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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
Sat Sep 01 2018
Journal Name
J Indian Soc Periodontol.
Osteoporosis effect on posterior mandible in preimplanted area for postmenopausal females using cone-beam computed tomography
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Publication Date
Thu Nov 13 2025
Journal Name
Alustath Journal For Human And Social Sciences
Musical relational in Andalusian poetry (Ibn al-Abar (d. 595 AH - 658 AH) as an example)
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The voice had a special place in the writting of the Andalusian poet (Ibn al-Abar ) , which aroused my attention because of the sonic capacity of the lettering inside the poetic at Ibn al-Abar poems . So Istudied the qualities of the lettering , structures and their exits . Scientists have not been able to determine the musical from the nonmusical sound , but we find the innate ability of Ibn al-Abar , which was able to determine this by using the lettering the right places and to revival the life to reflect the moments of his life , therefore came votes to express his purposes of praise and pride Etc. The poet Ibn al-Abar could exploit the lettering features in the effect of bilateral – static and moving and its ability to e

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Publication Date
Wed Jan 01 2020
Journal Name
Society Of Petroleum Engineering
Investigating geomechanical considerations on suitable layer selection for hydraulically fractured horizontal wells placement in tight reservoirs
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Publication Date
Sat Jan 28 2012
Journal Name
Rafidain Journal Of Science
Photodynamic Effect on Photosensitized Candida albicans with Hematoporphyrin Derivative Using Low Power Diode Laser In Vitro
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Publication Date
Tue Mar 05 2024
Journal Name
Scientific Reports
Mesoporous Ag@WO3 core–shell, an investigation at different concentrated environment employing laser ablation in liquid
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Abstract<p>In this study, silver-tungsten oxide core–shell nanoparticles (Ag–WO<sub>3</sub> NPs) were synthesized by pulsed laser ablation in liquid employing a (1.06 µm) Q-switched Nd:YAG laser, at different Ag colloidal concentration environment (different core concentration). The produced Ag–WO<sub>3</sub> core–shell NPs were subjected to characterization using UV–visible spectrophotometry, X-ray diffraction (XRD), transmission electron microscopy (TEM), energy-dispersive spectroscopy, electrical analysis, and photoluminescence PL. The UV–visible spectra exhibited distinct absorption peaks at around 200 and 405 nm, which attributed to the occurrence of surface Plasmon reson</p> ... Show More
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Publication Date
Thu Nov 01 2018
Journal Name
Optical Fiber Technology
Enhancing refractive index sensitivity using micro-tapered long-period fiber grating inscribed in biconical tapered fiber
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Publication Date
Sun Dec 03 2023
Journal Name
2023 Ieee International Conference On Energy Technologies For Future Grids (etfg)
Optimal Hybrid Type-2 Fuzzy-PID Controller for Blade Pitch Angle in Horizontal-axis Wind Turbines
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In the modern world, wind turbine (WT) has become the largest source of renewable energy. The horizontal-axis wind turbine (HAWT) has higher efficiency than the vertical-axis wind turbine (VAWT). The blade pitch angle (BPA) of WT is controlled to increase output power generation over the rated wind speed. This paper proposes an accurate controller for BPA in a 500-kw HAWT. Three types of controllers have been applied and compared to find the best controller: PID controller (PIDC), fuzzy logic type-2 controller (T2FLC), and hybrid type-2 fuzzy-PID controller (T2FPIDC). This paper has been used Mamdani and Sugeno fuzzy inference systems (FIS) to find the best inference system for WT controllers. Furthermore, genetic algorithm (GA) and particl

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Salivary Interleukin-6 Level in Iraqi Patients with Oral Lichen Planus receiving Platelet-Rich Plasma Injections
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Background: Interleukin-6 (IL-6) is a cytokine that has several functions, including stimulating growth and inhibiting cell death. It has the potential to operate as a biomarker for the accurate prediction of disease severity and activity, platelets-rich plasma was used in the treatment of oral lichen planus and can change the salivary IL-6 level.

Objectives: To study the clinical outcome of intralesional platelets-rich plasma in patients with oral lichen planus and to measure salivary IL-6 levels before and after the treatment with platelets-rich plasma were the aims of this study.

Subjects and Methods: In this clinical trial, for each patient a standardi

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Publication Date
Tue Jul 30 2024
Journal Name
Iraqi Journal Of Science
Frame-Based Change Detection Using Histogram and Threshold to Separate Moving Objects from Dynamic Background
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      Detecting and subtracting the Motion objects from backgrounds is one of the most important areas. The development of cameras and their widespread use in most areas of security, surveillance, and others made face this problem. The difficulty of this area is unstable in the classification of the pixels (foreground or background). This paper proposed a suggested background subtraction algorithm based on the histogram. The classification threshold is adaptively calculated according to many tests. The performance of the proposed algorithms was compared with state-of-the-art methods in complex dynamic scenes.

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Publication Date
Mon Feb 01 2021
Journal Name
Iop Conference Series: Materials Science And Engineering
Pre-dissolved Inorganic Carbon (DIC) for cultivation Chlorella sorokiniana MH923013, Coelastrella MH923011 and Coelastrella MH923012
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Abstract<p>A step to net-zero of carbon dioxide losses in the microalgae cultivation process was targeted in the current study. This research was carried out by using pre-dissolved inorganic carbon (DIC) as a source of carbon with two doses of twenty-five and fifty millilitres. <italic>C. sorokiniana</italic> MH923013, <italic>Coelastrella</italic> MH923011 and <italic>Coelastrella</italic> MH923012 strains were used in the present investigation. The experimental data emphasized the direct influence of carbonic solution on microalgal growth according to the fast adaption of algal cells and higher productivity compared to control and dilution cultures. It was observe</p> ... Show More
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