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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 Jun 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Emulsion Liquid Membrane for Pesticides Removal from Aqueous Solution: Emulsion Stability, Extraction Efficiency and Mass Transfer Studies
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The current study investigated the stability and the extraction efficiency of emulsion liquid membrane (ELM) for Abamectin pesticide removal from aqueous solution. The stability was investigated in terms of droplet emulsion size distribution and emulsion breakage percent. The proposed ELM included a mixture of corn oil and kerosene (1:1) as a diluent, Span 80 (sorbitan monooleate) as a surfactant and hydrochloric acid (HCl) as a stripping agent without utilizing a carrier agent. Parameters such as homogenizer speed, surfactant concentration, emulsification time and internal to organic volume ratio (I/O) were evaluated. Results show that the lower droplet size of 0.9 µm and higher stable emulsion in terms of breakage percent of 1.12 % we

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Publication Date
Sat Oct 31 2020
Journal Name
International Journal Of Intelligent Engineering And Systems
Automatic Computer Aided Diagnostic for COVID-19 Based on Chest X-Ray Image and Particle Swarm Intelligence
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Publication Date
Fri May 28 2021
Journal Name
Journal Of Microbiology And Biotechnology
Bioactive Levan-Type Exopolysaccharide Produced by <i>Pantoea agglomerans</i> ZMR7: Characterization and Optimization for Enhanced Production
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Publication Date
Tue Jan 01 2019
Journal Name
Ieee Access
Intelligent EMG Pattern Recognition Control Method for Upper-Limb Multifunctional Prostheses: Advances, Current Challenges, and Future Prospects
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Publication Date
Mon Jan 01 2024
Journal Name
Ieee Access
Transfer Learning and Hybrid Deep Convolutional Neural Networks Models for Autism Spectrum Disorder Classification From EEG Signals
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Publication Date
Tue Dec 16 2025
Journal Name
Cab Reviews: Perspectives In Agriculture, Veterinary Science, Nutrition And Natural Resources
From data to decision: How wearable plant sensors help improving proactive irrigation strategies and water use efficiency
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Wearable sensors are a revolutionary tool in agriculture because they collect accurate data on plant environmental conditions that affect plant growth in real-time. Moreover, this technology is crucial in increasing agricultural sustainability and productivity by improving irrigation strategies and water resource management. This review examines the role of wearable sensors in measuring plant water content, leaf and air humidity, stem flow, plant and air temperature, light, and soil moisture sensors. Wearable sensors are designed to monitor various plant physiological parameters in real-time. These data, obtained through wearable sensors, provide information on plant water use and physiology, making our agricultural choices more informed an

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Publication Date
Mon Mar 18 2019
Journal Name
Baghdad Science Journal
Enhancement of hydrothermally Co <sub>3</sub> O <sub>4</sub> thin films as H <sub>2</sub> S gas sensor by loading yttrium element
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The gas sensing properties of Co3O4and Co3O4:Y nano structures were investigated. The films were synthesized using the hydrothermal method on a seeded layer. The XRD, SEM analysis and gas sensing properties were investigated for Co3O4and Co3O4:Y thin films. XRD analysis shows that all films are polycrystalline in nature, having a cubic structure, and the crystallite size is (11.7)nm for cobalt oxide and (9.3)nm for the Co3O4:10%Y. The SEM analysis of thin films obviously indicates that Co3O4possesses a nanosphere-like structure and a flower-like structure for Co3O4:Y.The sensitivity, response time and recovery time to a H2S reducing gas were tested at different operating

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Publication Date
Fri Jan 01 2021
Journal Name
Annals Of Tropical Medicine & Public Health
Newly developed method for determination of methyldopa drug using ammonium ceric (IV) nitrate by continuous flow injection analysis via homemade NAG-ADF-300-2 analyser
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A new, simple, sensitive and fast developed method was used for the determination of methyldopa in pure and pharmaceutical formulations by using continuous flow injection analysis. This method is based on formation a burgundy color complex between methyldopa andammonium ceric (IV) nitrate in aqueous medium using long distance chasing photometer NAG-ADF-300-2. The linear range for calibration graph was 0.05-8.3 mmol/L for cell A and 0.1-8.5 mmol/L for cell B, and LOD 952.8000 ng /200 µL for cell A and 3.3348 µg /200 µL for cell B respectively with correlation coefficient (r) 0.9994 for cell A and 0.9991 for cell B, RSD % was lower than 1 % for n=8. The results were compared with classical method UV-Spectrophotometric at λ max=280 n

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Audit bank credit risk in accordance with international auditing standards: Applied research at Rafidain Bank, Public Administration - Baghdad
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This research dealt with the subject of auditing bank credit risks in accordance with international auditing standards and aims to develop procedures and design a credit risk audit program in accordance with international auditing standards and demonstrate their impact on the truth, truthfulness and fairness of financial statements and on their overall performance and continuity in the banking sector Its importance lies in relying on international auditing standards to assess and measure bank credit risk and its impact on the financial situation as well as the ability to predict financial failure. A set of conclusions have been reached, the most important of which is that the bank faces difficulties in measuring credit risk in accordance

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Publication Date
Sun Aug 05 2018
Journal Name
Journal Of Entomology And Zoology Studies
Some biochemical traits in broiler chicken as affected by insulin-like growth factor-1 (IGF-1) gene polymorphisms
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This study was conducted during the period 1/9/2014 – 1/2/2015 and aimed to identify the polymorphisms of IGF-1 gene in broiler chickens and their effects on some biochemical traits. A total of 300 one-day-old broiler chicks (Cobb500, n=150; Hubbard F-15, n=150) were evaluated in this study. Blood samples were individually collected from all birds for DNA extraction. PCR-RFLP method being used for determination the genotypes of IGF-1 gene which then correlated with biochemical traits studied. Cobb500 broilers with TT genotype had significantly (p˂0.05) higher serum triglycerides values than those of TC and CC genotypes. Low density lipoprotein (LDL) were significantly (p˂0.05) higher in Hubbard F-15 broilers with TT genotype than those

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