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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 01 2018
Journal Name
Fme Transaction
The influence of frictional facing thickness on the contact pressure distribution of multi-disc dry clutches
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Publication Date
Mon Jan 01 2018
Journal Name
Fme Transaction
The influence of frictional facing thickness on the contact pressure distribution of multi-disc dry clutches
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Frictional heat is generated when the clutch starts to engag. As a result of this operation the surface temperature is increased rapidly due to the difference in speed between the driving and driven parts. The influence of the thickness of frictional facing on the distribution of the contact pressure of the multi-disc clutches has been investigated using a numerical approach (the finite element method). The analysis of contact problem has been carried out for a multiple disc dry clutch (piston, clutch discs, separators and pressure plate). The results present the distribution of the contact pressure on all tShe surfaces of friction discs that existed in the friction clutch system. Axisymmetric finite element models have been developed to ac

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Publication Date
Fri Sep 30 2016
Journal Name
Al-khwarizmi Engineering Journal
Modeling the removal of Cadmium Ions from Aqueous Solutions onto Olive Pips Using Neural Network Technique
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The uptake of Cd(II) ions from simulated wastewater onto olive pips was modeled using artificial neural network (ANN) which consisted of three layers. Based on 112 batch experiments, the effect of contact time (10-240 min), initial pH (2-6), initial concentration (25-250 mg/l), biosorbent dosage (0.05-2 g/100 ml), agitation speed (0-250 rpm) and temperature (20-60ºC) were studied. The maximum uptake (=92 %) of Cd(II) was achieved at optimum parameters of 60 min, 6, 50 mg/l, 1 g/100 ml, 250 rpm and 25ºC respectively.

Tangent sigmoid and linear transfer functions of ANN for hidden and output layers respectively with 7 neurons were sufficient to present good predictions for cadmium removal efficiency with coefficient of correlatio

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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Nadaraya-Watson Estimator a Smoothing Technique for Estimating Regression Function
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    The using of the parametric models and the subsequent estimation methods require the presence of many of the primary conditions to be met by those models to represent the population under study adequately, these prompting researchers to search for more flexible models of parametric models and these models were nonparametric models.

    In this manuscript were compared to the so-called Nadaraya-Watson estimator in two cases (use of fixed bandwidth and variable) through simulation with different models and samples sizes.  Through simulation experiments and the results showed that for the first and second models preferred NW with fixed bandwidth fo

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Publication Date
Sun Jan 01 2023
Journal Name
Communications In Mathematical Biology And Neuroscience
A reliable numerical simulation technique for solving COVID-19 model
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Publication Date
Fri Mar 29 2024
Journal Name
Iraqi Journal Of Science
Determination of Timewise-Source Coefficient in Time-Fractional Reaction-Diffusion Equation from First Order Heat Moment
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     This article aims to determine the time-dependent heat coefficient together with the temperature solution for a type of semi-linear time-fractional inverse source problem by applying a method based on the finite difference scheme and Tikhonov regularization. An unconditionally stable implicit finite difference scheme is used as a direct (forward) solver. While by the MATLAB routine lsqnonlin from the optimization toolbox, the inverse problem is reformulated as nonlinear least square minimization and solved efficiently. Since the problem is generally incorrect or ill-posed that means any error inclusion in the input data will produce a large error in the output data. Therefore, the Tikhonov regularization technique is applie

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
Therapeutic Role of Isotretinoin in the Management of Recurrent Aphthous Stomatitis (Single-Blind Controlled Therapeutic Study)
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Publication Date
Wed Jun 26 2019
Journal Name
The Iraqi Geological Journal
A MODIFIED WATER INJECTION TECHNIQUE TO IMPROVE OIL RECOVERY: MISHRIF CARBONATE RESERVOIRS IN SOUTHERN IRAQ OIL FIELDS, CASE STUDY
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A modified water injection technique has organized by this study to improve oil recovery of the Mishrif reservoirs using polymerized alkaline surfactant water (PAS-Water) injection. It is planned to modify the existing water injection technology, first to control and balance the hazardous troublemaker reservoir facies of fifty-micron pore sizes with over 500 millidarcies permeability, along with the non-troublemaker types of less than twenty micron pore sizes with 45 to 100 millidarcies permeability. Second to control Mishrif reservoirs rock-wettability. Special core analysis under reservoir conditions of 2250 psi and 90 °C has carried out on tens of standard core plugs with heterogeneous buildup, using the proposed renewal water f

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
The role of organizational change to achieve strategic success A field research in the Petroleum Research & Development Center-Ministry of Oil
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  This current research deals with the "The role of organizational change in the achievement of strategic success" Who are getting increased attention to being one of the important topics and relatively new, And which have a significant impact on the future of the organization So there is a need for this research, which aims to identify the role of organizational change across dimensions (technology, organizational structure, human resources, organizational culture) in the strategic success through its components (a specific strategy, effective implementation, innovation, customer satisfaction)، And that by two main hypotheses, branched about eight hypothes

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Publication Date
Sat Jan 01 2022
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees21gr
Non-thermal plasma effects on of structural and optical properties of Nio:Li thin films prepared by the spray pyrolysis technique
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In this research ,Undoped Nio and 1%Li doped Nio thin films were deposited utilizing chemical spray pyrolysis on the glass substrates heated (450C). The effects of non-thermal plasma on the structural and optical properties were studied. XRD measurement shows that Nio and Nio:1%Li films were found to be polycrystalline and have cubic structure with a preferred orientation (111). Decreased crystal size after exposure especially at (7) sec. AFM data indicate that the surface roughness average and (RMS) values of the prepared doped films are increasing after exposure to plasma, the transmittance increases after doped samples exposure to plasma, it was found that the energy gap value decreased when doped samples exposure to plasma, also, thickn

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