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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
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Two Domain Flow Method for Leachate Prediction Through Municipal Solid Waste Layers in Al–Amari Landfill Site
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Existing leachate models over–or underestimates leachate generation by up to three orders of magnitude. Practical experiments show that channeled flow in waste leads to rapid discharge of large leachate volumes and heterogeneous moisture distribution. In order to more accurately predict leachate generation, leachate models must be improved. To predict moisture movement through waste, the two–domain PREFLO, are tested. Experimental waste and leachate flow values are compared with model predictions. When calibrated with experimental parameters, the PREFLO provides estimates of breakthrough time. In the short term, field capacity has to be reduced to 0.12 and effective storage and hydraulic conductivity of the waste must be increased to

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Using TD-ABC technology to determine idle production capacity: An applied research in Al-Wasat Oil Company
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The aim of the research to apply TD-ABC technology to determine the idle capacity of the central oil companies (oil field east of Baghdad), as a modern cost management technology based on time-oriented activities (TD-ABC) is used by industrial companies in general and oil companies on In particular to build a sustainable Calvinist pillar and make future decisions by identifying idle energy to gain it a competitive advantage, the descriptive analytical approach has been adopted in calculating and analyzing the company’s data for 2018, and the most prominent conclusions of this research are managing idle energy and the task of applying cost technology on the basis of time-oriented activities and providing Convenient spatial infor

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Publication Date
Fri Oct 16 2026
Journal Name
Journal Of Administration And Economics
Bayesian Method in Classification Regression Tree to estimate nonparametric additive model compared with Logistic Model with Application
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The use of Bayesian approach has the promise of features indicative of regression analysis model classification tree to take advantage of the above information by, and ensemble trees for explanatory variables are all together and at every stage on the other. In addition to obtaining the subsequent information at each node in the construction of these classification tree. Although bayesian estimates is generally accurate, but it seems that the logistic model is still a good competitor in the field of binary responses through its flexibility and mathematical representation. So is the use of three research methods data processing is carried out, namely: logistic model, and model classification regression tree, and bayesian regression tree mode

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Publication Date
Mon Apr 27 2026
Journal Name
Applied Fruit Science
Predicting Bitter Orange (Citrus aurantium L.) Maturity by Machine Learning Based on Picking Force in Smart Picker
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Manual fruit picking is labor-intensive and can damage fruit. Fully mechanized picking is efficient, but it also risks fruit damage. Therefore, semi-automated tools are needed to improve bitter orange picking. This paper presents a smart manual picker designed to facilitate picking while predicting fruit maturity based on picking force as well as various chemical and physical parameters using machine learning (ML). The study methodology consists of five stages: (1) manufacturing the smart picker, (2) picking 50 bitter orange samples, (3) measuring the characteristics of the bitter oranges in the laboratory, (4) training different ML models, and (5) identifying the most accurate model for predicting fruit maturity. The results indicate that

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Publication Date
Tue Mar 30 2021
Journal Name
Baghdad Science Journal
Aquatic Oligochaeta (Annalida:Clitellata) as Bio Indication for Sediment Quality Assessment in Tigris River Within Baghdad City /Iraq
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Aquatic Oligochaeta is an important group of Macroinvertebrates that has been very remarkable as bioindicators for assessing water pollution and determining its degree in water bodies. Hence, the idea of the current study aims at studying the impact of Baghdad effluents on the Tigris River by using oligochaetes community as bioindicators . For this purpose, four sites along the inside of Baghdad has been chosen. Site S1 has been located upstream, site S2 and S3 has been at midstream and site S4 at the downstream of the River.This investigation has used different types of biological indicators, including the  percentage of oligochaeta  within benthic invertebrates, which ranged from 49.2-51.28%. The highest percentage of the tubificid w

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Appropriate for Use Under Advanced Manu Facturing Technology: An Application in Baghdad Soft Drinks Company " Private Contribution
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Big developments in technology have led to upset the balance of ideas, given of its own post new properties for products not provided by traditional technology, especially economic units operating within the industrial sector, and therefore it is important to develop the Iraqi industrial sector and interest to do its vital role in light Of progress technological.The research aims to Find the use of advanced manufacturing technologies that lead to customized production and quality appropriate whether they are low quality and low cost or low cost and suitable quality or high quality and high cost to win customer satisfaction.While the important conclusions is that the application of advanced manufacturing technology is not limited to techn

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Publication Date
Wed Sep 30 2020
Journal Name
Cfd Letters
Numerical Analysis for Solar Panel Subjected with an External Force to Overcome Adhesive Force in Desert Areas
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Publication Date
Mon Jan 01 2018
Journal Name
Organic &amp; Biomolecular Chemistry
Small-molecule anticancer agents kill cancer cells by harnessing reactive oxygen species in an iron-dependent manner
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In the course of generating a library of open-chain epothilones, we discovered a new class of small molecule anticancer agents that has no effect on tubulin but instead kills selected cancer cell lines by harnessing reactive oxygen species in an iron-dependent manner.

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Publication Date
Mon Jan 01 2024
Journal Name
Ieee Access
An Evolutionary Algorithm With Heuristic Operator for Detecting Protein Complexes in Protein Interaction Networks With Negative Controls
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Publication Date
Sun Dec 01 2024
Journal Name
Journal Of Industrial And Engineering Chemistry
Highly efficient oil-in-water emulsion separation based on innovative stannic oxide/polyvinylchloride (SnO2/PVC) microfiltration membranes
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