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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 Jan 29 2024
Journal Name
Polymer Bulletin
An experimental study to investigate the effect of aluminum nanorod-reinforced epoxy matrix nanocomposites
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Publication Date
Wed Jan 01 2020
Journal Name
Plant Archives
Study of the environmental parameters on cephalexin degradation by anodic oxidation with biological indication
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Publication Date
Sun Jun 01 2025
Journal Name
Iop Conference Series: Earth And Environmental Science
Study the Impact of Soil Texture on Subsurface Trickle Irrigation Shifting towards Sustainable Sources
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Abstract<p>One of the most effective systems for managing water is subsurface trickle irrigation. Finding empirical formulas and studying the effect of soil texture are the main purposes of this paper. In order to reach an ideal irrigation system as a modern technique to save water, especially in arid regions, soil textures of loam, silt, and silt loam were studied on a subsurface trickle irrigation system by utilizing HYDRUS/2D. The trickle system is usually operated at low pressure, in this paper the used pressure is 30 cm with an emitter buried at 10, 15, and 20 cm at different diameters. Patterns of wetting fronts in both directions at various times depending on soil texture are gathered to </p> ... Show More
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Publication Date
Thu Jun 10 2021
Journal Name
Journal Of Mechanical Engineering Research And Developments
Study on the effect of diesel engine oil contaminated with fuel on engine performance
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An experiment was conducted to study how SAE 50 engine oil contaminated with diesel fuel affects engine performance. The engine oil was contaminated with diesel fuel at concentrations of 0%, 1%, and 3%. The following performance characteristics were studied: brake-specific fuel consumption, brake thermal efficiency, friction power, and exhaust gas temperature. Each treatment was tested three times. The three treatments (0%, 1%, and 3%) were analyzed statistically with a one-way ANOVA model at the 5% probability level to determine if the three treatments produced significant differences in engine performance. The statistical results showed that there were significant differences in engine performance metrics among the three treatments. The 3

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Publication Date
Sat May 01 2021
Journal Name
Https://www.researchgate.net/journal/journal-of-physics-conference-series-1742-6596
The management of water distribution network using GIS application case study: AL-Karada area
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Abstract<p>Clean water supply is one of the major factors contributing significantly to society’s socio-economic transformation by improving living standards, health, and increasing productivity. It is imperative to plan and construct appropriate water supply systems in modern society, which supply various segments of society with safe drinking water according to their requirements to ensure adequate and quality water supply. In the current study, here was an attempt to develop a model for geographic information systems to manage the assets of the water distribution networks in the Karrada region and to evaluate the network geometrically, and from the results of the engineering analysis of the</p> ... Show More
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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi Journal Of Physics
Nuclear structure study of some tin isotopes using the self-consistent mean field method
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Hartree-Fock calculations for even-even Tin isotopes using
Skyrme density dependent effective nucleon-nucleon interaction are
discussed systematically. Skyrme interaction and the general formula
for the mean energy of a spherical nucleus are described. The charge
and matter densities with their corresponding rms radii and the
nuclear skin for Sn isotopes are studied and compared with the
experimental data. The potential energy curves obtained with
inclusion of the pairing force between the like nucleons in Hartree-
Fock-Bogoliubov approach are also discussed.

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Publication Date
Sun Sep 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Study the Effect of Residence Time Parameters on Thermal Cracking Extract Phase Lubricating Oil
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This work studies with produce of light fuel fractions of gasoline, kerosene and gas oil from treatment of residual matter that will be obtained from the solvent extraction process as by product from refined lubricate to improve oil viscosity index in any petroleum refinery. The percentage of this byproduct is approximately 10% according to all feed (crude oil) in the petroleum refinery process. The objective of this research is to study the effect of the residence time parameter on the thermal cracking process of the byproduct feed at a constant temperature, (400 °C). The first step of this treatment is the thermal cracking of this byproduct material by a constructed batch reactor occupied with control device at a selective range of re

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Publication Date
Thu Sep 05 2024
Journal Name
Herald Of The Bauman Moscow State Technical University. Series Natural Sciences Scientific-theoretical And Applied-science Journal.
Study the Efficiency of Titanium Dioxide Nanoparticles for Water Treatment from Conge Red Dye
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A modified chemical method was used to prepare titanium dioxide nanoparticles (TiO2 NPs), which were diagnosed by several techniques: X-ray diffraction, Fourier transform infrared, field emission scaning electron microscopy, energy disperse X-ray, and UV-visible spectroscopy, which proved the success of the preparation process at the nanoscale level. Where the titanium oxide particles have an average particle size equal to 6.8 nm, titanium dioxide particles were used in the process of adsorption of Congo red dye from its aqueous solutions using a batch system. The titanium oxide particles gave an adsorption efficiency of Congo red dye up to more than 79 %. The experimental data of the adsorption process were analyzed with kinetic models and

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Identification Pseudomonas aeruginosa by 16s rRNA gene for Differentiation from Other Pseudomonas Species that isolated from Patients and environment
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Pseudomonas aeruginosa is a common and major opportunistic human pathogen, its causes many and dangersinfectious diseases due to death in some timesex: cystic fibrosis , wounds inflammation , burns inflammation , urinary tract infection , other many infections otitis external , Endocarditis , nosocomial infection and also causes other blood infections (Bacteremia). thereforebecomes founding fast and exact identification of P. aeruginosafrom samples culture very important.However, identification of this species may be problematic due to the marked phenotypic variabilitydemonstrated by samples isolates and the presence of other closely related species. To facilitate species identification, we used 16S ribosomal DNA(rRNA) sequence data

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Publication Date
Sat Jun 01 2024
Journal Name
Innovative Food Science &amp; Emerging Technologies
Non-thermal pasteurization of milk by elongated electrode moderate electrical field: Chemical and sensory analysis during cold storage and shelf-life determination
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