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.
Sustainability is a concept embodied in traditional architecture around the world since ancient times through spontaneous experimental compatibility with the environment and efficient exploitation of the natural resources of the environment according to a rapid development of trial and error over the years . Architecture was the basic means that man devised to protect him from the harsh conditions of the external environment by exploiting natural energy sources such as the sun, wind, and soil capabilitie, Many of the principles of sustainability overlapped with the social organization and human behavior of the community as it was reflected in the urban production at the level of standards of city planning and urban agglomerations as well
... Show MoreThe Role of Japan in the Reconstruction of Iraq
The research addresses smart city concept as it is the latest urban design trends, by the investment of the capabilities of human, and artificial intelligence for the sake of the advancement of the city. The concept of a smart city is described as one of the most important manifestations of the information revolution, with the end of the twentieth, and the beginning of twenty – first century, The research attributes the emergence of the concept to: deficiencies of means, and traditional methods in building and development of cities, as well as The significant increase in the number of city and global metropolises dwellers. So, smart city approach has been adopted, along with innovative principles and methods which cons
... Show MoreAgricultural development occupies an important position in the economies of developing countries, and its role is greater for the Arab countries. The first task is to provide food security for all the population through sustainable development, which includes the investment of available natural resources and employment opportunities for the rural population, As well as the provision of raw materials for agricultural processing in order to increase agricultural exports to reduce the balance of payments deficit. Sustainable development is linked to increased production and improvement, as well as to food security. On the one hand, it has to cope with the increase in population and if it is possible to achieve a surplus allocated for export, a
... Show MoreResults: it was found that labelled cells participated in the formation of myotubes, which formed mature muscle fibers, and possibly new satellite cells. The results of this experiment may eventually revolutionized therapeutic procedures for some form of muscle diseases
The development in the presentation and presentation of the service in order to distinguish them from the same, was one of the most important reasons to choose the current issue to upgrade the level of service, especially in the Iraqi restaurant sector, which has become today of the important sectors successful. The problem of research was to try to answer a range of questions: to what extent are Iraqi restaurants interested in physical service factors? Do Iraqi restaurants apply physical factors in a way that leads to customer satisfaction? Are Iraqi restaurants interested in the satisfaction of their customers? The objective of the current research is to try to determine the extent to which the
... Show MoreA Forensic Accounting is represent science that deals with the application of knowledge in the areas of accounting, finance, tax and audit for the analysis, investigation, inquiry, inspection and testing issues in the civil law and criminal law in an attempt to reach the truth through which enable the Forensic Accountant to provide his Expert opinion , forensic accounting plays a major role by providing a range of important services in the field of investigation for fraud and litigation support, As one of the most important legal and accounting functions is to investigate allegations of alleged by the related parties, especially those allegations related to the existence of fraud, since the goal of judicial accountant will depend
... Show MoreAjloun reserve is the most important reserved areas set up by the Jordanian government to encourage development and ecotourism, is located on the green mountains of Ajloun north of Jordan, was founded in 1989 and follow The Royal Society for the conservation of the natur, an area of 13 km2, and covered with thick forests of oak trees and Butm, maple and others, characterized by the diversity of vital consists of 319 species of medicinal and aromatic plants and wild flowers, and where there are 40 species of birds, 14 species of mammals, 16 reptiles, 5 species of plants registered in the world. The Reserve has a great importance in Jordan ,it is the most reservations attractive to tourists, both internally and externally, and prov
... Show MoreThis study seeks to highlights on the behavioral approach in organization theory as modern and effective entrance in constructing this theory and reflection extent on the behavior of both the product and the information user (accountant and financial information).
The study also focus on behavioral approach role in consolidating accounting concepts through making harmony between them so that the accountant can influence the user behavior with the concepts and principles of accounting in an effort to provide quality characteristic of accounting information produced by him in consistent with his behavior and information user and its impact on the decision making process by the latter.
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