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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 2014
Journal Name
Baghdad Science Journal
Study the effect of acid immersion on the hardness of (Epoxy – Granite) composite
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This work has been done with using of epoxy resin mixed with Granite powder were weighted by percent volume (5,10,15, and 20)%and then mixed with epoxy polymer to compose polymer composite. Hand lay-up technique is used in fabrication of the composite samples. Hardness test was carried out for the proper samples in both normal condition and after immersion in HCL (1 M and 2 M) solutions for periods ranging up to 10 weeks. After comparing the results between the polymer and their composite, the hardness increased with increasing Granite weight percent, it was found that Hardness were greater for the composites before immersion compared with their values after immersion.

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Publication Date
Sat Jan 05 2019
Journal Name
Iraqi Journal Of Physics
Study the effect of sodium hydroxide solution on the thermal conductivity of nanocomposites
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In this research, hand lay- up technique is used to prepare samples from epoxy resin reinforced with multi- walled carbon nanotubes in different weight fractions (0, 2, 3, 4, 5) wt%. The immersion effect by sodium hydroxide solution (NaOH) at normality (0.3N) for a period of (15 days) on the thermal conductivity of nanocomposites was studied, and compared to natural condition (before immersion). The thermal conductivity of epoxy nanocomposites specimens were carried out using Lee’s disk method. The experimental results showed that thermal conductivity increased with increase weight fraction before and after immersion for all specimens, while the immersion effect leads to decrease thermal conductive values compared to thermal conductivi

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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
The study of the literature review of hybrid classification approaches to credit scoring
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Publication Date
Tue Oct 30 2018
Journal Name
Journal Of Engineering
Study the Effect of Various Parameters on the Synthesis of ZSM-5 Zeolite
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ZSM-5 zeolite was synthesis under hydrothermal conditions at 175oC. The synthesis parameters have been investigated to find optimum synthesis method. Firstly, the crystallization time has been investigated to find the optimum crystallization time. Also, the ageing time was studied. The morphology, structure, and composition of the synthesized ZSM-5 zeolite were characterized using scanning electron microscopy (SEM), pH meter, viscometer, and X-ray powder diffraction (XRD). The bulk Si/Al ratio of ZSM-5 zeolite was in the range of 9.5—11.7. The synthesized ZSM-5 zeolite with appropriate ageing time could adjust crystal size and degree of the crystallinity. The crystal size of ZSM-5 zeolite obtained at an agei

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Study the Effect of Hydrolysis Variables on the Production of Soya Proteins Hydrolysis
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This study was conducted to determine the effects of concentration of hydrochloric acids, temperature, and time on the hydrolysis of soya proteins (defatted soya flour) by determining the value of total protein nitrogen  concentration, and amino nitrogen concentration of protein, peptides, and amino acids, and then calculated the hydrolysis rate of proteins.

        The variables of the conditions of hydrolysis process was achieved in this study with the following range value of tests parameter:

  • Concentration of HCl solution ranged between 1-7 N,
  • Hydrolysis temperature ranged between 35-95 °C, and
  • The time of hydroly

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Publication Date
Tue Mar 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Study of the marketing supply chain of the fuel oil productUsing transport models
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The marketing logistic chain, as an integrated system aimed to balance the achievement of its main opposite objectives which represented in the access to the best service presented to the customer with lowest possible logistic costs especially the transportation costs, where encourages the researcher to choose the second objective as a field of this study in order to reduce the transportation costs in the final link of marketing logistic chain which related to delivering of fuel oil to the customer that falls within organizational responsibilities of the company under consideration (Oil Marketing Company) and also known in a brief name by (SOMO) through two methods, the first is by functioning quantative techniques by using trans

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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
Study the effect of curved edges on the aerodynamics performance of suction slot
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Publication Date
Tue Jun 01 2021
Journal Name
Int. J. Nonlinear Anal. Appl.
Study of the dual ideal of ku-algebra
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In this work, we apply the notion of a filter of a KU-Algebra and investigate several properties. The paper defined some filters such as strong filter, n-fold filter and P-filter and discussed a few theorems and examples.

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Publication Date
Fri Nov 01 2019
Journal Name
Recent Technologies In Sustainable Materials Engineering
A Comparative Study Between the Individual, Dual and Triple Addition of (S.F.), (T.G.P.) and (P.V.A.) for Improving Local Gypsum (Juss) Properties
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Publication Date
Fri Jun 20 1930
Journal Name
College Of Islamic Sciences
Besharat and Quranic signs of the Prophet Muhammad (PBUH): Study and analysis
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In this paper, I highlight the bishops mentioned in the Bible in its sections
(The Old and New Testaments) where these books still retain the remaining remnant of the Bible
Issuing the prophets who preceded the mission of the Prophet Muhammad (peace and blessings of Allaah be upon him) and they must pray
And peace, as those bishops were mentioned in the Book of Formation through the recitation of the psalms
To Habakkuk, Malakhi, and Hajji.
As well as in the New Testament, which we see clearly in the four Angels: Matthew, Luke,
Disco, John.
Then the male lamented what was said of those bishops by expressing the eternal heavenly book (the Qur'an)
Al - Karim) as he focuses on this subject from multiple angles and exp

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