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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 Apr 01 2017
Journal Name
Applied Energy
Melting enhancement in triplex-tube latent heat energy storage system using nanoparticles-metal foam combination
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Publication Date
Sat Apr 01 2023
Journal Name
Digital Communications And Networks
Dynamic channel estimation-aware routing protocol in mobile cognitive radio networks for smart IIoT applications
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Publication Date
Wed Nov 05 2025
Journal Name
Irrigation And Drainage
Predicting Potential Salinity in River Water for Irrigation Water Purposes Using Integrative Machine Learning Models
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ABSTRACT<p>Accurate prediction of river water quality parameters is essential for environmental protection and sustainable agricultural resource management. This study presents a novel framework for estimating potential salinity in river water in arid and semi‐arid regions by integrating a kernel extreme learning machine (KELM) with a boosted salp swarm algorithm based on differential evolution (KELM‐BSSADE). A dataset of 336 samples, including bicarbonate, calcium, pH, total dissolved solids and sodium adsorption ratio, was collected from the Idenak station in Iran and was used for the modelling. Results demonstrated that KELM‐BSSADE outperformed models such as deep random vector funct</p> ... Show More
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Publication Date
Tue Jun 20 2023
Journal Name
Baghdad Science Journal
Hemato-Serological Findings as Early signals in Nile Tilapia Oreochromis niloticus Treated with Benzalkonium Chloride
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To evaluate the toxicity of benzalkonium chloride in aquaculture, the hemato-serological indices of Nile tilapia Oreochromis niloticus are used as biomarkers. Following exposure to three concentrations of benzalkonium chloride BAC 0.1, 0.25, 0.50, and 1 mg/l (BAC1,2,3 and 4) in aquaria for two durations 21 and 42 days, the microbiological assay in fish aquaria, in addition to blood parameters were assessed. Except for the mean difference between BAC2 and BAC3 (P > 0.05) at 42 days, the mean values of the bacterial counts revealed a significant difference between all compared groups (0.05 ≥ P ≤ 0.01). Following exposure to the lower concentrations of BAC (1, 2 and 3), the main blood parameters of Oreochromis niloticus namely red bl

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Publication Date
Fri Feb 24 2023
Journal Name
Membranes
Enhanced Antifouling in Flat-Sheet Polyphenylsulfone Membranes Incorporating Graphene Oxide–Tungsten Oxide for Ultrafiltration Applications
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In this study tungsten oxide and graphene oxide (GO-WO2.89) were successfully combined using the ultra-sonication method and embedded with polyphenylsulfone (PPSU) to prepare novel low-fouling membranes for ultrafiltration applications. The properties of the modified membranes and performance were investigated using Fourier-transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), contact angle (CA), water permeation flux, and bovine serum albumin (BSA) rejection. It was found that the modified PPSU membrane fabricated from 0.1 wt.% of GO-WO2.89 possessed the best characteristics, with a 40.82° contact angle and 92.94% porosity. The permeation flux of the best membrane was the highest. The pure water permeation f

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Publication Date
Mon Nov 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Treatability influence of municipal sewage effluent on surface water quality assessment based on Nemerow pollution index using an artificial neural network
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Abstract<p>Assessing water quality provides a scientific foundation for the development and management of water resources. The objective of the research is to evaluate the impact treated effluent from North Rustumiyia wastewater treatment plant (WWTP) on the quality of Diyala river. The model of the artificial neural network (ANN) and factor analysis (FA) based on Nemerow pollution index (NPI). To define important water quality parameters for North Al-Rustumiyia for the line(F2), the Nemerow Pollution Index was introduced. The most important parameters of assessment of water variation quality of wastewater were the parameter used in the model: biochemical oxygen demand (BOD), chemical oxygen dem</p> ... Show More
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Publication Date
Wed May 10 2023
Journal Name
Journal Of Engineering
REMOVAL OF PHENOLIC COMPUNDS FROM AQUEOUS SOLUTIONS BY ADSOPTION ONTO ACTIVTED CARBONS PREPARED FROM DATE STONES BY CHEMICAL ACTIVATION WITH FeCl3
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Activated carbon prepared from date stones by chemical activation with ferric chloride (FAC) was used an adsorbent to remove phenolic compounds such as phenol (Ph) and p-nitro phenol (PNPh) from aqueous solutions. The influence of process variables represented by solution pH value (2-12), adsorbent to adsorbate weight ratio (0.2-1.8), and contact time (30-150 min) on removal percentage and adsorbed amount of Ph and PNPh onto FAC was studied. For PNPh adsorption,( 97.43 %) maximum removal percentage and (48.71 mg/g) adsorbed amount was achieved at (5) solution pH,( 1) adsorbent to adsorbate weight ratio, and (90 min) contact time. While for Ph adsorption, at (4) solution pH, (1.4) absorbent to adsorbate weight ratio, and (120 min) contact

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Publication Date
Thu Sep 01 2016
Journal Name
Chem Istry & Chem Ical Technology
SYN TH ESIS, CH ARACTERIZATION AN D AN TIM ICROBIAL ACTIVITY OF N EW N UCLEOSIDE AN ALOGUES FROM BEN ZOTRIAZOLE
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Novel derivatives of 1-(´1, ´3, ´4, ´6-tetra benzoyl-β-D-fructofuranosyl)-1H- benzotriazole and 1-(´1, ´3, ´4, ´6-tetra benzoyl-β-D-fructofuranosyl)-1H- benzotriazole carrying Schiff bases moiety were synthesised and fully characterised. The protection of D- fructose using benzoyl chloride was synthesized, followed by nucleophilic addition/elimination between benzotria- zole and chloroacetyl chloride to give 1-(1- chloroacetyl)- 1H-benzotriazole. The next step was condensation reaction of protected fructose and 1-(1-chloroacetyl)-1H- benzotriazole producing a new nucleoside analogue. The novel nucleoside analogues underwent a second conden- sation reaction with different aromatic and aliphatic amines to provide new Schiff b

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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
Prioritized Text Detergent: Comparing Two Judgment Scales of Analytic Hierarchy Process on Prioritizing Pre-Processing Techniques on Social Media Sentiment Analysis
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Most companies use social media data for business. Sentiment analysis automatically gathers analyses and summarizes this type of data. Managing unstructured social media data is difficult. Noisy data is a challenge to sentiment analysis. Since over 50% of the sentiment analysis process is data pre-processing, processing big social media data is challenging too. If pre-processing is carried out correctly, data accuracy may improve. Also, sentiment analysis workflow is highly dependent. Because no pre-processing technique works well in all situations or with all data sources, choosing the most important ones is crucial. Prioritization is an excellent technique for choosing the most important ones. As one of many Multi-Criteria Decision Mak

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Publication Date
Thu Sep 13 2018
Journal Name
Baghdad Science Journal
An Efficient Numerical Method for Solving Volterra-Fredholm Integro-Differential Equations of Fractional Order by Using Shifted Jacobi-Spectral Collocation Method
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The aim of this article is to solve the Volterra-Fredholm integro-differential equations of fractional order numerically by using the shifted Jacobi polynomial collocation method. The Jacobi polynomial and collocation method properties are presented. This technique is used to convert the problem into the solution of linear algebraic equations. The fractional derivatives are considered in the Caputo sense. Numerical examples are given to show the accuracy and reliability of the proposed technique.

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