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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
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Using financial and non-financial information ) SASB standards) to enhance investor confidence
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Companies seek to enhance investor confidence by achieving the highest level of transparency in disclosure of financial and non-financial information (SASB standards) for Iraqi insurance companies listed on the financial market. The aim of the research is to identify the extent of the ability of financial and non-financial information to enhance transparency in reporting, which is reflected in Investor confidence. And the standards of sustainability development accounting issued by (SASB) through the electronic questionnaire that was distributed. Companies seek to achieve a set of goals, the most important of which is to enhance investor confidence by improving transparency in disclosure. Concerning the employment of financial an

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Publication Date
Sat Jan 14 2023
Journal Name
Cogent Engineering
C. B interrupt duty reduction based controlling TRV and symmetrical breaking current
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Publication Date
Thu Sep 23 2021
Journal Name
Egyptian Journal Of Chemistry
Some 3,4,5-Trisubstituted-1,2,4-triazole Synthesis, Antimicrobial Activity, and Molecular Docking Studies
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Publication Date
Sun Jun 12 2011
Journal Name
Baghdad Science Journal
Satellite Images Unsupervised Classification Using Two Methods Fast Otsu and K-means
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Two unsupervised classifiers for optimum multithreshold are presented; fast Otsu and k-means. The unparametric methods produce an efficient procedure to separate the regions (classes) by select optimum levels, either on the gray levels of image histogram (as Otsu classifier), or on the gray levels of image intensities(as k-mean classifier), which are represent threshold values of the classes. In order to compare between the experimental results of these classifiers, the computation time is recorded and the needed iterations for k-means classifier to converge with optimum classes centers. The variation in the recorded computation time for k-means classifier is discussed.

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Publication Date
Sun Sep 01 2013
Journal Name
2013 Ieee International Conference On Circuits And Systems (iccas)
Improved undetected error probability model for JTEC and JTEC-SQED coding schemes
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The undetected error probability is an important measure to assess the communication reliability provided by any error coding scheme. Two error coding schemes namely, Joint crosstalk avoidance and Triple Error Correction (JTEC) and JTEC with Simultaneous Quadruple Error Detection (JTEC-SQED), provide both crosstalk reduction and multi-bit error correction/detection features. The available undetected error probability model yields an upper bound value which does not give accurate estimation on the reliability provided. This paper presents an improved mathematical model to estimate the undetected error probability of these two joint coding schemes. According to the decoding algorithm the errors are classified into patterns and their decoding

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Publication Date
Wed Jan 01 2014
Journal Name
Pharmacology &amp;amp; Pharmacy
Gift Acceptance and Its Effect on Prescribing Behavior among Iraqi Specialist Physicians
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Publication Date
Wed Dec 08 2021
Journal Name
Scientific Reports
Weakly Supervised Sensitive Heatmap framework to classify and localize diabetic retinopathy lesions
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Abstract<p>Vision loss happens due to diabetic retinopathy (DR) in severe stages. Thus, an automatic detection method applied to diagnose DR in an earlier phase may help medical doctors to make better decisions. DR is considered one of the main risks, leading to blindness. Computer-Aided Diagnosis systems play an essential role in detecting features in fundus images. Fundus images may include blood vessels, exudates, micro-aneurysm, hemorrhages, and neovascularization. In this paper, our model combines automatic detection for the diabetic retinopathy classification with localization methods depending on weakly-supervised learning. The model has four stages; in stage one, various preprocessing techniques are app</p> ... Show More
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Publication Date
Tue Sep 21 2021
Journal Name
Journal Of Healthcare Engineering
Complexity and Entropy Analysis to Improve Gender Identification from Emotional-Based EEGs
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Investigating gender differences based on emotional changes becomes essential to understand various human behaviors in our daily life. Ten students from the University of Vienna have been recruited by recording the electroencephalogram (EEG) dataset while watching four short emotional video clips (anger, happiness, sadness, and neutral) of audiovisual stimuli. In this study, conventional filter and wavelet (WT) denoising techniques were applied as a preprocessing stage and Hurst exponent

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
Educational and psychological adjustment among hostel's students at Omer al-mokhtar University
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Educational and psychological adjustment considered to be one of the effective and serious matters at people dealings and behaviors. Generally, psychological adjustment reflects positively on an individual mental health and their capability to be creative at their field. In contrast to those people who lack this feature. As for educational adjustment, it refers to the compatibility and harmony between an individuals and people around. Thus, these features should be available among students particularly those who stay in students' hostel since they live far from their families. The findings of study revealed that there is Educational and psychological adjustment between male and female. Besides, significant differences were showed

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Publication Date
Fri Dec 24 2021
Journal Name
Journal Of Engineering Science And Technology. Journal Of Engineering Science And Technology
Grey-Level Image Compression Using 1-D Polynomial and Hybrid Encoding Techniques
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