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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
Thu Jan 01 2009
Journal Name
Ibn Al– Haitham Journal For Pure And Applied Science
Some Results on Fibrewise Lindelöf and Locally Lindelöf Topological Spaces
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In this paper we define and study new concepts of fibrewise topological spaces over B namely, fibrewise Lindelöf and locally Lindelöf topological spaces, which are generalizations of will-known concepts: Lindelöf topological space (1) "A topological space X is called a Lindelöf space if for every open cover of X has a countable subcover" and locally Lindelöf topological space (1) "A topological space X is called a locally Lindelöf space if for every point x in X, there exist a nbd U of x such that the closure of U in X is Lindelöf space". Either the new concepts are: "A fibrewise topological space X over B is called a fibrewise Lindelöf if the projection function p : X→B is Lindelöf" and "The fibrewise topological space X over B

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Publication Date
Mon Feb 18 2019
Journal Name
Iraqi Journal Of Physics
Transition rates and microscopic effective charges for 16C exotic nucleus
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Publication Date
Sun Jan 02 2011
Journal Name
Journal Of Educational And Psychological Researches
Mental Health and Its Relationship with Shyness for University Students
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This study aimed to show the relationship between mental health and shyness for university students in Baghdad and Al – Mustansiria university which its subject was (200) students  ,          ( 100) males and  ( 100) females , Mental Health scale which is constructed by (Al – Janabi 1991) and developed by (Hassan 2006) was used for this aim  ,The scale of shyness was built according to a questioner to the students and according to previous publications and studies .

Multiple regulation analysis step - wise was used for data analysis in order to identify the possibility to find single or couple indications for the independent variable (mental

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Publication Date
Sun May 10 2015
Journal Name
Al-academy
Wagner ideas and architectural scene Bayreuth ideal: علي عبد الله
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The (Richard Wagner) of cultural figures rare collected between philosophy and literature and the arts to reach the concept of the artwork destruction (Gesamtkunstwerk), who called for by the movement romantic, he is a thinker, and composer renewed, and playwright, designer and architect of a special kind.Able ( Wagner ) that translates his thoughts technical and design in the field of opera and disclose those ideas models actual dealt joints essential this art heritage, which was developed and laid his modern rules approach by achieving his dream creates theater ideal, which was held in the city ( Bayreuth) in ( Bavaria ), one of the German Federal States .The study reviews the ideas of Wagner and their sources, which have had an import

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Publication Date
Thu Nov 01 2012
Journal Name
2012 International Conference On Advanced Computer Science Applications And Technologies (acsat)
Data Missing Solution Using Rough Set theory and Swarm Intelligence
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This paper presents a hybrid approach for solving null values problem; it hybridizes rough set theory with intelligent swarm algorithm. The proposed approach is a supervised learning model. A large set of complete data called learning data is used to find the decision rule sets that then have been used in solving the incomplete data problem. The intelligent swarm algorithm is used for feature selection which represents bees algorithm as heuristic search algorithm combined with rough set theory as evaluation function. Also another feature selection algorithm called ID3 is presented, it works as statistical algorithm instead of intelligent algorithm. A comparison between those two approaches is made in their performance for null values estima

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Publication Date
Thu Jul 21 2022
Journal Name
Neuro Quantology
Astronomical Observation between Diffraction Limited Coherent and Incoherent Imaging Systems
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Numerical simulations are carried out to evaluate the coherence concept’s effect on the performance regarding the optical system, when observing and imaging the planet’s surface. In numerous optical approaches, the coherence qualities of light sources play an important role. This paper provides an overview about the mathematical formulation of temporal and spatial coherence and incoherence properties of light sources. The circular aperture was used to describe the optical system like a telescope. The simulation results show that diffraction-limited for incoherent imaging system certainly improves the image. Yet, the quality of the image is degraded by the light source's highly spatial and temporal coherence properties, resulting in a

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Publication Date
Sun Nov 12 2023
Journal Name
Migration Letters
Piezoelectric Energy Harvesting from Vortex-Induced Vibrations: Design and Correlations
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This study delves into the design optimization of a hydropower harvesting system, exploring various parameters and their influence on system performance. By modifying the variables within the model to suit different flow conditions, a judiciously optimized design is attainable. Notably, the lift force generated is found to be intricately linked to the strategic interplay of the bluff body's location, cylinder dimensions, and flow velocity. The findings culminate in the establishment of empirical equations, one for lift force and another for displacement, based on the force equation. Many energy harvesting approaches hinge on the reciprocating motion inherent to the structural system. The methodology developed in this study emerges as a pot

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Publication Date
Tue Dec 28 2021
Journal Name
2021 2nd Information Technology To Enhance E-learning And Other Application (it-ela)
Pedestrian and Objects Detection by Using Learning Complexity-Aware Cascades
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Publication Date
Sun Dec 31 2017
Journal Name
College Of Islamic Sciences
Abu Mijlaz Al-Basri and his approach to traditional interpretation
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Research summary

 


This research discloses the study of the methodology of one of the notables of the followers, which is: (Abi Mijlis Al-Basri), who had a clear impact on many commentators after him, especially in the field of interpretation by impact. This study included two topics:

The first: his biography and scientific

The second: his methodology in the traditional interpretation.

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Publication Date
Tue Jun 20 2023
Journal Name
Baghdad Science Journal
Comparison between Modified Weighted Pareto Distribution and Many other Distributions
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In 2020 one of the researchers in this paper, in his first research, tried to find out the Modified Weighted Pareto Distribution of Type I by using the Azzalini method for weighted distributions, which contain three parameters, two of them for scale while the third for shape.This research compared the distribution with two other distributions from the same family; the Standard Pareto Distribution of Type I and the Generalized Pareto Distribution by using the Maximum likelihood estimator which was derived by the researchers for Modified Weighted Pareto Distribution of Type I, then the Mont Carlo method was used–that is one of the simulation manners for generating random samples data in different sizes ( n= 10,30,50), and in di

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