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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 Jun 01 2021
Journal Name
Periodicals Of Engineering And Natural Sciences
Steganography using dual tree complex wavelet transform with LSB indicator technique
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Image steganography is undoubtedly significant in the field of secure multimedia communication. The undetectability and high payload capacity are two of the important characteristics of any form of steganography. In this paper, the level of image security is improved by combining the steganography and cryptography techniques in order to produce the secured image. The proposed method depends on using LSBs as an indicator for hiding encrypted bits in dual tree complex wavelet coefficient DT-CWT. The cover image is divided into non overlapping blocks of size (3*3). After that, a Key is produced by extracting the center pixel (pc) from each block to encrypt each character in the secret text. The cover image is converted using DT-CWT, then the p

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Engineering And Applied Sciences
Enhancing LSB algorithm against brute-force attack using ASCII mapping technique
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Publication Date
Sat Oct 03 2009
Journal Name
Proceeding Of 3rd Scientific Conference Of The College Of Science
Research Address: New Multispectral Image Classification Methods Based on Scatterplot Technique
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Publication Date
Tue Apr 02 2024
Journal Name
Al-iraqia Journal Of Scientific Engineering Research
Prioritise Five Tafseer Translators Using Clustering Technique for Surah Al-Baqarah
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Publication Date
Sat Apr 10 2021
Journal Name
المؤتمر العلمي الدولي الثالث - المجلة الامريكية الدولية للعلوم الانسانية والاجتماعية
Public Governance and Sustainable Development - A descriptive study of the reality of public institutions in Iraq
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In light of crises, the need for efficient and flexible public administrations to make quick and decisive decisions, also institutions capable of directing the internal elements and components of them and adapting them to the requirements of rapid change due to crises and disasters, which led to scarce resources becoming scarcer and economic, political and social problems becomes more prominent. For the majority of developing countries, including Iraq, the increasing need for the importance of moving towards enhancing the efficiency of the performance of public institutions while trying to predict their future, can only be achieved. Through solid mechanisms and principles of governance that enhance the ability of institutions and make them

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Publication Date
Sun Sep 29 2024
Journal Name
مجلة نسق
The diplomatic role of IGAD in regional peacemaking: Sudan after 2011 as a case study
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The research discusses the most important goals and means of IGAD in making peace in Sudan and then regional peace.

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Publication Date
Fri Dec 30 2022
Journal Name
Journal Of The College Of Education For Women
The Death Scene in the "Ayniyah" Poems of Abi Thuayib Al-Huthali and Suda bint Shamardal: A Contrastive Study
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This study is an objective literary study of the poems of Abu Dhu'ayb Al-Hudhali and Su'da Bint Al-Shamrdal. It aims to shed light on the philosophy of death in the poems, and the way this philosophy is treated by both poets. Thus, the main prominent poetic images have been addressed and the outstanding ones have been singled out. The study further investigates the intertextuality with other poetic verses and Quranic verses and reviews the deviation in their semantic, syntactic, and phonetic types. The study adopts the historical approach to examine the occasion of the poems by referring to several historical sources that indicate the seniority. It also adopts the and descriptive-analytical approach represented by the use of content anal

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Publication Date
Wed Dec 15 2021
Journal Name
Arab World English Journal
Reading Difficulties in English as a Second Language in Grade Five at a Saint Patrick’s High School for Boys, Hyderabad- India
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Reading is one of the essential components of the English language. Countries that use English as a second language (ESL) sometimes have difficulties in reading and comprehension. According to many researches, mother tongue has proved some interferences with learning a second language. This study investigated the results of reading difficulties of young second language learners in terms of accuracy, comprehension, and rate using the Neale Analysis of Reading Ability test. The study was carried out in one of the High Schools for Boys in Hyderabad, India and included Grade five, aged 10-12 years. In order to understand the reading difficulties of English as a second language, a qualitative approach was employed. Interview, reading tes

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Publication Date
Fri Nov 01 2019
Journal Name
Science International (lahore)
IRAQI WOMEN IN THE CIRCLE OF COMBATTING A STUDY OF CIVIL-MILITARY RELATIONS IN A GENDER PERSPECTIVE
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The current research includes a look at the participation of Iraqi women in the combat roles, which starts from the assumption of the democratic transition that must be led - in one of its aspect - until the army or the military foundation to become a "citizen army," the matter which is represented a demand increasingly needed in the experiences of Democratic transformation that facing serious security challenges such as in Iraq, this means that the army or security foundation - which is involved in counterterrorism - should not reflect a specific group in society , and hence embody the most important democratic principles, which are equality and equal opportunities, especially gender equality. On the other hand, the influence of armed conf

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Publication Date
Wed May 17 2023
Journal Name
Journal Of Engineering
The Effect of Tool Path Strategy on Twist Behavior In Single Point Incremental Sheet Metal Forming
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In Incremental sheet metal forming process, one important step is to produce tool path, an
accurate tool path is one of the main challenge of incremental sheet metal forming
process. Various factors should be considered prior to generation of the tool path i.e.
mechanical properties of sheet metal, the holding mechanism, tool speed, feed rate and
tool size. In this work investigation studies have been carried out to find the different tool
path strategies to control the twist effect in the final product manufactured by single point
incremental sheet metal forming (SPIF), an adaptive tool path strategy was proposed and
examined for several Aluminum conical models. The comparison of the proposed tool path with t

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