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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 Jul 20 2020
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Multi-Agent Systems: A Review Study
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Multi-agent systems are subfield of Artificial Intelligence that has experienced rapid growth because of its flexibility and intelligence in order to solve distributed problems. Multi-agent systems (MAS) have got interest from various researchers in different disciplines for solving sophisticated problems by dividing them into smaller tasks. These tasks can be assigned to agents as autonomous entities with their private database, which act on their environment, perceive, process, retain and recall by using multiple inputs. MAS can be defined as a network of individual agents that share knowledge and communicate with each other in order to solve a problem that is beyond the scope of a single agent. It is imperative to understand the chara

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Publication Date
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
Surat Al-Qaria: a linguistic study
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Praise be to God, Lord of the worlds, and the best of prayers, and extradition was made to our master Muhammad and his whole family and companions:
And after:
Surat Al-Qariah is from the royal fence, which is in the thirtieth part of the Noble Qur’an. The commentators differed on the number of verses, and the reason for its naming. This surah talked about the conditions of people on the Day of Resurrection, and about how people were removed from their graves, all of which I spoke about in the preamble.
The research is divided into six topics: the first topic dealt with strange terms, while the second topic dealt with the most important audio issues mentioned in the surah, namely (slurring, advertising, substitution, and silenc

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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Shared Congestion Detection: A Comparative Study
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Most Internet-tomography problems such as shared congestion detection depend on network measurements. Usually, such measurements are carried out in multiple locations inside the network and relied on local clocks. These clocks usually skewed with time making these measurements unsynchronized and thereby degrading the performance of most techniques. Recently, shared congestion detection has become an important issue in many computer networked applications such as multimedia streaming and
peer-to-peer file sharing. One of the most powerful techniques that employed in literature is based on Discrete Wavelet Transform (DWT) with cross-correlation operation to determine the state of the congestion. Wavelet transform is used as a de-noisin

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Publication Date
Sat Jul 18 2020
Journal Name
College Of Islamic Sciences
The jender and how it transformed into the Islamic world
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يتناول هذا البحث دراسة واحدة من المفاهيم المهمة الوافدة الى المجتمع الاسلامي، بعد أن تطور في بيئة غربية وتبنته حركة نسوية متطرفة، تدعو الى مركزية الأنثى والعداء للرجل والأسرة النمطية، إنتقل هذا المصطلح الى المجتمع الإسلامي بعد أن تبنته أجندة عالمية تحاول وباستمرار طمس معالم الفطرة الإنسانية وتغير هوية الشعوب.

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Publication Date
Wed Mar 15 2023
Journal Name
Al-academy
The Abilities Musical level and its relation with the forgiveness
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This study aimed to recognize the Abilities Musical level and its relation with the for positive thinking, The present study relied on the analytical correlational descriptive approach The study population consisted of 167 female students who participated in musical activities, among the students of Maysaloon Elementary School for Girls affiliated to the Directorate of Education for the Bani Ubaid Brigade in Irbid Governorate. While the sample of this study consisted of (65) female students; , from level: intermediate .

The correlative analytic descriptive method was used, Was applied to the study sample Seachor tests of musical capabilities (the abbreviated image), which was codified by the Arabic (Sadiq (2001), the scale of posi

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The economic importance of nanotechnology
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Abstract

Toady technology Nano since it launched human Alivia third interest and anticipation unusual and that by the decision-makers in the world's governments and its institutions and research departments productivity, especially after the US Congress enact a law (the National Initiative for Tknlojba nanotechnology in the United States of America) and the allocation of large sums of money To support this initiative, the research aims to shed light on the concept of technology nanotechnology, which is technology atheist and the twentieth century, and reflect its economic importance and in order to reach the objectives of the research has been the division of research into several axes has been allocated

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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
The Act Of An Operator
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In this paper we will study some of the properties of an operator by looking at the associated S-act of this operator, and conversely. We look at some operators, like one to one operators, onto operators. On the other hand, we look at some act theoretic concepts, like faithful acts, finitely generated acts, singular acts, separated acts, torsion free acts and noetherian acts. We try to determine what properties of T make the associated S-act has any of these properties.

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Geopolitical Problems of Eritrea
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The subject of multi- ethnics is one of the most important subjects in the study of political
geography, as multi- ethnics and its consequent problems are global geopolitical phenomena
that started early and reached its peak with the beginning of the twentieth century, because of
major changes in the political landscape that resulted by wars and led to the collapse of many
empires and major powers, a matter which led to put new political maps according to certain
considerations of the colonial powers, especially in Africa and Asia. All these things led to
the most serious challenges based on ethnic and sectarian conflict and led to the development
of geopolitical problems. Among the examples what most countries in th

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Publication Date
Sun Dec 31 2000
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Preparation of Isosorbide Dinitrate
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Publication Date
Wed Apr 23 2025
Journal Name
Defense University Journal
Military expenditures of the Umayyadstate
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