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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 Jul 12 2024
Journal Name
Biomass Conversion And Biorefinery
Chitosan-triphosphate/food grade algae/montmorillonite clay for adsorptive removal of methyl violet 2B dye removal: Behnken design optimization
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Publication Date
Thu Feb 06 2020
Journal Name
Scientific Reports
Waste foundry sand/MgFe-layered double hydroxides composite material for efficient removal of Congo red dye from aqueous solution
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Abstract<p>We aimed to obtain magnesium/iron (Mg/Fe)-layered double hydroxides (LDHs) nanoparticles-immobilized on waste foundry sand-a byproduct of the metal casting industry. XRD and FT-IR tests were applied to characterize the prepared sorbent. The results revealed that a new peak reflected LDHs nanoparticles. In addition, SEM-EDS mapping confirmed that the coating process was appropriate. Sorption tests for the interaction of this sorbent with an aqueous solution contaminated with Congo red dye revealed the efficacy of this material where the maximum adsorption capacity reached approximately 9127.08 mg/g. The pseudo-first-order and pseudo-second-order kinetic models helped to describe the sorption measure</p> ... Show More
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Publication Date
Wed Feb 01 2023
Journal Name
Measurement: Sensors
Dynamic monitoring of saturated stiff clay soil foundation structure by falling weight deflectometer system under impact loads sensors effect
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Experiments research is done to determine how saturated stiff clayey soil responds to a single impulsive load. Models made of saturated, stiff clay were investigated. To supply the single pulse energy, various falling weights from various heights were tested using the falling weight deflectometer (FWD). Dynamic effects can range from the major failure of a sensitive sensor or system to the apparent destruction of structures. This study examines the response of saturated stiff clay soil to a single impulsive load (vertical displacement at the soil surface below and beside the bearing plates). Such reactions consist of displacements, velocities, and accelerations caused by the impact occurring at the surface depth induced by the impact loads

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Publication Date
Tue Nov 01 2022
Journal Name
Journal Of Engineering
Finite Element Modeling of One-Way Recycled Aggregate Concrete Slabs Strengthened using Near-Surface Mounted CFRPs under Repeated Loading
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This study offers numerical simulation results using the ABAQUS/CAE version 2019 finite element computer application to examine the performance, and residual strength of eight recycle aggregate RC one-way slabs. Six strengthened by NSM CFRP plates were presented to study the impact of several parameters on their structural behavior. The experimental results of four selected slabs under monotonic load, plus one slab under repeated load, were validated numerically. Then the numerical analysis was extended to different parameters investigation, such as the impact of added CFRP length on ultimate load capacity and load-deflection response and the impact of concrete compressive strength value on the structural performance of

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Publication Date
Thu Feb 04 2016
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Economic losses caused by mole cricket Gryllotalpa gryllotalpa on some vegetable plants and agricultural crops: Economic losses caused by mole cricket Gryllotalpa gryllotalpa on some vegetable plants and agricultural crops
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The study was conducted to estimate the economic losses caused by insect mole cricket Gryllotalpa gryllotalpa on some agricultural crops and Potato tubers in collage of Agriculture- Abu Ghraib season 2012-2013. Study showed Mole cricket caused percentage of infestation in spring potato tubers variety Luciana reached to 11.61% and the percentage of loss in weight of tubers reached 18.88%. The study showed that addition of animal manure (organic fertilizer) to the soil when planting potatoes in the autumn increased the incidence of infestation and the number of tunnels caused by mole cricket which led to from increased economic losses. When matured potato tubers were left for a longer period in the soil percentage of infestation by mole cr

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Publication Date
Sat Jul 02 2016
Journal Name
Iraqi Medical Journal
Screeing for Hepatitis ( HBs Ag) and Hepatitis C (HCV Ab) Among Dialysis Children.
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Publication Date
Sat Jul 23 2022
Journal Name
Arab World English Journal
Impoliteness Formulas, Triggers, and Purposes to Refusal as Employed by Iraqi English Learners
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The present study aims at scrutinizing the impoliteness types, causes, and purposes utilized by Iraqi English language learners when refusing marriage proposals. Thus, it attempts to answer the questions: (1) what are the impoliteness formulas used by the Iraqi learners of English in refusing marriage proposals?, and (2) What are their impoliteness triggers/causes and the purposes? The study is significant in bridging the gap that few linguistic types of research concentrate on studying intentionality and emotions allied with impoliteness. Data were collected from 35 Iraqi learners of English responding to 6 situations of marriage. The data were analyzed using Culpeper’s (2011) formulas of impoliteness and Bousfield’s (2007) impolite

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Publication Date
Wed Jan 01 2020
Journal Name
Management Science Letters
Work-life balance and its impact on employee satisfaction on five star hotels
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This study aimed to find out the impact of work-life balance on employee satisfaction in five-star hotels in Amman, Jordan based on a descriptive analytical approach. The questionnaire of the survey was designed and distributed to a sample of participants in order to collect the necessary data for this study and they were analyzed later through the SPSS V22 program. The study population was the hotel sector in Jordan, while the study sample included the five-star hotels in the capital, Amman, and the sampling unit included the employees of the middle and lower levels of management in the five-star hotels in Amman. The study showed a number of results, including the existence of a good level of work-life balance by employees in top manage-me

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Composites Science
Sawdust-Based Concrete Composite-Filled Steel Tube Beams: An Experimental and Analytical Investigation
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Incorporating waste byproducts into concrete is an innovative and promising way to minimize the environmental impact of waste material while maintaining and/or improving concrete’s mechanical characteristics and strength. The proper application of sawdust as a pozzolan in the building industry remains a significant challenge. Consequently, this study conducted an experimental evaluation of sawdust as a fill material. In particular, sawdust as a fine aggregate in concrete offers a realistic structural and economical possibility for the construction of lightweight structural systems. Failure under four-point loads was investigated for six concrete-filled steel tube (CFST) specimens. The results indicated that recycled lightweight co

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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Comparison between Process Control Charts and Fuzzy Multinomial Control Charts with Practical Appliance
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     The control charts are one of the scientific technical statistics tools that will be used to control of production and always contained from three lines  central line and upper, lower lines to control quality of production and represents set of numbers so finally the operating productivity under control or nor than depending on the actual observations. Some times to calculating the control charts are not accurate and not confirming, therefore the Fuzzy Control Charts are using instead of Process Control Charts so this method is more sensitive, accurate and economically for assisting decision maker to control the operation system as early time. In this project will be used set data fr

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