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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 Aug 01 2017
Journal Name
International Journal Of Advanced Research In Computer And Communication Engineering
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Wed Sep 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Using Ultraviolet Technique for Well Water Disinfection
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Publication Date
Fri Jan 01 2016
Journal Name
Modern Applied Science
New Combined Technique for Fingerprint Image Enhancement
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This paper presents a combination of enhancement techniques for fingerprint images affected by different type of noise. These techniques were applied to improve image quality and come up with an acceptable image contrast. The proposed method included five different enhancement techniques: Normalization, Histogram Equalization, Binarization, Skeletonization and Fusion. The Normalization process standardized the pixel intensity which facilitated the processing of subsequent image enhancement stages. Subsequently, the Histogram Equalization technique increased the contrast of the images. Furthermore, the Binarization and Skeletonization techniques were implemented to differentiate between the ridge and valley structures and to obtain one

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Publication Date
Sun Feb 28 2021
Journal Name
Jurnal Teknologi
HEAT TRANSFER ENHANCEMENT USING PASSIVE TECHNIQUE: REVIEW
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Preserving and saving energy have never been more important, thus the requirement for more effective and efficient heat exchangers has never been more important. However, in order to pave the way for the proposal of a truly efficient technique, there is a need to understand the shortcomings and strengths of various aspects of heat transfer techniques. This review aims to systematically identify these characteristics two of the most popular passive heat transfer techniques: nanofluids and helically coiled tubes. The review indicated that nanoparticles improve thermal conductivity of base fluid and that the nanoparticle size, as well as the concentrations of the nanoparticles plays a major role in the effectiveness of the nanofluids.

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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Engineering
CONSTRUCTION DELAY ANALYSIS USING DAILY WINDOWS TECHNIQUE
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Delays occur commonly in construction projects. Assessing the impact of delay is sometimes a contentious
issue. Several delay analysis methods are available but no one method can be universally used over another in
all situations. The selection of the proper analysis method depends upon a variety of factors including
information available, time of analysis, capabilities of the methodology, and time, funds and effort allocated to the analysis. This paper presents computerized schedule analysis programmed that use daily windows analysis method as it recognized one of the most credible methods, and it is one of the few techniques much more likely to be accepted by courts than any other method. A simple case study has been implement

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Publication Date
Tue Jan 29 2019
Journal Name
Journal Of The College Of Education For Women
The Rights of the Non-Muslims During the Rule of the Prophet Mohammed and Rashidians Succession Theoretically With Historical Witnesses
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(Thimma) in Arabic means compact, and immunity. (People of Thimma) are the free non-Muslim people under Muslim rule. This includes Heavenly Religions people, i. e., Christian and Jews).
They have been called (People of Thimma) because they had paid (Jizyah: tribute) so they became safe for their souls, honor, properties at the custody of Muslims.
Islamic law had posed (Jizyah: tribute) upon the Jews and Christians who were living under Muslim rule as a reaction of not embracing Islam Faith against securing their rights and freedom.
Freedoms secured by Islam for the (People of Thimma) had been many, including the right of faith, not coercing them to be Muslim, the right to live, to possess properties, protect and secure them, the

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Publication Date
Tue Mar 02 2021
Journal Name
Sustainability
Effect of Twisted Fin Array in a Triple-Tube Latent Heat Storage System during the Charging Mode
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This study aims to assess the effect of adding twisted fins in a triple-tube heat exchanger used for latent heat storage compared with using straight fins and no fins. In the proposed heat exchanger, phase change material (PCM) is placed between the middle annulus while hot water is passed in the inner tube and outer annulus in a counter-current direction, as a superior method to melt the PCM and store the thermal energy. The behavior of the system was assessed regarding the liquid fraction and temperature distributions as well as charging time and energy storage rate. The results indicate the advantages of adding twisted fins compared with those of using straight fins. The effect of several twisted fins was also studied to discover

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Publication Date
Tue Dec 31 2024
Journal Name
Indian Journal Of Clinical Biochemistry
Farnesoid X Receptor-Mediated Bile Acids Regulation in Cholestasis
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The main process, for the elimination of cholesterol from the human body, involves the alteration of cholesterol into bile acid (BA), by the liver. The farnesoid X receptor (FXR), a member of the nuclear receptor superfamily, is essential for the regulation of BA, glucose, and lipid metabolism. It is largely found in the liver, intestines, kidney, and adrenal glands, and to a smaller degree in the heart and adipose tissue. The binding locations, of the FXR, are in close proximity to formerly undisclosed target genes, with distinctive activities associated with transcriptional regulators, autophagy, apoptosis, hypoxia, inflammation, RNA processing, and a number of cellular signaling pathways. The preservation of BA homeostasis, by the FXR, e

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Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The role of leader-member exchange in the organizational citizenship behavior according to organizational trust Analytical research at the center of Ministry of Migration and Displaced
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This research aimed to examine the correlation and influence of leader-member exchange in the organizational citizenship behavior in the existence of organizational trust as mediator variable among workers in ministry of migration and displaced, has been collecting data and information relating to research by designing questionnaire was distributed to the stratified random sample included (56) member of the workers in the ministry mentioned, and through the use of several statistical method were the main findings of research was the existence of a correlation relationship and influence between leader- member exchange and organizational trust, while the results confirmed no correlation and influen

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Publication Date
Fri Mar 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Accounting achievement and its impact on the measurement of operational efficiency: Applied research in the company of refineries Center / Al-Doura refinery
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The issue of measurement of operational efficiency and productivity plays a major role in determining the weakness of the company, especially in relation to the productive processes, and thus starting to address these points and improve their performance. Hence the problem of research on how to determine the constraints in the production process, to identify weaknesses in the company. The research aims to clarify the role of throughput accounting in measuring the operational efficiency of the company in addition to clarify some of the constraints and causes behind them. The study concluded a set of conclusions, the most important of which is the availability of throughput accounting indicators that help in measuring operational efficienc

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