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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The proposed design of neural network in this article is based on new accurate approach for training by unconstrained optimization, especially update quasi-Newton methods are perhaps the most popular general-purpose algorithms. A limited memory BFGS algorithm is presented for solving large-scale symmetric nonlinear equations, where a line search technique without derivative information is used. On each iteration, the updated approximations of Hessian matrix satisfy the quasi-Newton form, which traditionally served as the basis for quasi-Newton methods. On the basis of the quadratic model used in this article, we add a new update of quasi-Newton form. One innovative features of this form's is its ability to estimate the energy functio
... Show MoreOne of the most critical functions of the government is the devising and planning for the Public Budget for the coming years. Studying any budget of any given state would directly reflect on its intentions and collective direction during a certain time span. Since all allocations represent the government's agenda and time plan for coming years. And the size of each allocation would measure the priority of each budgetary item. Because of the eminent importance of the public budget planning in Iraq, a country of abundant riches and human resources that flow in the national economy, we present this research that would cover the resources versus expenditures of Iraq's public budget endured by the government to sustain its various sec
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