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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
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Priority Based Transmission Rate Control with Neural Network Controller in WMSNs
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Wireless Multimedia Sensor Networks (WMSNs) are networks of wirelessly interconnected sensor nodes equipped with multimedia devices, such as cameras and microphones. Thus a WMSN will have the capability to transmit multimedia data, such as video and audio streams, still images, and scalar data from the environment. Most applications of WMSNs require the delivery of multimedia information with a certain level of Quality of Service (QoS). This is a challenging task because multimedia applications typically produce huge volumes of data requiring high transmission rates and extensive processing; the high data transmission rate of WMSNs usually leads to congestion, which in turn reduces the Quality of Service (QoS) of multimedia appli

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Publication Date
Sun Sep 07 2014
Journal Name
Baghdad Science Journal
A comparative taxonomic study of nutlets of Stachys L. in Iraq
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Nutlets of 22 taxa of Stachys (13 species and seven subspecies and two varieties), representing seven of the currently recognized sections distributed in northern Iraq were examined by light microscope. The basic shape of nutlets in most taxa studied is Obovoid, but Oblong also found in S.megalodanta Hausskn.& Bornm. ex P.H.Davis, S.setirefa C.A.Mey. subsp daenensis (Gandog.) Rech.f.and S. kurdica Boiss.& Hohen. var.kurdica, while the Subgloboid shape found in S. iberica M.Bieb. and S. inflata Benth., more over the Broad triangular shape was found in S. nephrophylla Rech.f. and S.lanigera (Bornm.) Rech.f.., the biggest size of nutlets was found in S.inflata L. and the smallest was in S.melampyroides Hand.-Mzt. Regarding sculpturing pa

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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
The formation, structure, and electronic properties of Lansoprazol drug and cucurbit [7]urils complex (Theoretical Study)
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The current study deals with host-guest complex formation between cucurbit [7] urils as host and lansoprazole as guesti using PM3 (semi empirical molecules orbital calculations) also DFT calculations. In this complex, the formation of hydrogen bonding may be occurred through portal oxygen atoms(O2) of cucurbit [7] urils and amine groups (NH 2 )of the drug. The energies of HOMO and LUMO orbital’s have been computed for the host guest complex and its components. The result of the stabilization energy explained a complex formation.

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Publication Date
Tue Jan 01 2019
Journal Name
Energy Procedia
Synthesis and Study the Structure, electrical and optical properties of Bi2-xCdxSr2Ca2Cu3O10+ δ thin film Superconductors
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Publication Date
Fri Oct 01 2021
Journal Name
Journal Of Engineering
Analytical and Experimental Study of the Piles Cap Normal and Light Weight Aerated Concrete: Literature Review
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The main objective of this study is to understand the work of the pile caps made of lightweight aerated foam concrete and study the many factors affecting the ability and the capacity of the shear. The study was done by analyzing previous practical and theoretical experiences on the reinforced concrete pile caps. The previous practical results indicated that all specimens failed by shear diagonal compression or tension modes except one specimen that failed flexural-shear mode. Based on test specimens' practical results and behavior, some theoretical methods for estimating the ultimate strength of reinforced concrete pile caps have been recommended, some of which evolved into the design documents available on the subject.

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
US policy toward the political movement in the Arab countries Egypt a model
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The whole world and the Arab world, especially an important part of this international system, is undergoing a radical transformation at all levels. This mosaic of political, economic, social and military relations and alliances, whether based on the special interests of the major Powers or on the basis of mutual interests, The major transformations to social, economic, political and military conflict and these transformations still bear more surprises, at all levels, nothing remains constant, all changed, relations changed and alliances changed and loyalties fell and the principles of the M changed and the spectacular imperial economies collapsed and the will of the masses was no longer fixed.

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
The Existential Dilemma as a Philosophical Problem in The Beggar by Naguib Mahfouz
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     The Beggar (1965) is a story of isolation and depression which is written by the Egyptian novelist Naguib Mahfouz who is considered the father of Arabic Literature in the modern era. Specifically, he refers in his great novel called The Beggar that the man unable to achieve psychological revival after Nasser’s revolution, the man sacrificed his own job and his family for a desire that increases his feelings of alienation and depression which leads him to an emotional outcry against the indifferent. The main aim of the study highlights the concept of existential dilemma as a philosophical problem and personality crisis by the protagonist of The Beggar novel, Omer Al-Hamzawi who had acc

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Publication Date
Mon Mar 15 2021
Journal Name
The Journal Of Legal And Social Sciences
The Limitations on the Judge’s Authority in Judicial Interpretation – France as a Model
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When exercising their authority in the jurisprudence, judges are subject to a set of restrictions that they must adhere to, as they do not want their jurisprudence to be accepted and welcomed by law practitioners in general, and legal scholars in particular, and in contrast to it, the arrows of criticism and defamation will extend to that jurisprudence, and then they will have to reverse them . Perhaps the most important of those restrictions imposed on judges is their observance of justice between the parties to the lawsuit through their lack of bias for one of the parties at the expense of the other, in addition to their observance of public order and public morals, as well as their observance of the legal texts that they work under its u

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Publication Date
Sun Jan 02 2022
Journal Name
Journal Of The College Of Languages (jcl)
Ideological Polarization as a Deception Strategy in the Discourse of American Think Tanks: A Critical Discourse Analysis
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Deception is an inseparable facet of political discourse in attaining strategic political gains though compromising public opinion. However, the employment of discursive deception strategies by the policy-making institutions of think tanks has not received due attention in the literature. The current study aims at exploring how the ideologizing deception strategies are utilized by the conservative American think tank of the Washington Institute to reproduce socio-political realities and re-shape public opinion. To fulfill this task, van Dijk’s (2000) notion of ideological polarization which shows positive self-representation and negative other representation is adopted to conduct a critical discourse analysis of four Arabic texts relea

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Publication Date
Mon Sep 30 2024
Journal Name
مجلة التراث العلمي العربي
The problem of masculinity and femininity in Arabic
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Perhaps masculinity and femininity in our Arabic language are among the linguistic issues that have occupied the attention of researchers, ancient and modern. Many books, works, and research have been written on this subject, but there is still something in it that must be revealed, clarified, and established, as the ancients did not classify the feminine and masculine into real, metaphorical, auditory, analogical,

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