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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
Wed Jan 01 2025
Journal Name
Journal Of Engineering And Sustainable Development
Improving Performance Classification in Wireless Body Area Sensor Networks Based on Machine Learning Techniques
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Wireless Body Area Sensor Networks (WBASNs) have garnered significant attention due to the implementation of self-automaton and modern technologies. Within the healthcare WBASN, certain sensed data hold greater significance than others in light of their critical aspect. Such vital data must be given within a specified time frame. Data loss and delay could not be tolerated in such types of systems. Intelligent algorithms are distinguished by their superior ability to interact with various data systems. Machine learning methods can analyze the gathered data and uncover previously unknown patterns and information. These approaches can also diagnose and notify critical conditions in patients under monitoring. This study implements two s

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Publication Date
Tue Jan 01 2019
Journal Name
Diabetes &amp; Metabolic Syndrome: Clinical Research &amp; Reviews
Nephrotic range proteinuria; does it predict lung involvement in patients with type 2 diabetes
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Publication Date
Mon Dec 14 2020
Journal Name
Baghdad Science Journal
Smart Flow Steering Agent for End-to-End Delay Improvement in Software-Defined Networks
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Publication Date
Fri Jun 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Oral Health Status among 9 years old school Children in Al-Diwaniyah City/Iraq.
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Background: Although they are not life threatening, dental caries and periodontal disease are the most predominant and widely spread oral diseases throughout the world. Another most common dental problem seen in children is dental trauma. The aims of the study included the investigation of the prevalence and severity of dental caries, gingivitis and dental plaque in relation to gender, furthermore, the prevalence and severity of the traumatized anterior teeth were assessed. Materials and Methods: This oral health survey was conducted among primary school children aged 9 years old in Al-Diwaniyah city in Iraq. The total sample composed of 600 child (320 males and 280 females) selected randomly from different school in Al-Diwaniyah city. Dia

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Smart Flow Steering Agent for End-to-End Delay Improvement in Software-Defined Networks
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To ensure fault tolerance and distributed management, distributed protocols are employed as one of the major architectural concepts underlying the Internet. However, inefficiency, instability and fragility could be potentially overcome with the help of the novel networking architecture called software-defined networking (SDN). The main property of this architecture is the separation of the control and data planes. To reduce congestion and thus improve latency and throughput, there must be homogeneous distribution of the traffic load over the different network paths. This paper presents a smart flow steering agent (SFSA) for data flow routing based on current network conditions. To enhance throughput and minimize latency, the SFSA distrib

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Publication Date
Fri Jan 01 2021
Journal Name
Ieee Access
Microwave Nondestructive Testing for Defect Detection in Composites Based on K-Means Clustering Algorithm
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Publication Date
Tue Jan 01 2019
Journal Name
Diabetes &amp; Metabolic Syndrome: Clinical Research &amp; Reviews
Nephrotic range proteinuria; does it predict lung involvement in patients with type 2 diabetes
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Publication Date
Sun Nov 23 2025
Journal Name
Symmetry
Graph-FEM/ML Framework for Inverse Load Identification in Thick-Walled Hyperelastic Pressure Vessels
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The accurate identification of internal and external pressures in thick-walled hyperelastic vessels is a challenging inverse problem with significant implications for structural health monitoring, biomedical devices, and soft robotics. Conventional analytical and numerical approaches address the forward problem effectively but offer limited means for recovering unknown load conditions from observable deformations. In this study, we introduce a Graph-FEM/ML framework that couples high-fidelity finite element simulations with machine learning models to infer normalized internal and external pressures from measurable boundary deformations. A dataset of 1386 valid samples was generated through Latin Hypercube Sampling of geometric and l

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Publication Date
Fri May 19 2017
Journal Name
International Journal Of Environment, Agriculture And Biotechnology 2 (4 …‏
Effect of Knives Type on Some Operational Characteristics fora Locally Assembly Motorized Vibration Cutter Used for Date Palm Fronds Pruning‏
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Publication Date
Wed Jan 01 2014
Journal Name
Ibn Al- Haitham J. Fo R Pure & Appl. Sci
Multiple Mixing Ratios of Gamma Rays Reaction 32 70 70 33 Ge p n As (, ) γ Using a2-ratio Method.
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The δ-mixing of γ-transitions in 70As populated in the 32 70 70 33 Ge p n As (, ) γ reaction is calculated in the present work by using the a2-ratio methods. In one work we applied this method for two cases, the first one is for pure transition and the sacend one is for non pure transition, We take into account the experimental a2-coefficient for previous works and δ -values for one transition only.The results obtained are, in general, in a good agreement within associated errors, with those reported previously , the discrepancies that occur are due to inaccuracies existing in the experimental data of the previous works.