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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 May 01 2022
Journal Name
Optical Fiber Technology
Optical fiber sensor network integrating SAC-OCDMA and cladding modified optical fiber sensors coated with nanomaterial
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Publication Date
Mon Jul 01 2024
Journal Name
Journal Of Engineering
IoT-Based Low-Cost Smart Health Monitoring System using Raspberry Pi Pico W and Blynk Application
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في السنوات الأخيرة، أدى التقدم التكنولوجي في إنترنت الأشياء (IoT) وأجهزة الاستشعار الذكية إلى فتح اتجاهات جديدة وإعطاء حلول عملية في مختلف قطاعات الحياة. يتم التعرف على إنترنت الأشياء كتنولوجيا حديثة تربط بين مختلف انواع الشبكات. تم تحسين أنواع مختلفة من قطاعات الرعاية الصحية في المجال الطبي بناءً على هذه التكنولوجيا. أحد هذه القطاعات الهامة هو نظام مراقبة الصحة (HMS). تعتبر مراقبة المريض عن بعد لاسلكيًا وبت

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Fri Oct 01 2010
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2010 Ieee Symposium On Industrial Electronics And Applications (isiea)
Distributed t-way test suite data generation using exhaustive search method with map and reduce framework
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Publication Date
Mon Oct 31 2022
Journal Name
Iraqi Geological Journal
Formulating Inhibited Fluids for Stable Drilling Operations into Tanuma and Zubair Shales, Zubair Oilfield, Southern Iraq
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Tanuma and Zubair formations are known as the most problematic intervals in Zubair Oilfield, and they cause wellbore instability due to possible shale-fluid interaction. It causes a vast loss of time dealing with various downhole problems (e.g., stuck pipe) which leads to an increase in overall well cost for the consequences (e.g., fishing and sidetrack). This paper aims to test shale samples with various laboratory tests for shale evaluation and drilling muds development. Shale's physical properties are described by using a stereomicroscope and the structures are observed with Scanning Electron Microscope. The shale reactivity and behavior are analyzed by using the cation exchange capacity testing and the capillary suction test is

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Aip Conference Proceedings
Biogenic selenium nanoparticles by probiotics streptococcus salivarius and effect on oprM gene expression from Pseudomonas aeruginosa
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Renewable And Sustainable Energy Reviews
Dye-sensitised solar cells: Development, structure, operation principles, electron kinetics, characterisation, synthesis materials and natural photosensitisers
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Publication Date
Sat Apr 01 2023
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International Journal Of Electrical And Computer Engineering (ijece)
Flexible handover solution for vehicular ad-hoc networks based on software defined networking and fog computing
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<p>Vehicular ad-hoc networks (VANET) suffer from dynamic network environment and topological instability that caused by high mobility feature and varying vehicles density. Emerging 5G mobile technologies offer new opportunities to design improved VANET architecture for future intelligent transportation system. However, current software defined networking (SDN) based handover schemes face poor handover performance in VANET environment with notable issues in connection establishment and ongoing communication sessions. These poor connectivity and inflexibility challenges appear at high vehicles speed and high data rate services. Therefore, this paper proposes a flexible handover solution for VANET networks by integrating SDN and

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Thu Apr 15 2021
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CYTOKINES PROFILE FOR INTESTINAL AND SPLEEN HOMOGENATE FOR IMMUNOSUPPRESSANT BALB/C MICE INFECTED WITH CRYPTOSPORIDIUM PARVUM
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Cryptosporidiosis is mainly cause a persistent diarrhea in immune compromised patients, BALB/c mice have been suppressed by dexamethasone, tissue Th1, Th2 and Th17 cytokines concentrations in the ileum were significantly diminished in both infected and immunosuppressed mice. Level of IFN-g, TNF-a, IL-12, IL-6, IL-17A was increased in level, IL-4 didn’t increases, in both ileal and spleen tissue. Levels of above cytokines were examined in spleen in order to follow the proliferation of CD4+ T-cell during C. parvum infection.

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Publication Date
Wed Mar 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Complete Blood Count and saliva parameters as an indicator for infected patients with coronavirus covid-19
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Background: Coronavirus, which causes respiratory illness, has been a public health issue in recent decades. Because the clinical symptoms of infection are not always specific, it is difficult to expose all suspects to qualitative testing in order to confirm or rule out infection as a test. Methods: According to the scientific studies and investigations, seventy-three results of scientific articles and research  were obtained using PubMed, Medline, Research gate and Google Scholar. The research keywords used were COVID-19, coronavirus, blood parameters, and saliva. Results: This review provides a report on the changes in the blood and saliva tests of those who are infected with the COVID-19.COVID-19 is a systemic infection that has

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