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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
Wed Mar 29 2023
Journal Name
Aip Conference Proceedings
(𝓹,𝔼)-convex sets and (𝓹,𝔼)-Convex functions with their properties
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Publication Date
Tue Oct 25 2022
Journal Name
Minar Congress 6
HANDWRITTEN DIGITS CLASSIFICATION BASED ON DISCRETE WAVELET TRANSFORM AND SPIKE NEURAL NETWORK
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In this paper, a handwritten digit classification system is proposed based on the Discrete Wavelet Transform and Spike Neural Network. The system consists of three stages. The first stage is for preprocessing the data and the second stage is for feature extraction, which is based on Discrete Wavelet Transform (DWT). The third stage is for classification and is based on a Spiking Neural Network (SNN). To evaluate the system, two standard databases are used: the MADBase database and the MNIST database. The proposed system achieved a high classification accuracy rate with 99.1% for the MADBase database and 99.9% for the MNIST database

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Publication Date
Wed Jan 28 2026
Journal Name
Journal Of Physical Education
Special Endurance And its Relationship With 10 Km Walking Achievement for Youth
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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
E-Learning and Its Relationship with Academic Passion among Middle School Students
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Abstract

The current research aims to identify the level of E-learning among middle school students, the level of academic passion among middle school students, and the correlation between e-learning and academic passion among middle school students. In order to achieve the objectives of the research, the researcher developed two questionnaires to measure the variables of the study (e-learning and study passion) among students, these two tools were applied to the research sample, which was (380) male and female students in the first and second intermediate classes. The research concluded that there is a relationship between e-learning and academic passion among students.

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Publication Date
Tue Mar 02 2021
Journal Name
Turkish Journal Of Computer And Mathematics Education
Deep understanding skills and their relationship to mathematical modelling among fifth grader
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Abstract: The aim of the current research is to identify (the relationship between deep understanding skills and mathematical modeling among fifth grade students) the research sample consisted of (411) male and female students of the fifth grade of biology distributed over the General Directorates of Education in Baghdad / Al-Rusafa / 2 / and Al-Karkh / 1 /, and two research tools were built: 1- A test of deep understanding skills, consisting of (20) test items and a scale for two skills. 2- The second test consists of (24) test items distributed among (18) essay items and (6) objective items. The psychometric properties of validity, stability, discriminatory strength, and effectiveness of alternatives were verified for the two tests fo

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of The Mechanical Behavior Of Materials
Time and finance optimization model for multiple construction projects using genetic algorithm
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Abstract<p>Construction contractors usually undertake multiple construction projects simultaneously. Such a situation involves sharing different types of resources, including monetary, equipment, and manpower, which may become a major challenge in many cases. In this study, the financial aspects of working on multiple projects at a time are addressed and investigated. The study considers dealing with financial shortages by proposing a multi-project scheduling optimization model for profit maximization, while minimizing the total project duration. Optimization genetic algorithm and finance-based scheduling are used to produce feasible schedules that balance the finance of activities at any time w</p> ... Show More
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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Crack Growth Behavior through Wall Pipes under Impact Load and Hygrothremal Environment
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This research concerns study the crack growth in the wall of pipes made of low carbon steel under the impact load and using the effect of hygrothermal (rate of moisture 50% and 50℃ temperature). The environmental conditions were controlled using high accuracy digital control with sensors. The pipe have a crack already. The test was performed and on two type of specimens, one have length of 100cm and other have length 50cm. The results were, when the humidity was applied to the pipe, the crack would enhance to growth (i.e. the number of cycles needed to growth the crack will reduce). In addition, when the temperature was increase the number of cycles needed to growth the crack are reduced because the effect of heat on the mechanical pro

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Environmental Stress and their relationship to self-rebellion for Preparatory Stage Students
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The Present research aimed at identifying:   

1- The level of environmental stress among preparatory students

2- The level of self-rebellion  among preparatory students

3- The correlation between the two variables of research (environmental stress and self-rebellion) and the extent to which the independent variable contributes to the variable of the middle school students

The current research has determined the students of the fifth stage of the preparatory stage and all the branches in the departments of education in Baghdad province the morning study for the academic

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Publication Date
Tue Jul 01 2025
Journal Name
Mastering The Minds Of Machines
Unsupervised Learning: Discovering Patterns without Labels: Health Care, E-Commerce, and Cybersecurity
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Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
Temperatture esttiimattiion off EXDRA and SSUMI dwarff Nova systtems from spectroscopic data
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The seasonal behavior of the light curve for selected star SS UMI and EXDRA during outburst cycle is studied. This behavior describes maximum temperature of outburst in dwarf nova. The raw data has been mathematically modeled by fitting Gaussian function based on the full width of the half maximum and the maximum value of the Gaussian. The results of this modeling describe the value of temperature of the dwarf novae star system leading to identify the type of elements that each dwarf nova consisted of.

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