Background: Laparoscopic cholecystectomy has many difficulties which include port Insertion, Dissectionof the Calot’s Triangle , Grasping of the Gallbladder , Wall thickness, Adhesion and extraction of theGallbladder. Aim of the Study: To predict how difficult cholecystectomy will be from assessing the patientpreoperatively which, in turn, help in decreasing the risks on the patients and preventing post-operativecomplications. Patients and Methods: A prospective study conducted in the department of General Surgeryat Al-Ramadi Teaching Hospital for the period of nine months from 15th of May 2018 till the 15th of February2019. It included 60 patients, all of them were undergone laparoscopic cholecystectomy for Gallstone. Patientswith common bile duct calculus, dilated common bile duct, current attack of acute cholecystitis, those withabsolute contraindications to laparoscopic cholecystectomy, The data were collected prospectively to predictthe significance of association with patients’ characteristics. The time of operation was calculated from thefirst port site incision until the last port closure. All the intra operative events were recorded. Conversionsto open cholecystectomy were done by median or subcostal laparotomy according to the surgeon’s decisionand each patient’s condition. Results: In this study, the highest proportion of operations was categorizedas easy (58.3%), 28.3% of operations were considered difficult and 13.3% of them were very difficult. Asignificant association (P < 0.05) between operation difficulty and all of the following characteristics: Aging,obesity, history of previous biliary hospitalization, thickened bladder wall, pericholecystic collection, andlarge stones. Conclusions: The difficult laparoscopic cholecystectomy can be predicted preoperativelybased on number of factors, like: obesity, previous biliary admission, gall bladder wall thickness, ultrasoundfindings (stone size and pericholecystic fluid) and aging process, evaluating of such factors minimize thecomplications of laparoscopic cholecystectomy and conversion to the open procedure.
Abstract :-
The aim of the research is to explain the role of quality costs their importance and their classification, and to clarify the most important tools that help to reduce costs.
In order to achieve the objective of the research and test hypotheses adopted the descriptive approach, as well as the adoption of the analytical approach in the study of applied data has been relied upon in providing data on the financial and production reports of the research sample company, the data were used to study and analyze financial and productivity reports . A number of conclusions have been reached the most important being the following
... Show MoreIncluded a research problem , pointing to deficiencies and neglect in Arabic language teaching in primary and middle school , what makes sense to form your linguistic Bell ( Listening ) is missing , especially grammar, vocabulary endings .
And stressed the importance of research that teaching students the Arabic language is the balance of the next life , and that any defect infects will demolish an important part of their structure and the fact that the theater is a form of human directcommunication , and it`s way is the word this helps students to develop some communication skills , and language the backbone of these skills ,1- The research sample was identified in all age children ( 6-12 ), which c
... Show MoreInternal Audit is one of the most important backers of corporate governance, the researcher expanded his interest in this subject to examine the efficiency of Internal Auditors at the Arab Bank and its branches in Jordan to achieve Accountability which enhances the Corporate Governance and to identify the effect of the International Internal Audit Standards in strengthening the role of Internal Auditors in Accountability, and the effect of Attribute and Performance Standards in Accountability. The researcher applied descriptive analysis method to define the role of Internal Audit in the Arab Bank in achieving one of the basic principles of Corporate Governance assimilated in Accountability. The researcher’s sources include
... Show MoreThis researchable paper aims to focus of the role & mechanism of market makers in Iraqi stock market through analyzing its role in other Arabian as well as global stock ones, especially in current period through activate the use of bonds, shares, and trying to create a continued price balance. Then decreasing the opportunity having gaps between highest and lowest level without reasonable causes. In addition trying to deactivate the common decision without supported information. Moreover, this paper aims to explain the rules of increasing liquidity and having balance to lead the market into positive direction. Thus, for achieving the above-mentioned requirements, such conditions should be underlined by market makers as well as t
... Show MoreThe Industrial Banks in most countries in the world plays an essential and vital role in developing the industrial sector due to its effective importance in the economic and social development. The research aims to study the ability of the Industrial Bank of Iraq to the growth and development of the mixed industrial sector companies through loans granted to them. In addition, the research seeks to study credit policies pursued by the Industrial Bank of Iraq to finance the mixed industrial sector companies. The data of the research has been collected from the financial statements of the Industrial Banks of Iraq for the period 2007-2011, and by means of questionnaire distributed to a sample of the mixed industrial sector companies in
... Show MoreBackground: Pseudomonas aeruginosa is a devious pathogen with the tendency to prompt many acute and serious chronic diseases. This study aims to detect novel genes (Toxins-Antitoxins II system), especially; higB and higA encoded from P. aeruginosa by PCR technique and the relation between these genes and antibiotic resistance of P. aeruginosa. Methods: This study detected 50 isolates of P. aeruginosa from distinct clinical sources. The most common origin of isolates was (44%) burn swabs, (22%) urine culture, (12%) wound swabs, (14%) sputum, and (8%) ear swabs. The bacteria were isolated using implantation MacConkey agar and blood agar, as well as biochemical tests including oxidase test, catalase test then VITEK-2 System of P. aerug
... Show MoreThe current research aims to identify the nature of the relationship between training human resources in administrative innovation elements In the General Directorate for the education of the third Rusafa one of the formations of the Iraqi Ministry of Education in Baghdad, In order to achieve the objectives of the research, the researcher provided a comprehensive theoretical framework and the preparation and development of a questionnaire as a tool for collecting data based on the prepared measurements and benefit from previous studies, which contains (28) For the purpose of obtaining realistic results for the variables of the research, the researcher used the random sample in the selection of the research sample A total of (63)
... Show MoreConflict, peace, and sports have a long history as practical realities, and their correlation has become an important subject of study in the last decades of the twentieth century. Sport has infiltrated peace and conflict studies as a tool for resolving conflict and building peace, but opinions have differed between those who say it is a positive tool and others who see it as negative. The Gulf Cup is one of the champions that have never been studied, and in-depth research about it has not been done. This tournament has affected the relations between the states involved. The politics cast its shadow on the Gulf Cup. The paper aims to shed light on how political events in the region have consistently affected the Gulf Cup and how politics in
... Show MoreThe problem of the paper focused on the role of the learning organization in the crisis management strategy, and the extent of the actual interest in both the learning organization and the crisis management and aimed at diagnosing and analyzing that and surrounding questions. The Statistical Package for the Social Sciences (SPSS) program was used to calculate the results and the correlation coefficient between the two main variables. The methodology was descriptive and analytical. The case study was followed by a questionnaire that was distributed to a sample of 31 teachers. The paper adopted a seven-dimensional model of systemic thinking that encourages questioning, empowerment, provision of advanced technologies, and strategic lea
... Show MoreFor Spanish learners who are not immersed in everyday contexts, such as students of Spanish as a foreign language, interaction with native speakers is an enriching experience that allows them to contrast their knowledge in a meaningful way. For its part, understanding the cognitive and grammatical functions of the so-called verbs of change plays an essential role in the development of everyday conversation,including the management of aspects such as dialectal variations.In relation to this important function, the central theme of our proposal is verbs of change. The latter have been the research base of several linguists who highlight, amidst their complex functioning in Spanish, positive communicative bases. By observing these perspecti
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