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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 Oct 19 2025
Journal Name
Lecture Notes In Networks And Systems
The Impact of Black Marketing on Purchasing Decisions: An Exploratory Study Using AI-Driven Analytical Tools
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Publication Date
Sun Sep 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Study the Effects of Machining Parameters on Surface Roughness for Free Form Surface Using Taguchi Method
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The surface finish of the machining part is the mostly important characteristics of products quality and its indispensable customers’ requirement. Taguchi robust parameters designs for optimizing for surface finish in turning of 7025 AL-Alloy using carbide cutting tool has been utilized in this paper. Three machining variables namely; the machining speeds (1600, 1900, and 2200) rpm, depth of cut (0.25, 0.50, 0.75) mm and the feed rates (0.12, 0.18, 0.24) mm/min utilized in the experiments. The other variables were considered as constants. The mean surface finish was utilized as a measuring of surface quality. The results clarified that increasing the speeds reduce the surface roughness, while it rises with increasing the depths and fee

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Publication Date
Wed May 31 2017
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
THE EFFECT OF ALCOHOLIC EXTRACT OF ANETHUM GRAVEOLENS IN ALLOXAN INDUCED DIABETIC RATS.: THE EFFECT OF ALCOHOLIC EXTRACT OF ANETHUM GRAVEOLENS IN ALLOXAN INDUCED DIABETIC RATS.
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Active compounds were extracted from Anethum gravoelens to produce safety vegetable treat for diabetic, the results showed that alcoholic extract of Anethum gravoelens contain Alkaloid, glycosides, phenols, resins, saponins, coumarins, flavonoide, terpenes, steroids and volatile oils. after that it was studied the effect of alcoholic extract at dose 50, 100 mg/kg of body weight in reduced glucose level in serum of diabetic rats induced by alloxan, after the end of experiment for period 30 days the rats fasting 12 hours to measure the level of glucose in serum, the result showed asignificant decrease in serum glucose level of rats treated with extract in comparison with positive group (alloxan), So biochemical tests showed significant dec

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Publication Date
Sun Dec 10 2017
Journal Name
Al-academy
The ideological effect in the in Interior space structure
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Design system often generated relationship within the frame work of their concept of interior design a system or more can be created between design relationships within this concept in the structure of its internal space product. Through the division of all to it parts to reveal the hidden places and stages of composition and their relationship and interdependence between them. And then re- composition of all its parts, doth in the deign process at the initial stages or in the processes of treatments that are necessary after the completion of design and circulation. To be able to use other events close to the first events designed for them. In terms of idea logical in fluency and its social, economic, cultural and political dimension. As

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Publication Date
Thu Oct 31 2024
Journal Name
Mathematical Modelling Of Engineering Problems
Investigating the Effects of Canard Dihedral Angle on the Wing Span Loading in a Forward-Swept Wing Aircraft at Transonic Speeds at Steady State Conditions Using Computational Fluid Dynamics
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Forward-swept wings were researched and introduced to improve maneuverability, control, and fuel efficiency while reducing drag and they are often used alongside canards, to further enhance their characteristics. In this research, the effects of canard dihedral angles on the wing loading of a forward-swept wing in transonic flow conditions were studied, as the wing loading provides a measure of wing’s efficiency (lift/drag). A generic aircraft model from literatures was selected, simulated, and compared to, using CFD software ANSYS/Fluent where the flow equations were solved to calculate the aerodynamic characteristics. The research was carried at two different Mach numbers, 0.6 and 0.9, for five different canard dihedral angles which tra

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Female education in Iraq 1921-1958 - A historical Study-
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In spite of the foundation of Iraqi state in 1921 and the formation of the new features of
the modern state, however, the inherited costumes and traditions sustained in the conservative
society. But due to the development that inflicted to the Iraqi society and the development of
the staff in all fields and requirement conducting to female learning. After WW II and the
1950s, women get out of their houses to seek learning by approaching the doors.
What is positive about that phase was the formation of the College of Queen A'liya
which is regarded as a positive indicator. In any case the Iraqi family encouraged women to
be indulged in higher education. Calling the college Queen A'liya

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Publication Date
Thu Sep 01 2022
Journal Name
مجلة الأستاذ للعلوم الإنسانية والاجتماعية
Impoliteness in Some American Presidential Debates: A Pragmatic Study
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The current research is concerned with a pragmatic study of attack and defense acts that are used by President Donald Trump in the American Presidential Debate in 2020. Attack is an attempt to harm or defeat someone, and it is a bold message that the speaker or attacker does not like or disagree with the other antagonist. On the contrary, defense means a person responds to an attack of his or her opponent. After an attack, the politician either negates or fact-checks claims made by his opponents or tries to set the record straight. By the end of the study, it is expected to answer the following questions: What are the most frequent strategies of attack and defense that utilized by President Trump to formulate his speech? What are the reason

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
A Scoping Study on Lightweight Cryptography Reviews in IoT
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The efforts in designing and developing lightweight cryptography (LWC) started a decade ago. Many scholarly studies in literature report the enhancement of conventional cryptographic algorithms and the development of new algorithms. This significant number of studies resulted in the rise of many review studies on LWC in IoT. Due to the vast number of review studies on LWC in IoT, it is not known what the studies cover and how extensive the review studies are. Therefore, this article aimed to bridge the gap in the review studies by conducting a systematic scoping study. It analyzed the existing review articles on LWC in IoT to discover the extensiveness of the reviews and the topics covered. The results of the study suggested that many re

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Publication Date
Sat Aug 06 2022
Journal Name
Ijci. International Journal Of Computers And Information
Techniques for DDoS Attack in SDN: A Comparative Study
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Abstract Software-Defined Networking (commonly referred to as SDN) is a newer paradigm that develops the concept of a software-driven network by separating data and control planes. It can handle the traditional network problems. However, this excellent architecture is subjected to various security threats. One of these issues is the distributed denial of service (DDoS) attack, which is difficult to contain in this kind of software-based network. Several security solutions have been proposed recently to secure SDN against DDoS attacks. This paper aims to analyze and discuss machine learning-based systems for SDN security networks from DDoS attack. The results have indicated that the algorithms for machine learning can be used to detect DDoS

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
A study for Bacterial Infection in Acute Diarrhea Patients
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500 samples of diarrhea stool were collected from different ages(less than 1year –upto30years) and for both genders from some patients in (Alwiya hospital for children, Al-kendi, central health public laboratory and some gavernarated labs) period(1/11/2009—1/10/2010). Kinds of bacteria and parasites agents were isolated and identified from patients with diarrhea. Nine species of gram negative bacteria from enterobacteriaceae were isolated, E. coli isolated are the higher ratio 4.8% of all, then Salmonella typhi4.6% while the lowest ratios is Citrobacterfreundii 0.4%, while the other identified species were be among the previous rotios. also Plesomonasshigelloides was isolated which concedride one of the bacterial local studies.many met

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