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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 Jun 08 2025
Journal Name
Journal Of Applied Engineering And Technological Science (jaets)
Secure E-Voting System Utilizing Fingerprint Authentication, AES-GCM Encryption and Hybrid Blind Watermarking
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Ensuring security, integrity, and reliability of the election process consider as the main challenges in the electronic voting system. This paper describes the e-voting system by integrating the biometric authentication, advanced encryption, and watermarking techniques towards meeting such challenges. The system employs the fingerprint authentication by utilizing the Scale-Invariant Feature Transform (SIFT) for verifying the identity of the voter to ensure genuineness and non-repudiation of the service. The vote will be encrypted with the AES-GCM technique to be employed in securing the voting process, thus ensuring both data privacy and integrity. Hybrid Blind Watermarking employs the technique of Discrete Wavelet Transform (DWT) a

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Publication Date
Mon Jun 05 2023
Journal Name
Al-khwarizmi Engineering Journal
Citric Acid Production: Raw Material, Microbial Production, Fermentation Strategy and Global Market: Critical Review
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Citric acid is an essential ingredient for the manufacture of (12) key industrial chemicals. Citric acid use is increasing steadily with a high annual growth rate as a result of the development of ever more sophisticated applications. Citric acid is widely utilized in the food and pharmaceutical industries due to its low toxicity when compared to other acidulous. Other uses for citric acid can be found in cleaning supplies and detergents. Based on information from a review of the literature, Citric acid production substrates and methods for surface fermentation, submerged fermentation, solid-state fermentation, and international market expansion are all covered in the current review study. Finally, there is still much to learn about the

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Publication Date
Thu Apr 12 2012
Journal Name
Pramana
Nucleon momentum distributions and elastic electron scattering form factors for some 1p-shell nuclei
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Publication Date
Thu Feb 09 2023
Journal Name
Artificial Intelligence Review
Community detection model for dynamic networks based on hidden Markov model and evolutionary algorithm
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Finding communities of connected individuals in complex networks is challenging, yet crucial for understanding different real-world societies and their interactions. Recently attention has turned to discover the dynamics of such communities. However, detecting accurate community structures that evolve over time adds additional challenges. Almost all the state-of-the-art algorithms are designed based on seemingly the same principle while treating the problem as a coupled optimization model to simultaneously identify community structures and their evolution over time. Unlike all these studies, the current work aims to individually consider this three measures, i.e. intra-community score, inter-community score, and evolution of community over

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Publication Date
Wed Nov 19 2014
Journal Name
Journal Of Biosciences
Caspase-like proteins: Acanthamoeba castellanii metacaspase and Dictyostelium discoideum paracaspase, what are their functions?
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Publication Date
Tue Apr 02 2024
Journal Name
Engineering, Technology &amp; Applied Science Research
Two Proposed Models for Face Recognition: Achieving High Accuracy and Speed with Artificial Intelligence
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In light of the development in computer science and modern technologies, the impersonation crime rate has increased. Consequently, face recognition technology and biometric systems have been employed for security purposes in a variety of applications including human-computer interaction, surveillance systems, etc. Building an advanced sophisticated model to tackle impersonation-related crimes is essential. This study proposes classification Machine Learning (ML) and Deep Learning (DL) models, utilizing Viola-Jones, Linear Discriminant Analysis (LDA), Mutual Information (MI), and Analysis of Variance (ANOVA) techniques. The two proposed facial classification systems are J48 with LDA feature extraction method as input, and a one-dimen

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Publication Date
Fri May 01 2015
Journal Name
Journal Of Engineering
Cooling Load Calculations For Typical Iraqi Roof And Wall Constructions Using Ashrae's RTS Method
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The present work is an attempt to develop design data for an Iraqi roof and wall constructions using the latest ASHRAE Radiant Time Series (RTS) cooling load calculation method. The work involves calculation of cooling load theoretically by introducing the design data for Iraq, and verifies the results experimentally by field measurements. Technical specifications of Iraqi construction materials are used to derive the conduction time factors that needed in RTS method calculations. Special software published by Oklahoma state university is used to extract the conduction factors according to the technical specifications of Iraqi construction materials.  Good agreement between the average theoretical and measured cooli

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Publication Date
Sat Nov 07 2020
Journal Name
Journal Of Advanced Research In Fluid Mechanics And Thermal Sciences
Fully Automated Measurement Setup for Photovoltaic Panel Performance Evaluation and Testing under LabVIEW Platform
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Photovoltaic (PV) devices are widely used renewable energy resources and have been increasingly manufactured by many firms and trademarks. This condition makes the selection of right product difficult and requires the development of a fast, accurate and easy setup that can be implemented to test available samples and select the cost effective, efficient, and reliable product for implementation. An automated test setup for PV panels using LabVIEW and several microcontroller-based embedded systems were designed, tested, and implemented. This PV testing system was fully automated, where the only human intervention required was the instalment of PV panel and set up of required testing conditions. The designed and implemented system was

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Publication Date
Wed Mar 16 2022
Journal Name
International Journal Of Recent Contributions From Engineering, Science & It
Smart Learning based on Moodle E-learning Platform and Digital Skills for University Students
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Publication Date
Wed Mar 29 2023
Journal Name
Aspac J. Mol. Biol. Biotechnol.
Utilizing waste mango and avocado seeds for highly effective dye removal with activated carbon
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Activated carbon (AC) is a highly important adsorbent material, as it is a solid form of pure carbon that boasts a porous structure and a large surface area, making it effective for capturing pollutants. Thanks to its exceptional features, AC is widely used for purifying water that is contaminated with odors and removing dyes in a cost-effective manner. A variety of carbonic materials have been employed to prepare AC, and this study aimed to evaluate the suitability of utilizing waste mango and avocado seeds for this purpose, followed by testing their efficacy in removing dye from aqueous solutions. The results indicate that using waste mango and avocado as AC is technically feasible, achieving dye removal percentages of 98% and 93%,

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