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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
Sun Mar 05 2017
Journal Name
Baghdad Science Journal
Cache Coherence Protocol Design and Simulation Using IES (Invalid Exclusive read/write Shared) State
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To improve the efficiency of a processor in recent multiprocessor systems to deal with data, cache memories are used to access data instead of main memory which reduces the latency of delay time. In such systems, when installing different caches in different processors in shared memory architecture, the difficulties appear when there is a need to maintain consistency between the cache memories of different processors. So, cache coherency protocol is very important in such kinds of system. MSI, MESI, MOSI, MOESI, etc. are the famous protocols to solve cache coherency problem. We have proposed in this research integrating two states of MESI's cache coherence protocol which are Exclusive and Modified, which responds to a request from reading

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Thu Apr 12 2012
Journal Name
Pramana
Nucleon momentum distributions and elastic electron scattering form factors for some 1p-shell nuclei
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Publication Date
Tue Aug 15 2023
Journal Name
Sumer 1
Biologically synthesized Copper Nanoparticles from S. epidermidis on resistant S. aureus and cytotoxic assay
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The risk of significant concern is resistance to antibiotics for public health. The alternative treatment of metallic nanoparticles (NPs), such as heavy metals, effects on antibiotic resistance bacteria with different types of antibiotics of - impossible to treat using noval eco-friendly synthesis technique nanoparticles copper oxide (CuO NPs) preparation from S. epidermidis showed remarkable antimicrobial activity against S.aureus Minimum inhibitory concentra range (16,32,64,256,512) µg/ml via well diffusion method in vitro, discover those concentrations effected in those bacteria and the best concentration is 64 µg/ml, characterization CuO NPs to prove this included atomic force microscope, UV, X-ray Diffraction and TEM, and ant

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Publication Date
Thu Feb 09 2023
Journal Name
Artificial Intelligence Review
Community detection model for dynamic networks based on hidden Markov model and evolutionary algorithm
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Finding communities of connected individuals in complex networks is challenging, yet crucial for understanding different real-world societies and their interactions. Recently attention has turned to discover the dynamics of such communities. However, detecting accurate community structures that evolve over time adds additional challenges. Almost all the state-of-the-art algorithms are designed based on seemingly the same principle while treating the problem as a coupled optimization model to simultaneously identify community structures and their evolution over time. Unlike all these studies, the current work aims to individually consider this three measures, i.e. intra-community score, inter-community score, and evolution of community over

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Publication Date
Wed Jan 24 2018
Journal Name
The Journal Of Physical Chemistry C
Novel Approach for Fabricating Transparent and Conducting SWCNTs/ITO Thin Films for Optoelectronic Applications
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Publication Date
Wed Nov 19 2014
Journal Name
Journal Of Biosciences
Caspase-like proteins: Acanthamoeba castellanii metacaspase and Dictyostelium discoideum paracaspase, what are their functions?
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Publication Date
Wed Aug 25 2021
Journal Name
Caai Transactions On Intelligence Technology
Shoulder girdle recognition using electrophysiological and low frequency anatomical contraction signals for prosthesis control
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Publication Date
Sat Dec 31 2022
Journal Name
International Journal Of Intelligent Engineering And Systems
Using Three-Dimensional Logistic Equations and Glowworm Swarm Optimization Algorithm to Generate S-Box
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Publication Date
Tue Apr 02 2024
Journal Name
Engineering, Technology &amp; Applied Science Research
Two Proposed Models for Face Recognition: Achieving High Accuracy and Speed with Artificial Intelligence
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In light of the development in computer science and modern technologies, the impersonation crime rate has increased. Consequently, face recognition technology and biometric systems have been employed for security purposes in a variety of applications including human-computer interaction, surveillance systems, etc. Building an advanced sophisticated model to tackle impersonation-related crimes is essential. This study proposes classification Machine Learning (ML) and Deep Learning (DL) models, utilizing Viola-Jones, Linear Discriminant Analysis (LDA), Mutual Information (MI), and Analysis of Variance (ANOVA) techniques. The two proposed facial classification systems are J48 with LDA feature extraction method as input, and a one-dimen

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Publication Date
Fri May 01 2015
Journal Name
Journal Of Engineering
Cooling Load Calculations For Typical Iraqi Roof And Wall Constructions Using Ashrae's RTS Method
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The present work is an attempt to develop design data for an Iraqi roof and wall constructions using the latest ASHRAE Radiant Time Series (RTS) cooling load calculation method. The work involves calculation of cooling load theoretically by introducing the design data for Iraq, and verifies the results experimentally by field measurements. Technical specifications of Iraqi construction materials are used to derive the conduction time factors that needed in RTS method calculations. Special software published by Oklahoma state university is used to extract the conduction factors according to the technical specifications of Iraqi construction materials.  Good agreement between the average theoretical and measured cooli

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