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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
Thu Feb 04 2016
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Economic losses caused by mole cricket Gryllotalpa gryllotalpa on some vegetable plants and agricultural crops: Economic losses caused by mole cricket Gryllotalpa gryllotalpa on some vegetable plants and agricultural crops
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The study was conducted to estimate the economic losses caused by insect mole cricket Gryllotalpa gryllotalpa on some agricultural crops and Potato tubers in collage of Agriculture- Abu Ghraib season 2012-2013. Study showed Mole cricket caused percentage of infestation in spring potato tubers variety Luciana reached to 11.61% and the percentage of loss in weight of tubers reached 18.88%. The study showed that addition of animal manure (organic fertilizer) to the soil when planting potatoes in the autumn increased the incidence of infestation and the number of tunnels caused by mole cricket which led to from increased economic losses. When matured potato tubers were left for a longer period in the soil percentage of infestation by mole cr

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Publication Date
Fri Jan 01 2016
Journal Name
Iraqi National Journal Of Chemistry
Novel Biomarker in Polycystic Ovary Syndrome (PCOS) Infertile Females With Diabetes Mellitus Prone to Atherosclerosis
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The study aimed to evaluate Glucagon-Like Peptide-1 levels in Polycystic ovary syndrome (PCOS) infertile female with Diabetes Mellitus (DM) and compare the results with control group, also, to find the correlation for GLP-1 with Luteinizing hormone (LH), Follicle stimulating hormone (FSH) and LH/FSH ratio that may be used in prediction atherosclerosis in these patients. The study included nineteen women with age ranged (30-40) years and BMI ranged between (30-35) Kg/m 2. Subjects were divided into two groups: group (1) consist of (45) females as a healthy control and group (2) consist of (45) infertile females with PCOS and DM as complication. Fasting serum glucose was determined by using commercial kits (Biolabo SA-France); LH, FSH, prolac

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of The College Of Education For Women
Applying Decisions’ Theory to choose an Alternative Factor for Spatial Development in Holy Karbala Governorate
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It is very well known in the planning publications that when creating spacing development to a region or sub-region, it can be able to make more than an alternative consisting with the strategic directions overtaken from the actual development of region and the situational and developmental objectives needed. However, the difficulty facing the situational planning is in selecting one of these alternatives to be the best in order to make a balanced situational re-structure, and achieving the economic, social and civil objectives. The developmental situation elements in the regions and governorates, including (Karbala) impose themselves as situational power which implies the process of re-structural arrangement where the situational develo

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Publication Date
Wed Jul 31 2019
Journal Name
Journal Of Engineering
Enhancing Heat Transfer in Tube Heat Exchanger by Inserting Discrete Twisting Tapes with Different Positions
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Enhancement of heat transfer in the tube heat exchanger is studied experimentally by using discrete twisted tapes. Three different positions were selected for inserting turbulators along tube section (horizontal position by α= 00, inclined position by α= 45 0 and vertical position by α= 900). The space between turbulators was fixed by distributing 5 pieces of these turbulators with pitch ratio    PR = (0.44). Also, the factor of constant heat flux was applied as a boundary condition around the tube test section for all experiments of this investigation, while the flow rates were selected as a variable factor (Reynolds number values vary from 5000 to 15000). The results s

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Publication Date
Tue Jun 30 2020
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
Immiscible CO2-Assisted Gravity Drainage Process for Enhancing Oil Recovery in Bottom Water Drive reservoir
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The CO2-Assisted Gravity Drainage process (GAGD) has been introduced to become one of the mostinfluential process to enhance oil recovery (EOR) methods in both secondary and tertiary recovery through immiscibleand miscible mode. Its advantages came from the ability of this process to provide gravity-stable oil displacement forenhancing oil recovery. Vertical injectors for CO2 gas have been placed at the crest of the pay zone to form a gas capwhich drain the oil towards the horizontal producing oil wells located above the oil-water-contact. The advantage ofhorizontal well is to provide big drainage area and small pressure drawdown due to the long penetration. Manysimulation and physical models of CO2-AGD process have been implemented

