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.
Abstract:
The research seeks to explain the role of the international auditing standard (3402) in the auditor's procedures, where the importance of the research stems from the adoption of international auditing standards in the Iraqi environment, including the standard (3402) of assurance engagements that the external auditor performs by submitting reports on the design of control tools and their operational effectiveness in a service facility that provides the beneficiaries with a service. To provide useful information for service organizations The control tools are of great benefit in rationalizing decisions, and many recommen
The energy aimed at examining the mode of energy drinks consumption among athletes in
Baghdad and assessing their drinks were spread greatly among the athletes and students. This
study impression toward such drinks. The study sample comprised of 102 mal athletes aged
between 19-27 years and selected randomly .The obtained results showed that football was
most practiced among the test samples at 40.54% based on twice daily .The athletes
consumed one can each day at 41.18% .As the data on energy drinks was supplied from
friends .The prefared period for drinking was before or during exercise .The athletes thought
that there products can provide energy ,vitamins ,tell ale materials ,does not affect
appetite.The most f
The research focuses on the withdrawal of the United States from the nuclear agreement signed between the permanent members of the United Nations Security Council and the Islamic Republic of Iran concerning its nuclear program. This withdrawal has caused disruption in the official media discourse of the concerned countries. Therefore, the main question can be posed: Are there differences in the positions of countries related to the nuclear agreement, as well as those countries affected by it, before and after the official withdrawal of the United States on May 8, 2018?
The research aims to shed light on the trends in media discourse of the countries that signed the nuclear agreement and those affected by it b
The TV has the ability to combine sound and picture, which makes it of a direct impact on the recipient as it is a rich communicative tool with various artistic forms that display through this small screen programs and films, so that the TV has become superior over many other means of communication.
This research is concerned with the technical and artistic ability in the production of programs owned by the TV as a means of attraction of educated children aged between 5-12 years old, which makes it an educational supplement for the school that helps them in providing knowledge, acquiring skills and being informed about the different sciences through educational programs. It is known that the child at this stage enjoys when wa
The musical sign was associated with the first appearances of acting that are based on human gestures and expressive and silent movements, and they contributed in accentuating and clarifying these gestures and explain their meanings and indications, and they remained with them until these gestures turned into artistic theatrical shows so that the musical sign would have many functions and constitute the main pillars for this kind of show.
The musical sign is a language not much different than the human language in the semiotic analysis. There has been an increased interest in it and its use in the mime shows by the graduates who realized its necessity and significance in the pantomime show intellectually, artistically and aesthetical
This research dealt with the subject of auditing bank credit risks in accordance with international auditing standards and aims to develop procedures and design a credit risk audit program in accordance with international auditing standards and demonstrate their impact on the truth, truthfulness and fairness of financial statements and on their overall performance and continuity in the banking sector Its importance lies in relying on international auditing standards to assess and measure bank credit risk and its impact on the financial situation as well as the ability to predict financial failure. A set of conclusions have been reached, the most important of which is that the bank faces difficulties in measuring credit risk in accordance
... Show MoreThe theater has live foundations that interact with all symbols and signs. It has never been far from these innovations and developments in the manner of dealing with those symbols and how and the extent of their effects on society through the world of technology because the theatrical performance contributes to its structure, a technique that is employed by designers in various technologies such as ( Music, lighting and sound effects engineer, as well as fashion designer, architecture, and modeling designer). The theater today also relied on various interactive techniques represented in the use of body language and a sign in order to communicate the meaning by forming movements, singing and dancing in order for the recipient to interact
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