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:
In light of the development in the banking environment and the increasing reliance on electronic systems in providing banking services and due to the intense competition witnessed by the banking sector, the need has emerged to apply the comprehensive electronic banking system, which works on the Internet in providing new and diverse banking services regardless of time and place by linking all branches to one central database, and despite the advantages achieved from the application of the comprehensive system, there is a set of risks that accompany the use of that system, What requires the auditors to develop the audit method in line with the size of the development in the
... Show MoreThe e-commerce is one of the best achievements of the twentieth century, since the conduct commercial transactions via the Internet may be the consumer easy selection process and purchase convenient manner different from traditional methods, and with the beginnings of the new millennium impose the emergence of e-commerce term significant challenges to the insurance industry as an important economic sectors Generally, and insurance companies in particular as a result of scientific development, which has led to a reduction in costs and innovation in the production, which led to intense competition on both levels local or global. The insurance industry is a vital part of the economy and it has a varied impact to the community and individual
... Show MoreThe article is devoted to the issue of word-formation motivation, which does not lose its relevance and plays a role not only in disclosing formal-semantic relations between words of one language and has not only theoretical, but also applied significance. The authors consider word-formation motivation consistently in its varieties in a comparative way on the materials of so different languages as Russian and Arabic and approach the mechanism of achieving semantic equivalence of translation. To the greatest extent, word-formation activity today, due to objective reasons, affects some special branch (technical, medical, etc.) vocabulary, which is increasing from year to year in national dictionaries. This extensive material, selected
... Show MoreSeptember 11th attacks held the biggest tragedy in American history. It was a day of grief, and it proved that America was not immune to attacks and threat. Afterwards life has changed not only for the American Muslims but also American Christians and Jews and to people from other religions. The cruelty of that day has left its shed particularly on the Muslims’ life in America who in reality had nothing to do with the attacks. Arab American Muslim writer Laila Halaby’s novel, Once in a Promised Land, intensely displays the problems that Arab Muslims went through after September 11th attacks. This paper discusses this issue through analysing Halaby’s novel, where she deals with the issues such as discrimination, stereotype, and prejudi
... Show MoreThis study showed the basic features of corporate tax in Iraq by showing what was in the Income Tax Law in force .The study aims of this to indicate the role of tax corprates in tax revenue and then the possibility of strengthening the revenue of this tax as an important source of local funding sources in the form that is with him reduce dependence on oil revenues to finance the general budget in Iraq, the risks and the study found a number of conclusions from the most important: that the corporate tax comes in the introduction to the components of the income tax structure in terms of relative importance and formed a revenue source of prime The gross proceeds of the income tax in Iraq, where it contributed to more than a quarter of that
... Show MoreThe current research deals with the study of aesthetic relations in the field of interior design and the extent to which its mechanisms achieve sensory stimulation between the internal and external spaces, to generate a continuous visual connection that is an extension of it, achieving in turn sensory stimulation for the users of those spaces. The internal and external spaces meet the desired purpose of feeling pleasure and beauty.” The current research aims to “discover the nature of aesthetic relations between the internal and external spaces and the extent to which mechanisms can achieve sensory stimulation in residential spaces.” The first topic included the concept of aesthetic relations, sensory excitement, and perception at
... Show Moreالزكاة فريضة من فرائض الإسلام وعبادة من العبادات التي اقرها الشرع الإسلامي هذه الفريضة المالية التعبدية بالإضافة الى دورها المعنوي الذي يهدف الى إرساء قواعد العدالة الاجتماعية والقضاء على مشكلة الفقر في المجتمع الاسلامي وكما ينص عليها الدين الإسلامي فان لها ابعادها ووظائفها الكثيرة التي تخدم اليات العمل الاقتصادي في مجتمع يعمل وفق نظام اقتصادي أسلامي .
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... Show MoreThe current paper highlights an important character represented by the American president John Tyler 1841 – 1845, who is considered the tenth American president. The importance of this paper lies in identifying his personality in terms of his upbringing and the political activities he practiced before assuming the presidency and his most significant internal achievements, which showed his decisions as a president. He was fully prepared to support national policies since they do not exceed the authorities of the states. With his achievements in the foreign policy, he was capable to draw and define the features of the American foreign relations that were in harmony with the general situation in the United States of America at that time.
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