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Publication Date
Wed Nov 05 2025
Journal Name
Irrigation And Drainage
Predicting Potential Salinity in River Water for Irrigation Water Purposes Using Integrative Machine Learning Models
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ABSTRACT<p>Accurate prediction of river water quality parameters is essential for environmental protection and sustainable agricultural resource management. This study presents a novel framework for estimating potential salinity in river water in arid and semi‐arid regions by integrating a kernel extreme learning machine (KELM) with a boosted salp swarm algorithm based on differential evolution (KELM‐BSSADE). A dataset of 336 samples, including bicarbonate, calcium, pH, total dissolved solids and sodium adsorption ratio, was collected from the Idenak station in Iran and was used for the modelling. Results demonstrated that KELM‐BSSADE outperformed models such as deep random vector funct</p> ... Show More
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Publication Date
Mon May 01 2023
Journal Name
Kurdish Studies
Establishing Proof Against Those Who Claimed to Contradict Al-Noman in Matters Such as Sales
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Jurisprudential disagreements are a significant source of a vast jurisprudential wealth. Among the manifestations of these disagreements are scholarly critiques raised by some scholars against others, claiming their divergence from the legal evidence or established principles for deducing legal rulings. One such critique is presented by the narrator scholar Abu Bakr Ibn Abi Shaybah, may Allah have mercy on him, directed towards Abu Hanifah al-Nu‘man, may Allah have mercy on him. In his compilation, Ibn Abi Shaybah cited numerous hadiths and traditions that he considered conflicting with the judgments as perceived by Imam Abu Hanifah, may Allah have mercy on him. These issues cover various branches of jurisprudence, including worship, sale

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Publication Date
Mon Jul 18 2022
Journal Name
Ieee Access
Moderately Multispike Return Neural Network for SDN Accurate Traffic Awareness in Effective 5G Network Slicing
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Due to the huge variety of 5G services, Network slicing is promising mechanism for dividing the physical network resources in to multiple logical network slices according to the requirements of each user. Highly accurate and fast traffic classification algorithm is required to ensure better Quality of Service (QoS) and effective network slicing. Fine-grained resource allocation can be realized by Software Defined Networking (SDN) with centralized controlling of network resources. However, the relevant research activities have concentrated on the deep learning systems which consume enormous computation and storage requirements of SDN controller that results in limitations of speed and accuracy of traffic classification mechanism. To fill thi

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Publication Date
Tue Jun 01 2021
Journal Name
Baghdad Science Journal
Ammonia Removal in Free-Surface Constructed Wetlands Employing Synthetic Floating Islands: Employing synthetic floating islands
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Free water surface constructed wetlands (FSCWs) can be used to complement conventional waste water treatment but removal efficiencies are often limited by a high ratio of water volume to biofilm surface area (i.e. high water depth). Floating treatment wetlands (FTWs) consist of floating matrices which can enhance the surface area available for the development of fixed microbial biofilms and provide a platform for plant growth (which can remove pollutants by uptake).  In this study the potential of FTWs for ammoniacal nitrogen (AN) removal was evaluated using experimental mesocosms operated under steady-state flow conditions with ten different treatments (two water depths, two levels of FTW mat coverage, two different plant densities and

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Publication Date
Wed Mar 20 2024
Journal Name
Journal Of Petroleum Research And Studies
Advanced Machine Learning application for Permeability Prediction for (M) Formation in an Iraqi Oil Field
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Permeability estimation is a vital step in reservoir engineering due to its effect on reservoir's characterization, planning for perforations, and economic efficiency of the reservoirs. The core and well-logging data are the main sources of permeability measuring and calculating respectively. There are multiple methods to predict permeability such as classic, empirical, and geostatistical methods. In this research, two statistical approaches have been applied and compared for permeability prediction: Multiple Linear Regression and Random Forest, given the (M) reservoir interval in the (BH) Oil Field in the northern part of Iraq. The dataset was separated into two subsets: Training and Testing in order to cross-validate the accuracy

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