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 study aims to know the degree of secondary school managers' practice of servant leadership in Gaza from their teachers’ perspective. It further aims to examine whether there are any statistically significant differences at (α 0.05≥) between the means of the study sample’s members attributed to variables such as (gender, educational qualification, and years of experience). To achieve the objectives of the study, the study adopted the descriptive survey method, using a questionnaire consisting of (30) items distributed to four domains: (workers service, ethical dealing, motivation & influence, and building an organized, integrated society). Then, the questionnaire was distributed to t
... Show MoreA study of Zooplankton community has been carried out at four selected sites on Dukan Lake. Samples of water and zooplankton were collected monthly for the period from July 2015 to February 2016. Some physical and chemical properties of water were studied and the results showed that the air temperature were ranged from 0 to 36.16 °C, water temperature ranged from 2.83 to 34.66 °C, hydrogen ion concentration of studied sites were found to lie in alkaline side, it was ranged between 6.87 to 8.57, electrical conductivity ranged from 190.79 to 850.08 µs.cm¹, turbidity ranged from 0.9-7.7 NTU, and dissolved oxygen from 3.3 to 6.8 mg.l-¹ while BOD5 were ranged from 0.53 to 34.66 mg.l-¹. Concerning to the zooplankton, 37 species were ident
... Show MoreThe study aims to set an image to the mechanisms of the skills of the 21st century in the educational competencies of the basic education stage. To achieve this aim, a qualitative research design has been adopted in its analytical content analysis way. The study has arrived to the following conclusions: the availability of: the communicative and team work skills with a percentage of 25.9%, linguistic competency with a percentage of 24.6%, the skills of local and global citizenship, creativity, and problem solving with a percentage of 13.6%, critical thinking with a percentage of 10.38%, technological culture with a percentage of 5.8%, pioneerism and initiativeness with a percentage of 10.38%, technological culture with a percentage of
... Show MoreThe study examines Julia Alvarez's role as a Dominican American author, poet, and essayist. Despite being born in New York City in 1950, she was raised in the Dominican Republic by a family with Dominican heritage. Her residence in her ancestral homeland significantly influenced her subsequent literary works. Upon her father's implication in a conspiracy against Dominican President, he departed from the Dominican Republic. Alvarez encountered the challenge of the English language. They were compelled to acquire proficiency in English due to the prevailing perception that anyone who spoke a language other than English were deemed "un-American" during that period. Alvarez recounted her initial encounters in the United States and the subseque
... Show MoreThis research studies the Saudi women participation in the visual arts, presents descriptive and analytical overview on their artworks and assess development through their participation in the said exhibition, frequency of participation, and aims to understand the most important stages and changes of the subjects addressed, artistic styles and the factors affecting these results in view of female artist's attitude pertaining to several aspects such as administrative organization, judging committees etc.
Interviews were held with a sample of female artists, 17 artists from different regions and generations out of 182 participants and reviewed relevant exhibition literature during the period 1979-2018. The research problem is to id
... Show MoreThis research is a modest effort to talk about the great world of ancient lineage, Imam Majd al-Din Abu Saadat, known as Ibn al-Atheer island, through the statement of his name, surname, nickname, family, elders and his pupils and his most important works.
It also deals with the modern research on his famous book in the field of modern science called (the end in the strange talk and impact), which is one of the most wonderful books of modern and especially the strange talk, through the scientific effort of the Imam and the importance of the book and methodology, and the most prominent aspects of the service and care of Ibn Al Atheer For the modern stranger, which boils down to two aspects:
First: the linguistic rooting of the stran
The study was planned to evaluate the effect of adding Guanidinoacetic acid in some characteristics of the sperm of the rams. This study was conducted in the animal field of the Animal Production Department / Faculty of Agricultural Engineering Sciences / University of Baghdad, for the period from 5/8/2018 to 28/2/2019. In this experiment, 3 rams were used at the age of 2-2.5 years and weighed 50-54 kg. The semen was collected early in the morning and once a week and the semen was pooled to remove the individual differences. The treatments were divided: GAA-free control group, treatment T1 (0.05 mg / 100 ml GAA), T2 treatment (0.1 mg / 100 ml GAA) and T3 treatment (0.2 mg / 100 ml GAA). The results of the study showed a significant decrease
... Show MoreThe Evaluation of the immune response in Golden Hamsters experimentally infected with Leishmania donovani was determined in this study, particularly, the cellular immune response. Follow up has maintained to determine the Delayed Type of Hypersensitivity using skin test both in infected and control lab animals. Chicken red blood cells were used as a parameter to evaluate the immune system; they are dull and have the ability of immunization. Two concentrations of chicken R.B.C were examined to determine which gives the higher titration in Hamsters and those were 1.5 X 109 cell/ml and 3 X 109 cell/ml , the second concentration gave the maximum titration where then used in this work. After sensitization with Chicken R.B.C for both infected a
... Show MoreThe Evaluation of the immune response in Golden Hamsters experimentally infected with Leishmania donovani was determined in this study, particularly, the cellular immune response. Follow up has maintained to determine the Delayed Type of Hypersensitivity using skin test both in infected and control lab animals. Chicken red blood cells were used as a parameter to evaluate the immune system; they are dull and have the ability of immunization. Two concentrations of chicken R.B.C were examined to determine which gives the higher titration in Hamsters and those were 1.5 X 109 cell/ml and 3 X 109 cell/ml , the second concentration gave the maximum titration where then used in this work. After sensitization with Chicken R.B.C for both in
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