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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
Fri Jun 28 2013
Journal Name
Journal Of Materials Science And Engineering B
Synthesis of Zirconia Nanoparticles in Distilled Water Solution by Laser Ablation Technique
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Pulsed laser ablation in liquid (PLAL) has become an increasingly important technique for metals production and metal oxides nanoparticles (NPs) and others. This technique has its many advantages compared with other conventional techniques (physical and chemical). This work was devoted for production of zirconia (ZrO2) nanoparticles via PLAL technique from a solid zirconium target immersed in a wet environment in order to study the effect of this environment on the optical properties and structure of ZrO2 nanoparticles. The solutions which used for this purpose is distilled water (D.W). The produces NPs were characterized by mean of many tests such as UV-visible (UV-Vis.), transmission electron microscope (TEM) and Z-Potential. The UV-Vis.

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Publication Date
Thu Jun 01 2023
Journal Name
Results In Engineering
Effectiveness of embedded through-section technique in strengthening reinforced concrete spandrel beams
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Publication Date
Sat Apr 01 2017
Journal Name
Iosr Journal Of Computer Engineering (iosr-jce)
A New Approach to DNA, RNA, and Protein Motifs Templates Visualization and Analysis via Compilation Technique
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Motifs template is the input for many bioinformatics systems such codons finding, transcription, transaction, sequential pattern miner, and bioinformatics databases analysis. The size of motifs arranged from one base up to several Mega bases, therefore, the typing errors increase according to the size of motifs. In addition, when the structures motifs are submitted to bioinformatics systems, the specifications of motifs components are required, i.e. the simple motifs, gaps, and the lower bound and upper bound of each gap. The motifs can be of DNA, RNA, or Protein. In this research, a motif parser and visualization module is designed depending on a proposed a context free grammar, CFG, and colors human recognition system. GFC describes the m

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Publication Date
Sat Mar 31 2018
Journal Name
Journal Of Engineering
Evaluation the Effect of Vibration on the Corrosion Rate of Automotive Paints
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This paper studies the influence of temperature on the corrosion rate of coated AA6111 aluminum alloy used in vehicle bodies under static and vibration states. The vibration test system was collected laboratory and used for testing of five different types of paints (EASI, Numix, Lesonal, DENSO and Polaron paints) in the 5 % NaCl solution using immersion test method. Lesonal paint provided the best corrosion protection, while DENSO paints show large values of corrosion rate, other coatings exhibit moderate values. Model of paints corrosion was developed to characterize the corrosion processes occur at the surfaces. It is found that corrosion rate obtained at vibration cases is larger than static cases and vibration effect

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Publication Date
Fri Jan 01 2021
Journal Name
Aip Conference Proceedings
Structural characterization of nickel and zinc aluminate prepared by sol-gel technique
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This work concerned on nanocrystalline NiAl2O4 and ZnAl2O4 having spinel structure prepared by Sol–gel technique. The structural and characterization properties for the obtained samples were examined using different measurements such as X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), finally, Field emission scanning electron microscope (FESEM).The Spinel-type for two prepared compound (NiAl2O4) and (ZnAl2O4) at different calcination temperature examined by XRD. Williamson-Hall Methods used to estimate crystallite size, Average distribution crystallite size of two compound were, 34.2 nm for NiAl2O4 and32.6 for ZnAl2O4, the increase in crystallite size affecting by increasing in calcination temperature for both comp

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Publication Date
Fri Mar 30 2012
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Extraction of Pelletierine from Punica granatum L.by Liquid Membrane Technique and Modelling
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This work was conducted to study the extraction of pelletierine sulphate from Punica granatum L. roots by liquid membrane techniques. Pelletierine sulphate is used widely in medicine. The general behavior of extraction process indicates that pelletierine conversion increased with increasing the number of stages and the discs rotation speed but high rotation speed was not favored because of the increased risk of droplet formation during the operation. The pH of feed and acceptor solution was also important. The results exhibit that the highest pelletierine conversion was obtained when using two stages,(10 rpm) discs speed of stainless steel discs,(pH= 9.5) of feed solution and (pH= 2) of acceptor solution in n-decane. Assuming the existence

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Publication Date
Sat Nov 04 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences( P-issn 1683 - 3597 E-issn 2521 - 3512)
Solubility and Dissolution Enhancement of Atorvastatin Calcium using Phospholipid Solid Dispersion Technique
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Atorvastatin (ATR) is a poorly water-soluble anti-hyperlipidemic drug. The drug belongs to the class II group according to the biopharmaceutical classification system (BCS) with low bioavailability due to its low solubility. Solid dispersion is an effective technique for enhancing the solubility and dissolution of drugs. Phospholipid solid dispersion (PSD) using phosphatidylcholine (PC) as a carrier with or without adsorbent (magnesium aluminum silicate, silicon dioxide 15nm, silicon dioxide 30nm, calcium silicate) was used to prepare ATR PSD using different drug: PC: adsorbent ratios by solvent evaporation method. The resulted PSD was evaluated for its percentage yield, drug content, solubility, dissolution rate, Fourier transforma

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Publication Date
Sun Jun 09 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Preparation and Evaluation of Rebamipide Film using Casting Technique for Local Action
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Abstract

The aim of this study was to prepare rebamipide ocular inserts in order to extend its release on the ocular surface for dry eye treatment. Solubility study was applied to the drug with or without l-arginine using different solvents. Solvent casting technique was used to prepare the inserts; l-arginine was used to solubilize the drug, hydroxypropyl methylcellulose grades (E5 and K15M) and poly ethylene glycol 200 were used as excipients. The inserts were evaluated for their physical and mechanical properties, moisture loss% and absorption %, surface pH, and in-vitro drug release. The use l-arginine exhibited an enhancement of rebamipide solubility in both deionized water and phosphate buffer (pH 7.4) by a

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Publication Date
Fri Mar 30 2012
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Extraction of Pelletierine from Punica granatum L.by Liquid Membrane Technique and Modelling
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This work was conducted to study the extraction of pelletierine sulphate from Punica granatum L. roots by liquid membrane techniques. Pelletierine sulphate is used widely in medicine. The general behavior of extraction process indicates that pelletierine conversion increased with increasing the number of stages and the discs rotation speed but high rotation speed was not favored because of the increased risk of droplet formation during the operation. The pH of feed and acceptor solution was also important. The results exhibit that the highest pelletierine conversion was obtained when using two stages, (10 rpm) discs speed of stainless steel discs, (pH=9.5) of feed solution and (pH=2) of acceptor solution in n-decane. Assuming the existen

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Publication Date
Sun Apr 23 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Structural and Electrical Properties of InSb Films Prepared By Flash Evaporation Technique
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 Indium antimony (InSb) alloy were prepared successfully. The InSb films were prepared by flash thermal evaporation technique on glass and Si p-type substrate at various substrate temperatures (Ts= 423,448,473, and 498 K).       The compounds concentrations for prepared alloy were examined by using Atomic Absorption Spectroscopy (AAS) and X-ray fluorescence (XRF). The structure of prepared InSb alloy and films deposited at various Ts were examined by X-ray diffraction (XRD).It was found that all prepared InSb alloy and films were polycrystalline with (111) preferential direction .       The electrical properties of the films are studied with the varying Ts. It is found that

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