trends and tendencies). The German scientist Autogroot defines it as "the objective expression of the mentality of the audience, their spirit, their tendencies, and their trends at the same time." Whereas for  "Aristotle", (Language) is a specific verbal system created as a result of an agreement between the members of the human group somewhere )). It is a symbol of thought, and  a difference between humans and animals. Pronunciation and thought for “Aristotle” are intertwined: without pro

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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Crisis of the Greeks (the euro crisis) and the lessons learned
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After more than ten years of successful march of the European single currency and EU countries faced a crisis in one of its debt, which recently joined the monetary union is not Greece . Perhaps mpre than th effects of this crisis, the fact that its consequences were not confined to Greece alone , but expand it to include all EU countries in general and the countries of the European Monetary Union in particular.

Sine the debt crisis that emerged Greek and talk a lot a bout their effects on the global economy and the potential harm done th the situation of the global economy recovers from the global financial crisis (mortgage crisis), or delayed and also the fears of other crises to other member states suf

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
The New Middle East and the Implications of the Arab Spring
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الخلاصة لقد شكل المحافظون الجدد وهم بالأساس نخبة من المثقفين ومن السياسيين الأمريكيين كتلة ضغط كبيرة التأثير على الإدارة في عهد الجمهوريين. حمل هؤلاء المحافظون مشروعاً إيديولوجياً البسوه لسلطة الجمهوريين وهو يهدف إلى جعل أمريكا سيدة العالم من دون منازع خاصة بعد انهيار الاتحاد السوفييتي ونهاية الحرب الباردة. واكب هذا الحدث التاريخي الكثير من الأفكار ومنها (نهاية التاريخ)، وصراع الحضارات، وكذ

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Publication Date
Thu Mar 30 2006
Journal Name
College Of Islamic Sciences
The Islamic call for the unity of human society and the rejection of division
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الحمد الله أولا واخرا وبعد .. إن الواقع الذي عايشه الناس في ظل دولة المسلمين منذ إقامة دولة الإسلام بعد بعثة الرسول الكريم (صلى الله عليه وسلم ) في المدينة ولأكثر من أربعة عشر قرنا نرى إنه عاش في كنف هذه الدولة الكبيرة من بلاد الصين شرقا وإلى وسط أوربا وجنوب فرنسا غربا العشرات من الملل و الأديان والأجناس وممن لا يدينون بالإسلام وهم كما تحفظ لهم دولة الإسلام منهم وعيشهم الرغيد فهم يمارسون شعائرهم وطقوسهم الديني

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Publication Date
Wed May 01 2013
Journal Name
Chemical And Process Engineering Research
Synthesis and Characterization of Polycyclicacetal Derived from PEG & Erythro-Ascorbic Acid Derivative and Study Its Effect on the Activity of ACh Enzyme (In Vitro)
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Polycyclicacetal was prepared from the reaction of PEG with aldehyde derived from Erythro-ascorbic acid (pentulosono-ɣ-lactone-2,3-enedianisoate).All these compounds were characterized by Thin Layer Chromatography (TLC) and FTIR spectra and aldehyde was also characterized by (U.V-Vis), 1HNMR, 13CNMR, and mass spectra.The inhibitory effect of prepared polymer on the activity of human serum AcetylCholinesterase has been studied in vitro. The polymer showed a remarkable activity at low concentration (4.7x10-3 – 4.7x10-8M).

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Publication Date
Sun Nov 23 2025
Journal Name
Al–bahith Al–a'alami
US Policy Image Regarding the Middle East Region as Reported by the Iraqi Newspapers (An Analytical Study of the Public Opinion in Editorials: Al-Sabah, Al-Mashriq and Tariq Al-Shaab Papers Over the Period from 1st of July to 30th of September 2013)
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The present study is an attempt to throw light on the nature of the US policy regarding the Middle East region as portrayed by AI-Sabah, Al-Mashriq and Tariq Al-Shaab papers over a period of three months from 1st of July to 30th of September 2013.

In writing this study, a number of goals have been set by the researcher. These goals may include but in no way limited to the nature of the US image as carried by the above three papers, the nature of the topics tackled by them and the nature of the Arab countries which received more and extensive coverage than others.

A qualitative research approach is proposed for the study. This approach has allowed the researcher to arrive at definite answers for the possible questions rais

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