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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 Jun 01 2025
Journal Name
Methodsx
How mathematical models might predict desertification from global warming and dust pollutants
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Publication Date
Mon Jan 01 2018
Journal Name
Opcion
Fast-slow thinking and its relationship to cognitive failure At university students
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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Using financial and non-financial information ) SASB standards) to enhance investor confidence
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Companies seek to enhance investor confidence by achieving the highest level of transparency in disclosure of financial and non-financial information (SASB standards) for Iraqi insurance companies listed on the financial market. The aim of the research is to identify the extent of the ability of financial and non-financial information to enhance transparency in reporting, which is reflected in Investor confidence. And the standards of sustainability development accounting issued by (SASB) through the electronic questionnaire that was distributed. Companies seek to achieve a set of goals, the most important of which is to enhance investor confidence by improving transparency in disclosure. Concerning the employment of financial an

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Publication Date
Sat Dec 01 2018
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science
An Energy-Aware and Load-balancing Routing scheme for Wireless Sensor Networks
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<p>Energy and memory limitations are considerable constraints of sensor nodes in wireless sensor networks (WSNs). The limited energy supplied to network nodes causes WSNs to face crucial functional limitations. Therefore, the problem of limited energy resource on sensor nodes can only be addressed by using them efficiently. In this research work, an energy-balancing routing scheme for in-network data aggregation is presented. This scheme is referred to as Energy-aware and load-Balancing Routing scheme for Data Aggregation (hereinafter referred to as EBR-DA). The EBRDA aims to provide an energy efficient multiple-hop routing to the destination on the basis of the quality of the links between the source and destination. In

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Publication Date
Wed Jun 10 2026
Journal Name
Iraqi Journal Of Science
UNSTEADY PRESSURE DROP AND HEAT TRANSFER OFMAGNETOHYDRODYNAMIC ANNULAR TWO-PHASE INRECTANGULAR CHANNEL
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An annular two-phase, steady and unsteady, flow model in which a conductingfluid flow under the action of magnetic field is concavely. Two models arepresented, in the model one; the magnetic field is perpendicular to the long side ofthe channel, while in the model two is perpendicular to the short side. Also, westudy, to some extent the single-phase liquid flow.It is found that the motion and heat transfer equations are controlled by differentdimensionless parameters namely, Reynolds, Hartmann, Prandtl, and Poiseuilleparameters. The Laplace transform technique is used to solve each of the motion andheat transfer equations. The effects of each of dimensionless parameters upon thevelocity and heat transfer is analyzed.A comprehensive study fo

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Publication Date
Tue Aug 31 2021
Journal Name
International Journal Of Intelligent Engineering And Systems
FDPHI: Fast Deep Packet Header Inspection for Data Traffic Classification and Management
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Traffic classification is referred to as the task of categorizing traffic flows into application-aware classes such as chats, streaming, VoIP, etc. Most systems of network traffic identification are based on features. These features may be static signatures, port numbers, statistical characteristics, and so on. Current methods of data flow classification are effective, they still lack new inventive approaches to meet the needs of vital points such as real-time traffic classification, low power consumption, ), Central Processing Unit (CPU) utilization, etc. Our novel Fast Deep Packet Header Inspection (FDPHI) traffic classification proposal employs 1 Dimension Convolution Neural Network (1D-CNN) to automatically learn more representational c

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Publication Date
Tue Dec 11 2018
Journal Name
Baghdad Science Journal
Water flow velocity and oxide film formation effect on copper pipe corrosion
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An overall mathematical model for copper pipe corrosion in flowing water was derived based on mass transfer fundamentals where we introduced the effects of boundary layer velocity, bulk flow velocity and the surface oxide protective film on the corrosion rate. A set of experiments were conducted in a straight 10mm diameter copper pipe, flow of water include six velocities of maximum value 7.33m/sec at 200C and 350C. The good agreement between the calculated and experimental corrosion rate values were achieved , the agreement reached 92% .

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Publication Date
Fri Apr 26 2019
Journal Name
Journal Of Contemporary Medical Sciences
Cord Blood Sex Hormones Concentration: Relation to Birth Weight and Pregnancy Complications
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Objectives: Umbilical cord blood can be taken at birth and largely gives indication of fetal and maternal conditions. The aim of the study was to investigate the relation between sex hormones in cord blood and birth weight of newborns and pregnancy complications. Methods: Fifty cord blood samples were collected from newborns at labor room of Baghdad Teaching Hospital between May and October 2018. Blood was withdrawn from their mothers for lead analysis. Five milliliters (ml) of cord blood was taken, 3 ml was used for testosterone and estradiol analysis (using enzyme-linked immunosorbent assay) and 2 ml for lead measurement by lead care analyzer. Newborns weight and head circumference were measured. Delivered women were divided into four gro

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
Arabic Speech Classification Method Based on Padding and Deep Learning Neural Network
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Deep learning convolution neural network has been widely used to recognize or classify voice. Various techniques have been used together with convolution neural network to prepare voice data before the training process in developing the classification model. However, not all model can produce good classification accuracy as there are many types of voice or speech. Classification of Arabic alphabet pronunciation is a one of the types of voice and accurate pronunciation is required in the learning of the Qur’an reading. Thus, the technique to process the pronunciation and training of the processed data requires specific approach. To overcome this issue, a method based on padding and deep learning convolution neural network is proposed to

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Publication Date
Wed Mar 16 2022
Journal Name
Journal Of Educational And Psychological Researches
Psychological Comfort and Its Relationship to Job Performance among Secondary School Teachers
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The current research aims to identify the level of both psychological comfort and job performance among a sample of high school teachers for the academic year (2019-2020). The researcher has built two tools to measure psychological comfort, and one to measure job performance. The researcher applied the two scales to a random stratified sample of (100) male and female teachers. The results showed a low level of feeling with psychological comfort among secondary school teachers and a good level of sense of job performance. There is no statistically significant difference in the level of psychological comfort according to gender. There is a significant difference in psychological comfort according to the variable of the length of service in

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