Background: Acute cholecystitis is common surgical
problem, which was treated previously by conservative
treatment .Later early open has been introduced as an
alternative to interval for treatment of acute cholecystitis.
Early open was found to be a safe, successful with
comparable postoperative complication rate. With the
advent of laparoscopy laparoscopic have been used for
chronic cholecystitis and became the first line of
treatment. New reports have shown that laparoscopic can
be used as an alternative to open for surgical treatment of
acute cholecystitis.
Objectives: to compare the success, safety of early
laparoscopic versus early open as a primary treatment of
acute cholecystitis.
Methods: out of 68 patients were treated for clinical
acute cholecystitis between January 2002 and February
2004 in the department of surgery, at Al – Kindy teaching
hospital. A total of 62 patients underwent early for acute
cholecystitis as soon as possible after diagnosis. The
preferred preoperative imaging technique was ultrasound.
30 (48.3%) of the operations were attempted
laparoscopically, whereas the remaining 32 patients
(51.7%) underwent initial open .
Results: The mean operative time for the open cases
was 75 minutes versus 60 minutes for the laparoscopic
group. There was no perioperative mortality in either
group. The incidence of conversion to open was 10% (3
patients). Surgical complications related to laparoscopic
and open occurred in 2 (6.6%) and 3 (9.3%) cases,
respectively. There was no difference between the open
and laparoscopic groups in regard to the major
postoperative complications.
Conclusion: The current study shows that early
(whether performed by open or laparoscopically) is a
safe and effective treatment for acute cholecystitis. Low
conversion rates can be maintained with strict guidelines
for appropriate patient selection, adequate experience,
and proper laparoscopic technique.
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In many applications such as production, planning, the decision maker is important in optimizing an objective function that has fuzzy ratio two functions which can be handed using fuzzy fractional programming problem technique. A special class of optimization technique named fuzzy fractional programming problem is considered in this work when the coefficients of objective function are fuzzy. New ranking function is proposed and used to convert the data of the fuzzy fractional programming problem from fuzzy number to crisp number so that the shortcoming when treating the original fuzzy problem can be avoided. Here a novel ranking function approach of ordinary fuzzy numbers is adopted for ranking of triangular fuzzy numbers with simpler an
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The flexible joint robot (FJR) typically experiences parametric variations, nonlinearities, underactuation, noise propagation, and external disturbances which seriously degrade the FJR tracking. This article proposes an adaptive integral sliding mode controller (AISMC) based on a singular perturbation method and two state observers for the FJR to achieve high performance. First, the underactuated FJR is modeled into two simple second-order fast and slow subsystems by using Olfati transformation and singular perturbation method, which handles underactuation while reducing noise amplification. Then, the AISMC is proposed to effectively accomplish the desired tracking performance, in which the integral sliding surface is designed to reduce cha
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The Jeribe Formation, the Jambour oil field, is the major carbonate reservoir from the tertiary reservoirs of the Jambour field in northern Iraq, including faults. Engineers have difficulty organizing carbonate reserves since they are commonly tight and heterogeneous. This research presents a geological model of the Jeribe reservoir based on its facies and reservoir characterization data (Permeability, Porosity, Water Saturation, and Net to Gross). This research studied four wells. The geological model was constructed with the Petrel 2020.3 software. The structural maps were developed using a structural contour map of the top of the Jeribe Formation. A pillar grid model with horizons and layering was designed for each zone. Followin
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This paper introduces a Laplace-based modeling approach for the study of transient converter-grid interactions. The proposed approach is based on the development of two-port admittance models of converters and other components, combined with the use of numerical Laplace transforms. The application of a frequency domain method is aimed at the accurate and straightforward computation of transient system responses while preserving the wideband frequency characteristics of power components, such as those due to the use of high frequency semiconductive switches, electromagnetic interaction between inductive and capacitive components, as well as wave propagation and frequency dependence in transmission systems.
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