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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
Mon Oct 28 2019
Journal Name
Journal Of Mechanics Of Continua And Mathematical Sciences
Heuristic Initialization And Similarity Integration Based Model for Improving Extractive Multi-Document Summarization
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Publication Date
Mon Oct 14 2024
Journal Name
Irish Journal Of Medical Science (1971 -)
Comparison between early and late weight bearing after anterior cruciate ligament reconstruction surgery
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Publication Date
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
Build and Implemented Learning Package for Prolog Programming Language Using Visual Basic.Net 2010
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E-Learning packages are content and instructional methods delivered on a computer
(whether on the Internet, or an intranet), and designed to build knowledge and skills related to
individual or organizational goals. This definition addresses: The what: Training delivered
in digital form. The how: By content and instructional methods, to help learn the content.
The why: Improve organizational performance by building job-relevant knowledge and
skills in workers.
This paper has been designed and implemented a learning package for Prolog Programming
Language. This is done by using Visual Basic.Net programming language 2010 in
conjunction with the Microsoft Office Access 2007. Also this package introduces several
fac

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Publication Date
Thu Jan 20 2022
Journal Name
Webology
Hybrid Intrusion Detection System based on DNA Encoding, Teiresias Algorithm and Clustering Method
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Until recently, researchers have utilized and applied various techniques for intrusion detection system (IDS), including DNA encoding and clustering that are widely used for this purpose. In addition to the other two major techniques for detection are anomaly and misuse detection, where anomaly detection is done based on user behavior, while misuse detection is done based on known attacks signatures. However, both techniques have some drawbacks, such as a high false alarm rate. Therefore, hybrid IDS takes advantage of combining the strength of both techniques to overcome their limitations. In this paper, a hybrid IDS is proposed based on the DNA encoding and clustering method. The proposed DNA encoding is done based on the UNSW-NB15

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Comparison Between Tree regression (TR), and Negative binomial regression (NBR) by Using Simulation.
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            In this paper, the process of comparison between the tree regression model and the negative binomial regression. As these models included two types of statistical methods represented by the first type "non parameter statistic" which is the tree regression that aims to divide the data set into subgroups, and the second type is the "parameter statistic" of negative binomial regression, which is usually used when dealing with medical data, especially when dealing with large sample sizes. Comparison of these methods according to the average mean squares error (MSE) and using the simulation of the experiment and taking different sample

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
Parental Treatment Styles and their Relationship to Self-Efficacy among Middle School Students
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The current research aims to identify the level of parental treatment methods tolerance, hostility, strictness, and warmth, as well as the level of self-efficacy among middle school students. Moreover, it aims to identify the correlation relationship between the variables of parental treatment methods and self-efficacy among middle school students. The research sample included (150) middle school students. For achieving the objectives of the current research, the researchers adopted a scale of parental treatment methods prepared by (Zughair, 2006), and a scale of self-efficacy prepared by (Youssef, 2016), which were applied in their final form to the research sample. The research reached the following results: parents use a low-level hos

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Publication Date
Fri Aug 01 2008
Journal Name
2008 International Symposium On Information Technology
Algebraic strategy to generate pairwise test set for prime number parameters and variables
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Publication Date
Wed Jan 01 2025
Journal Name
Transactions Of The Chinese Society Of Agricultural Machinery
Evaluating Tillage Quality under Varying Speed and Depth Using YOLOv7-Based Image Analysis
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Soil tillage is a critical agricultural practice that creates favorable conditions for seedbed preparation and plant growth. This study presents an innovative application of artificial intelligence (AI) in agriculture by employing the YOLOv7 algorithm to classify and assess post-tillage soil surface conditions, a domain underexplored in current research. The integration of mechanical operation parameters with AI-based image classification enables optimization of tillage quality and mitigation of soil compaction, highlighting the novelty of this approach. The study aims to improve the efficiency of moldboard plow operations by examining the effects of tillage speed and depth on soil clod distribution, fuel consumption, and power requ

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Publication Date
Mon Nov 24 2025
Journal Name
2025 13th International Conference On Control, Mechatronics And Automation (iccma)
Modeling Twisting and Coiling Actuators with Regression-Based Learning: Application to Neck Rehabilitation
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Twisting and coiling actuators (TCAs) are lightweight artificial muscles that can produce large linear contractions while lifting heavy loads with low power. A TCA consists of two or more strings connected to a rotational motor and a load. When activated, the strings twist and coil, causing contraction. This study presents a data-driven framework for modeling TCA behavior using experimental data. Polynomial regression, Support Vector Regression (SVR), and symbolic regression were applied using the motor angle and payload weight as inputs. The models were evaluated under various loads and implemented in a neck-rehabilitation prototype. SVR showed the highest accuracy (RMSE: 6.17 mm upward, 4.98 mm downward); however, it lacks a closed-form e

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Publication Date
Tue Dec 05 2023
Journal Name
Baghdad Science Journal
Synthesis and Antibacterial Evaluation for Some New Schiff-bases Derived from P-aminoacetanilide
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Derivatives of Schiff-bases possess a great importance in pharmaceutical chemistry. They can be used for synthesizing different types of bioactive compounds. In this paper, derivatives of new Schiff bases have been synthesized from several serial steps. The acid (I) was synthesized from the reaction of dichloroethanoic acid with 2 moles of p-aminoacetanilide. New acid (I) converted to its ester (II) via the reaction of (I) with dimethyl sulphate in the present of anhydrous of sodium carbonate and dry acetone. Acid hydrazide (III) has been synthesized by adding 80% of hydrazine hydrate  to the new ester using ethanol as a solvent. The last step included the preparation of new Schiff-bases (IV-VIII) by the reaction of acid hydrazide with

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