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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 Jun 30 2024
Journal Name
Iraqi Journal Of Science
Gray-Scale Image Compression Method Based on a Pixel-Based Adaptive Technique
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     Today in the digital realm, where images constitute the massive resource of the social media base but unfortunately suffer from two issues of size and transmission, compression is the ideal solution. Pixel base techniques are one of the modern spatially optimized modeling techniques of deterministic and probabilistic bases that imply mean, index, and residual. This paper introduces adaptive pixel-based coding techniques for the probabilistic part of a lossy scheme by incorporating the MMSA of the C321 base along with the utilization of the deterministic part losslessly. The tested results achieved higher size reduction performance compared to the traditional pixel-based techniques and the standard JPEG by about 40% and 50%,

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
the aspect of the radiation superposed on the soliton pulse propagated in single mode optical fiber
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the first part of the research involves investigate the aspect of the radiation superposed on the one bright soliton pulse propagated on ideal single mode

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Publication Date
Sat Jun 01 2019
Journal Name
Agricultural Engineering
Comparing Nozzles with Different Wear Rate and Working with the Same Application Rate of Different Plant Protection Products in Aspect of Plants Condition
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Abstract<p>Three different types of nozzles (different wear rate) were used in this study. They are classified depending on the severity of their wear to three groups: new, worn and damaged nozzles. Those nozzles were spraying with the same application rate (303 l/ha) on two-year field trials; this was achieved by changing the spraying pressure for each group of nozzles in order to get the same application rate. This practice is usually done by operators of sprayers, who calibrate the sprayers on the same application rate every year without changing the nozzles, so they tend to reduce the spraying pressure in order to compensate the flow rate increase due to the nozzles yearly wear. Two types of</p> ... Show More
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Publication Date
Thu Jun 28 2018
Journal Name
Journal Of The College Of Education For Women
The literature of the teacher and learner is a study in the light of “Holly Quran
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Praise be to Allah, Lord of the Worlds, teach the pen, taught the human what he didn't know, Ihmad - Almighty - and thank him, and repent to him and ask forgiveness, which is the most forgiving, and bear witness that there is no god but Allah alone has no partner, gives and prevents, And I bear witness that Muhammad is  a slave to Allah  and his Messenger, who called for guidance and good speech and spoke, peace be upon him and his family and companions, and those who followed them until the Day of Judgment.

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of International Dental And Medical Research
The effects of progesterone administration in mice during pregnancy on ovarian development and anogenital distance of the offspring
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Progesterone is highly used in pregnant women as therapeutic agent to maintain and support pregnancy. To explore the effects of progesterone usage allover gestation till 7days postnatally on mice offspring ovaries development and anogenital distance. Ten pregnant mice were equally divide into control group that was injected with sesame oil which is used as a solvent for progesterone and treated group that is daily intraperitoneally injected with progesterone (dissolved in sesame oil 1: 10) at dose 10.2 mg/kg (the equivalent human dose) all through gestation till7day postnatal then sacrificed and measuring the anogenital distance (the distance between anus and genital papilla). Histological slides were prepared, and Diameters of the ovary, p

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Publication Date
Sat Jan 01 2022
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees21gr
The possibility of implementing smart mobility in the traditional city: Studying the possibility of establishing an intelligent transportation system in the city center of Kadhimiya
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The possibility of implementing smart mobility in the traditional city: Studying the possibility of establishing an intelligent transportation system in the city center of Kadhimiya

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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Laboratory Investigation on Roller Compaction Technique in Concrete Construction
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Roller compacted concrete (RCC) is a concrete compacted by roller compaction. The concrete mixture in its unhardened state must support a roller while being compacted. The aim of this research work was to investigate the behavior and properties of roller compacted concrete when constructed in the laboratory using roller compactor manufactured in local market to simulate the field conditions. The roller compaction was conducts in three stages; each stage has different loading and number of passes of the roller. For the first stage, a load of (24) kg and (5) passes in each direction had been employed. For the second stage, a load of (104) kg and (10) passes in each direction were conducted. Finally, at the third stage, a load of (183) kg a

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Publication Date
Wed Oct 06 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Image segmentation by using thresholding technique in two stages
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Publication Date
Sun Oct 31 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Image segmentation by using thresholding technique in two stages
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Image segmentation can be defined as a cutting or segmenting process of the digital image into many useful points which are called segmentation, that includes image elements contribute with certain attributes different form Pixel that constitute other parts. Two phases were followed in image processing by the researcher in this paper. At the beginning, pre-processing image on images was made before the segmentation process through statistical confidence intervals that can be used for estimate of unknown remarks suggested by Acho & Buenestado in 2018. Then, the second phase includes image segmentation process by using "Bernsen's Thresholding Technique" in the first phase. The researcher drew a conclusion that in case of utilizing

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Publication Date
Thu Feb 02 2012
Journal Name
Education College Journal/al-mustansiriyah University
On Significance Testimator in Pareto Distribution Via Shrinkage Technique
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In this paper, preliminary test Shrinkage estimator have been considered for estimating the shape parameter α of pareto distribution when the scale parameter equal to the smallest loss and when a prior estimate α0 of α is available as initial value from the past experiences or from quaintance cases. The proposed estimator is shown to have a smaller mean squared error in a region around α0 when comparison with usual and existing estimators.

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