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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 Jul 04 2010
Journal Name
Journal Of Educational And Psychological Researches
guidance program Structured to address therapeutic cognitive emotional disorders (Anxiety and depression model)
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           Is one of the processes of educational guidance to help the individual to design educational plans that fit with the abilities and inclinations and goals.
And research aims the current instruction program heuristic therapeutic knowledge to deal with emotional disorders. And may the researcher instruct a program according to the theories of interested and competent guidance to education and has studied the large number of studies available in this field, as has been the program on a number of specialists in education and Psychology and took their views. And then was adopted the final version of the indicative program, consistent with the sample, which was built

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Publication Date
Sun Jan 02 2022
Journal Name
Journal Of The College Of Languages (jcl)
To Domesticate or to Foreignize: An Approach to Translating Fables and Fairy Tales
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      The present study deals with the strategies used in the Arabic translations of the most popular genres of children’s literature; namely fairy tales and fables as an attempt to identify the best methods and strategies to be adopted in translating these genres to fulfill the ultimate purpose of enriching the children’s knowledge in addition to attracting their interest and arousing the joy sought for in every piece of literature.

The study sets off from three dominating trends: the first calls for the adoption of domestication strategy of translation as the most appropriate and effective strategy in translation for children. In the same line, the second opposes using the foreignization strategy, w

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Publication Date
Fri Aug 12 2022
Journal Name
Future Internet
Improved DDoS Detection Utilizing Deep Neural Networks and Feedforward Neural Networks as Autoencoder
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Software-defined networking (SDN) is an innovative network paradigm, offering substantial control of network operation through a network’s architecture. SDN is an ideal platform for implementing projects involving distributed applications, security solutions, and decentralized network administration in a multitenant data center environment due to its programmability. As its usage rapidly expands, network security threats are becoming more frequent, leading SDN security to be of significant concern. Machine-learning (ML) techniques for intrusion detection of DDoS attacks in SDN networks utilize standard datasets and fail to cover all classification aspects, resulting in under-coverage of attack diversity. This paper proposes a hybr

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Publication Date
Mon Mar 20 2023
Journal Name
2023 International Conference On Information Technology, Applied Mathematics And Statistics (icitams)
Hybrid Color Image Compression Using Signals Decomposition with Lossy and Lossless Coding Schemes
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Publication Date
Mon Feb 07 2022
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Mathematical connection skills and their relationship with productive thinking among secondary school students
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Publication Date
Wed Aug 29 2018
Journal Name
Journal Of Engineering
Zeta Potential, Effective Membrane Charge and Donnan Potential for TiO2 NF Ceramic Membrane
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Nanofiltration (NF) ceramic membrane have found increasing applications particularly in wastewater and water treatment. In order to estimate and optimize the performance of NF membranes, the membrane should be characterized correctly in terms of their basic parameters such as effective pore radius (rp) and equivalent effective thickness as well as effective surface charge ( ), the effective charge density ( ) and Donnan potential ( ). The impact of electrokinetic (zeta) potential on the membrane surface charge density, effective membrane charge density and Donnan potential at two different concentrations of the reference solutions 0.001, 0.01 M sodium chloride at various pH values from 3 to 9, and effective po

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Composites Science
Sawdust-Based Concrete Composite-Filled Steel Tube Beams: An Experimental and Analytical Investigation
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Incorporating waste byproducts into concrete is an innovative and promising way to minimize the environmental impact of waste material while maintaining and/or improving concrete’s mechanical characteristics and strength. The proper application of sawdust as a pozzolan in the building industry remains a significant challenge. Consequently, this study conducted an experimental evaluation of sawdust as a fill material. In particular, sawdust as a fine aggregate in concrete offers a realistic structural and economical possibility for the construction of lightweight structural systems. Failure under four-point loads was investigated for six concrete-filled steel tube (CFST) specimens. The results indicated that recycled lightweight co

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Publication Date
Thu Jan 30 2020
Journal Name
Neuroquantology
Electronic Transfers and (NLO) Properties Predicted by AB Initio Methods with Prove Experimentally
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Hartree-Fock (HF) method relies in the calculations of nonlinear optical properties (NLO) for benzoic acid molecule. Also, another theoretical study is conducted by using the TD-DFT Density Functional Theory through B3LYP/High Base Set 6-311++G (2d,2p) on Gaussian program09. Moreover, an experimental study has been done to obtain the electrons spectrum for benzoic acid with and without ethanol. While the experimental study is done by using UV/VIS. spectrophotometer. Energy gap values of electronic transition between HOMO and LUMO is obtained from theoretical and experimental results. Consequently, the theoretical result for determining the energy gap calculated from EHOMO-LUMO wasvery close to the results of UV / VIS. spectrum. A theoretica

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Publication Date
Sun Sep 08 2024
Journal Name
Al Rafidain Journal Of Engineering Sciences
Oscillating Heat Pipe Start-up and Flow Characteristics with Water as Working Fluid
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Thermal management has grown more and more problematic as electronic components continue to get faster and smaller. One of the passive two-phase cooling systems are Oscillating heat pipe (OHP) that have the capacity to transmit a significant quantity of thermal energy across long distances. Oscillating heat pipe is a device that has the potential to satisfy this developing requirement. An investigation into the effects of orientation, filling ratio, and heat load on the initiation and characteristics of oscillatory motion, combining numerical simulations with experimental validation. A copper tube with a 2 mm inner diameter and a 2 mm wall thickness is used to fabricate the OHP. The condenser, evaporator, and adiabatic sections are

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Publication Date
Sun Jun 27 2021
Journal Name
Journal Of The College Of Education For Women
Persuasive Strategies in WHO COVID-19 Virtual Press Conferences: فراس مجيت حماد , جمعة قادر حسين
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Persuasion is an indispensable skill in everyday life; that is why, it has aroused researchers’ interest. This study aims to investigate the most frequently used persuasive strategies in texting WHO COVID-19 Virtual Press Conferences and explore how these strategies are employed to achieve persuasive messages.To this end, a text of WHO COVID-19 Virtual Press Conferences has been chosen randomly to be analyzed based on Dillard and Shen’s (2013) “Persuasive strategies in Health Campaigns”. A qualitative method has been adopted in analyzing the selected data to investigate the credibility and validity of the persuasive strategies used in such a domain. Findings have shown that most of the persuasive appeals based on the adopted mode

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