Background :The incidence of bile ducts injuries( BDI )has risen from) 0.1 to 0.2%( to) 0.4 to 0.6% ( between the era of open cholecystectomy( O C) and the age of laoaroscopic cholycystectomy( LC.) The aim of the study is to review the management and surgical outcome of the bile duct injuries in gastroenterology and hepatology teaching hospital .Methods: This study is Prospective, done in G.I.T hospital ,From January 2008 –to –February 2011, patients included in this study had prevouse history of cholecystectomy which followed by sign and symptoms of bile duct injures .Most patients have been reffered from other hospitals,supprting therapy were given to them and investigations performed to evaluate the the type of injureis ,minor injuries managed conservatively and by using ERCP while major injuries reconstructive surgery done in form of Roux en y bilioenteric anastomosis,All patients followed up for 8 -50 months by doing liver function tests ,abdominal US and MRCP for some patients .Assesment the out come of the patients using Treblanche grading to good,fair and poor Results: The total number of patients are 53 , female were 37 patients (70.5%) 16 patients (29%) were male.The range of age group from 18 -65 years.Average age is 29 years .Patient with minor BDI treated with drainage and ERCP, while 36 patients had major BDI treated by surgical reconstruction by elective manner using a technique Roux en Y (HJ). Follow up done for (8—50 months). (69.4%) have good result, (25%) got fair result and (5.5%) had poor results which mainly occur in E3 and E4 type injuriesConclusions: .If the diagnosis of BDI occurrence is delayed more than 24h , any attempt of primary reconstruction should be avoided and early referral of the patient to a tertiary care centre with experienced hepatobiliary surgeons and skilled interventional radiologists to assure optimal short-term and long-term outcome
The construction process of reception containing rebuild educated new gloss within the context of real-time knowledge with previous experience and learning environment, accounting for all of the real experiences and information beside Education backbones structural climate (olive 0.2002: p. 212 .) Based on two basic principles - : I: - The natural science that we do know from our experiences, we can not say for sure Bhakaigah realism and clearly, but built by creative minds of certain interpretations be applicable in light of our expectations. Other: - The knowledge built effectively active learner who adapts new knowledge with the conceptual framework has, since everyone has a conceptual framework can break at any time and replaced by a ne
... Show MoreThe avoidance of failure in construction projects is not an easy task, which makes the failure of the construction project to achieve its objectives a major problem experienced by all countries in the world, especially Iraq. Where nearly two-thirds of the construction projects in the world have been suffered by significant problems as an increase in the cost of the project, delay in the specified duration for execution, and stopping the project. Therefore it is required to study and apply new methods for managing the construction project to ensure its success and achieve its objectives. The aim of this study is to study the Agile project management method and its impact on the construction project. In addition, to identi
... Show MoreThe aims of research is diagnose and indicate the role of fairness in the work of accounting, which is important in reducing the unacceptable practices to manage earnings by economic units, As well as the interpretation and indicate Ethical inside in the accounting and accountants in particular practices in the area of earnings management to reduce the negative effects of the practice and display the results mentioned acts according to what is supposed to be for the purposes of service users, Researchers have identified that one hypothesis, that "Fairness of accountants in of their work accounting lead to a reduction of earnings management practices". The results suggest that the accounting practices that lead to the manipu
... Show MoreThat achieve a level of excellence for the quality of university education cannot be achieved only by uniting the efforts of all employees at the university and active participation by students and by alumni and the labor market and society, however we can say that the administrative and academic university staff play an active role and the largest in achieving equivalent quality of higher education, It should unite the efforts of all employees in the educational institution in order to achieve quality education. It is the concept of quality of education, quality assurance and overall management of the quality of the basic pillars on which it is based university education. That highlight the need fo
... Show MoreHuman resources constitute the most important recourses that the organization owned today, as it may have developed financial and technology resources to achieve their goals, but they are not able to use it with required efficiency and effective and quality desired unless there is human resources that have good skills, experiences and talents that able to directing and exploited ideally that compatible with market requirements, where today's market and business organizations which compete naturally inherent talent, so the task is to attracting and developing talented resources and preservation these talented resources from the challenges that facing organizations.
The research seek to achieve
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