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.
This research is marked by " lighting and processors formalism for spaces of shops selling mobile phones ," aims to " reveal about the relationship between lighting treatments formal designs spaces own internal selling mobile phone in addition to the recognition criteria Altsamama to lighting techniques and processes formality spaces shops competent to sell mobile phone " and lies the importance of this research in the " active role of the lighting in the building processors formalities and processes to prepare designs and show the final form integrated functionally and aesthetically so as to be ready for implementation , taking into consideration the role expressionist in the recipient and to make these spaces more than meet the require
... Show MorePreserving the Past and Building the Future: A Sustainable Urban Plan for Mosul, Iraq
Abstract:
If we neglect the value of historical fashions as a source of inspiration for
contemporary fashion designers we will neglect a treasure of original designs.
In neglecting such a treasure how could we then know what is original. Today
the most famous fashion designers are often inspired, in the outwardly from
and internal lines of their fashions, by fashion designed during the ages of the
past.
Designers can find such fashions in books of history and museums. But
the historical ages are not equal in the fertility of the originality and novelty of
their fashions. Thus the contemporary designer may not find the old designs
inspiring so he invents them.
The researcher was keen in this paper to inclu
Abstract
The concept of unipolar has allowed the united states of America to
control the rest of the internations community units through the rxclusively of
control in international affairs without enabling other countries who have the
ability to compete with it to appear this comes as a result of it's position to all
kinds of powers like military, economic and technical powers that enable it to
continue dominating other countries, this superior control enabled it to be the
(hyper power) on the international political scene so that it allowed it to
exercise and implement the policy of domination against all this appeared
after its empire superiority became clear, in a unique way that have never
been known in
Methods of teaching plays an important vole in the educational process
because is the link between the teacher and the learner. The process of
teaching doesut fulfill the desirable results unless the methods of guiding and
teaching are provided and through a qualified educationalist capable of
communicating the syllabus to the students in an easy and clear way. In spite
of the diversity of the methods of teaching ,there is no one way suitable for all
the educational purposes , all the sciences ,all the subjects ,all the levels of
growth ,levels of teaching, maturity and intelligences ,all teachers and
educationalists and all the circum stances surrounding the teaching processes
.The teacher is the one who choos
The contemporary development applications on scientific areas of acyclic and cyclic Schiff bases and their complexes.